Duodenal Cancers

Duodenal cancers are rare cancers that arise in the first part of the small bowel. Symptoms can be subtle at first (indigestion, anaemia), then progress to abdominal pain, weight loss, vomiting or jaundice (near the bile duct). Early investigation with endoscopy and biopsy is key.

At The New Foscote Hospital, we offer consultant-led assessment, onsite gastroscopy (OGD) with biopsy, and rapid access to cross-sectional imaging. Where specialist surgery or oncology is required, we coordinate referral to the appropriate regional multidisciplinary team (MDT) and provide ongoing follow-up and supportive care.

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Symptoms

• Persistent indigestion or upper-abdominal discomfort
• Iron-deficiency anaemia, fatigue, or breathlessness
• Unintentional weight loss, reduced appetite, early fullness
• Nausea or vomiting, particularly after meals
• Black, tarry stools (melaena) or visible bleeding
• Jaundice (yellowing of eyes/skin) and dark urine if the tumour is near the bile duct (peri-ampullary region)

Urgent help (999/A&E): collapse, heavy bleeding, severe abdominal pain, or signs of shock.

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Risk Factors

• Duodenal adenomas/polyps (including ampullary adenomas)
• Inherited syndromes: FAP, Lynch syndrome, Peutz–Jeghers
• Chronic inflammation or previous upper-GI surgery
• Coeliac disease (small-bowel cancer risk increased), smoking, obesity (general GI risk factors)

Having a risk factor does not mean you will develop cancer, but it strengthens the case for early assessment of symptoms.

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Diagnosis At New Foscote Hospital

Your consultant will tailor investigations based on your symptoms and risk profile:

• Onsite Gastroscopy (OGD) with biopsy to confirm the diagnosis and assess location/extent.
• Cross-sectional imaging (CT/MRI) for staging and treatment planning (arranged promptly where indicated).
• Endoscopic ultrasound (EUS) or MRCP may be recommended for peri-ampullary disease (arranged via our network).
• Blood tests: full blood count (anaemia), liver profile (jaundice), iron studies.
• H. pylori testing or coeliac screen where appropriate.

Endoscopy – Gastroscopy
Imaging & Diagnostics

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Treatment Overview

Management depends on tumour type, location and stage. After diagnosis and staging, patients are discussed by a specialist Upper-GI/HPB MDT:

• Surgery (specialist centres): options include segmental duodenal resection or pancreaticoduodenectomy (Whipple) for peri-ampullary tumours, when appropriate.
• Endoscopic therapy for some adenomas (e.g., EMR/ESD) and stenting to relieve obstruction in selected cases.
• Oncology: chemotherapy ± radiotherapy according to MDT recommendations.
• Supportive care at New Foscote: optimisation of anaemia, nutrition, symptom control, and coordinated follow-up.

We will explain your results clearly and guide you through the next steps, including referrals and timelines.

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Recovery, Follow-Up And Support

• Individualised aftercare plan with your consultant, including wound/medication advice if you’ve had procedures, and nutrition support where needed.
• Surveillance endoscopy may be advised after removal of adenomas or as part of your MDT plan.
• Ongoing monitoring of bloods (e.g., haemoglobin, iron levels, liver tests) and imaging where indicated.

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When To Seek Specialist Assessment

Book an appointment if you have:

• Ongoing indigestion, early fullness or upper-abdominal pain
• Unexplained iron-deficiency anaemia or black stools
• Persistent vomiting, weight loss, or new jaundice
• A history of duodenal/ampullary polyps or a hereditary syndrome

Early investigation improves clarity and speeds access to the right treatment.