Duodenal cancer is a rare cancer that develops in the duodenum, the first part of the small intestine connecting the stomach to the jejunum. Although the small intestine makes up most of the digestive tract, cancers of the small intestine are uncommon, with duodenal cancer accounting for more than half of all small bowel cancers22. The most common type is adenocarcinoma, which arises from the glandular lining of the duodenum. Because early symptoms are often vague or absent, many patients are diagnosed at an advanced stage.
Treatment depends on the stage and location of the tumour. Surgery remains the primary treatment for localized disease and offers the best chance of cure. For patients with advanced or unresectable disease, minimally invasive treatments, chemotherapy, targeted therapy, and supportive care may help control tumour growth, prolong survival, relieve symptoms, and improve quality of life.
Duodenal cancer is classified according to the type of cells from which it originates.
The most common type, accounting for approximately 50–60% of duodenal cancers. It develops from the glandular cells lining the duodenum.
Arises from hormone-producing neuroendocrine cells. These tumours are generally slower growing but may produce hormones that cause specific symptoms.
Develops from the interstitial cells of Cajal within the intestinal wall. GISTs have distinct molecular characteristics and are treated differently from adenocarcinoma.
Originates from lymphoid tissue within the intestinal wall and is managed primarily with chemotherapy rather than surgery.
A rare tumour arising from connective tissues such as muscle or blood vessels.
Duodenal cancer staging is based on the TNM system (Tumor size, lymph Node involvement, and Metastasis).
Stage I:Cancer is confined to the inner layers of the duodenum.
Stage II:Cancer has grown deeper into the intestinal wall or nearby tissues but has not spread to lymph nodes.
Stage III:Cancer has spread to nearby lymph nodes.
Stage IV:Cancer has spread to distant organs such as the liver, lungs, or peritoneum.
Factors associated with an increased risk of duodenal cancer include:
Increasing age (more common after age 60)
Familial adenomatous polyposis (FAP)
Lynch syndrome (Hereditary Nonpolyposis Colorectal Cancer)
Peutz-Jeghers syndrome
Crohn's disease
Celiac disease
Smoking
High-fat diet and obesity
Family history of gastrointestinal cancers
Duodenal adenomas or polyps
Symptoms are often mild or absent.
Common symptoms include:
Persistent upper abdominal pain or discomfort
Indigestion
Nausea and vomiting
Loss of appetite
Unexplained weight loss
Fatigue
Iron deficiency anaemia
Occult gastrointestinal bleeding
Intestinal obstruction
Jaundice (if the tumour blocks the bile duct)
Vomiting after meals
Palpable abdominal mass
Severe gastrointestinal bleeding
Liver-related symptoms if metastasis occurs
Diagnosis requires imaging, endoscopic evaluation, and histological confirmation.
Upper gastrointestinal endoscopy (OGD) with biopsy
Endoscopic ultrasound (EUS)
Contrast-enhanced CT scan
MRI
PET-CT (selected cases)
CT angiography when vascular involvement is suspected
Endoscopic biopsy
Surgical biopsy when necessary
In advanced disease, selected patients may undergo testing for:
Microsatellite instability (MSI) / mismatch repair (MMR) status
HER2 amplification
KRAS, NRAS, and BRAF mutations (selected cases)
Next-generation sequencing (NGS) for actionable mutations
Yes. Early-stage duodenal cancer can often be cured with complete surgical removal. The prognosis is generally better when diagnosed before lymph node or distant spread.
No. Duodenal cancer is rare and accounts for only a small proportion of all gastrointestinal cancers.
Surgery is the standard treatment for localized disease. Chemotherapy, targeted therapy, or immunotherapy may be recommended depending on the cancer stage and molecular characteristics.
Yes. Tumours located near the ampulla of Vater may block the bile duct, leading to jaundice, dark urine, and pale stools.
Individuals with inherited syndromes such as Familial Adenomatous Polyposis (FAP), Lynch syndrome, Peutz-Jeghers syndrome, and those with chronic inflammatory bowel conditions have an increased risk.
Diagnosis is made through upper gastrointestinal endoscopy with biopsy, supported by CT or MRI imaging for staging.
Yes. Advanced duodenal cancer commonly spreads to nearby lymph nodes, the liver, peritoneum, and less commonly the lungs.
Persistent abdominal pain, unexplained weight loss, anaemia, gastrointestinal bleeding, vomiting, jaundice, or symptoms of bowel obstruction should be evaluated promptly by a healthcare professional.
Prostate cancer
Endometrial Cancer
Tongue Cancer
*Disclaimer: The effect of treatment varies from person to person. The information on the website of Modern Cancer Hospital Guangzhou is for reference only, and cannot be used as the basis for medical diagnosis and treatment, nor can it replace the doctor's diagnosis and treatment. For more details, please review the Liability Clause.
