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Below, week by week, is what OnCo's record of Localised small bowel adenocarcinoma (stage I to III, resected) says about the first two months: the order is typical, the timing is yours to ask about. Localised small bowel adenocarcinoma is cancer of the duodenum, jejunum or ileum that has not spread beyond nearby lymph nodes and can be removed by surgery, the only cure. Duodenal tumours need a Whipple operation and tumours further along a segmental resection; chemotherapy afterwards is offered for node-positive disease by analogy with colon cancer while the BALLAD trial tests whether it helps. Sections appear only where the record has something to say. Orientation, not medical advice.
Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.
Endoscopy or enteroscopy with biopsy, CT of chest, abdomen and pelvis, mismatch repair testing and germline assessment.
Ask which of these were tested and what the results were; see the report reader for what each value means.
These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.
A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.
Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.
Observation for stage I and low-risk stage II; adjuvant CAPOX or FOLFOX for stage III and high-risk stage II, extrapolated from colon cancer pending BALLAD.
Pancreaticoduodenectomy for proximal duodenal tumours; segmental resection for distal duodenal tumours; endoscopic resection only for adenomas.
Segmental resection with wide mesenteric lymphadenectomy; right hemicolectomy for terminal ileal tumours.
CT and CEA every six to twelve months; endoscopic surveillance of the remaining duodenum in FAP.
Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.
Trials open now for this cancer in OnCo, largest phase first. Joining a trial is a decision like any other: ask what the comparison arm is, whether a placebo is used, and what happens if you leave. The cancer page searches ClinicalTrials.gov live for more.
Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.
Every term links to the glossary.