Small Intestine Cancer

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Treating Small Intestine Cancer TOPICS

Chemotherapy for small intestine adenocarcinoma

Chemotherapy (chemo) uses anti-cancer drugs that are injected into a vein or a muscle or taken by mouth to kill cancer cells. Because these drugs enter the bloodstream and can reach cancer cells anywhere in the body, this treatment can be useful for cancers that have metastasized (spread). But small intestine adenocarcinoma does not seem to be very sensitive to chemotherapy. This is why chemo is not often part of the main treatment for this cancer. Instead, it may be used when the cancer has spread to other organs.

When chemo is given after the tumor is removed with surgery, it is called adjuvant treatment. In this setting, the chemo is meant to get rid of the cancer cells that are left after surgery (but that are too small to see). This lowers the chance that the cancer will come back later. Adjuvant chemo is often used for colon cancer, but it is not known if it works as well for small intestine cancer.

Some of the chemo drugs that can be used include: capecitabine (Xeloda®), 5-fluorouracil (5-FU), oxaliplatin, and irinotecan (Camptosar®, CPT-11). 5-FU is often given with a vitamin-like drug called leucovorin, which helps it work better.

Because small intestine cancer is rare, only a small number of patients have been treated with chemo. This makes it hard to know which drugs work best. Some of the drug combinations that seem to work in advanced small intestine cancer include capecitabine and oxaliplatin (called CAPOX), 5-FU and leucovorin with oxaliplatin (FOLFOX), and 5-FU and leucovorin with irinotecan (FOLFIRI). Oncologists often use combinations that are used to treat colon or stomach cancer.

Chemo drugs kill cancer cells but also damage some normal cells, causing some side effects. Your health care team will pay careful attention to try and avoid or lessen side effects. These depend on the type of drugs, amount taken, and length of treatment. Common temporary side effects might include

  • Nausea and vomiting
  • Loss of appetite
  • Loss of hair
  • Mouth sores.
  • Low blood counts

Chemotherapy can damage the blood-producing cells of the bone marrow, so you may have low blood cell counts. This can lead to:

  • An increased risk of infection (caused by a shortage of white blood cells)
  • Bleeding or bruising after minor cuts or injuries (caused by a shortage of blood platelets)
  • Fatigue (tiredness) or shortness of breath (caused by low red blood cell counts)

Other side effects that may occur depend upon the specific drugs used. For example, 5-FU and irinotecan often cause diarrhea. Capecitabine can cause painful reddening of the hands and feet (known as hand-foot syndrome). Oxaliplatin can damage nerves (called neuropathy) leading to numbness, tingling, or even pain in the hands and feet. This can last a long time or even be permanent. Oxaliplatin can also affect nerves in the throat, causing pain that is much worse when trying to eat or drink cold liquids or foods. This pain can lead to trouble swallowing or even breathing, and can last a few days after treatment.

Information about specific chemo drugs and their side effects can be found in our guide to cancer drugs. Some side effects disappear a few days after treatment. In addition, there are medicines that can help prevent or minimize treatment side effects. For example, your doctor can prescribe drugs to help prevent or reduce nausea and vomiting.

For more information about chemo and its side effects, see our document Understanding Chemotherapy: A Guide for Patients and Families.

Last Medical Review: 02/04/2013
Last Revised: 02/14/2014