Medical Oncologist
CION Cancer Clinics
Small bowel cancer and how it differs from colon cancer | CION Cancer Clinics
Small bowel cancer is not colon cancer. It starts in the small intestine, the long tube between the stomach and the colon, and it is far rarer. It comes in four main types, most of it sits beyond the reach of a colonoscopy, and each type is treated in its own way. This page explains the differences, how these tumours are usually found, and what decides the plan. At CION Cancer Clinics in Hyderabad, our oncologists explain colon cancer in plain words and plan care around you and your family.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- Is small intestine cancer the same as colon cancer?
- How does small bowel cancer differ from colon cancer?
- Which kind of small bowel tumour is on the report?
- How is a small bowel tumour found?
- Four things families assume, and what is actually true
- What this page cannot tell you
- Common questions about small bowel cancer
The short answer
Is small intestine cancer the same as colon cancer?
No. The small intestine, or small bowel, is the long, narrow tube between the stomach and the colon. The colon is the large bowel that comes after it. Cancer of the small bowel is far rarer than colon cancer, even though the small bowel makes up most of the length of the gut, and it is found, named and treated differently.
Why the two get mixed up
In everyday speech, and in many Telugu households, both are simply "the intestine". The phrase bowel cancer adds to it, because in most health writing it means colon and rectal cancer only. If your report names the colon, caecum or sigmoid, this page is not about you. Our page on colon, colorectal and bowel cancer sorts out the names.
Why the difference matters to you
The small bowel has three parts: the duodenum just after the stomach, then the jejunum and the ileum. Most of it cannot be reached by a colonoscopy, there is no routine screening test for it, and its tumours come in several unrelated types. Knowing which part and which type is the first thing any plan needs.
Vomiting with a swollen, painful abdomen and no wind passing is a possible blockage. Go to an emergency department today.Side by side
How does small bowel cancer differ from colon cancer?
Small bowel cancer
Colon cancer
Rare, and seen by most specialists only occasionally
One of the commoner cancers in adults
Several unrelated types, each with its own treatment
Almost always one type, adenocarcinoma
Mostly out of reach of a colonoscopy
Seen and sampled at colonoscopy
No routine screening test
Screening with stool tests and colonoscopy
Evidence for treatment is thinner
Large trials guide most decisions
Not sure whether this applies to you?
Ask an oncologistThe four main types
Which kind of small bowel tumour is on the report?
Four names cover almost every small bowel cancer. They share an organ and very little else.
Adenocarcinoma
The type most like colon cancer, growing from the gland cells of the lining. It is found most often in the duodenum. It is removed by surgery where possible, and chemotherapy decisions often borrow from colon cancer practice.
Neuroendocrine tumour (NET)
Grows from hormone-producing cells, most often in the ileum, and is usually slow. Once it has spread to the liver it can cause flushing and diarrhoea, called carcinoid syndrome. Our neuroendocrine tumours page explains the type.
Lymphoma
A cancer of immune cells that happens to start in the bowel wall. It is treated mainly with medicines rather than an operation, and surgery is kept for a blockage, a bleed or getting a diagnosis.
A lymphoma is planned as a lymphoma, not as a bowel cancer.GIST
A gastrointestinal stromal tumour grows from the muscle layer of the wall. Surgery removes it where possible. Some need targeted therapy tablets, which CION prescribes and monitors.
The usual sequence
How is a small bowel tumour found?
Vague symptoms, often for a long time
Cramping pain after meals, tiredness from slow bleeding, weight loss or bouts of vomiting. Far more common things cause every one of these, which is partly why small bowel tumours are often found late.
Blood tests and a CT scan
A blood count may show anaemia, a low haemoglobin, from bleeding too slow to see. A CT of the abdomen, sometimes after a drink that fills the bowel, is arranged through a diagnostic partner.
Looking inside the middle stretch
An upper endoscopy reaches the duodenum. Further down needs a swallowed camera capsule or a longer scope called an enteroscope. The capsule is avoided when a blockage is suspected, because it can get stuck.
A biopsy names the type
A sample is taken through the scope or at surgery, and the pathologist reports which of the four types it is. Without that name no treatment plan can be made.
The tumour board decides
The scans and report go to the tumour board. Surgery is planned by CION's surgical oncologists and carried out at an accredited partner hospital. Medicines are given at CION centres.
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Commonly believed
Four things families assume, and what is actually true
"The colonoscopy was normal, so the intestine is clear."
A colonoscopy looks at the colon and only the last short stretch of the small bowel. If iron-deficiency anaemia continues after a normal colonoscopy and upper endoscopy, the small bowel is the next place doctors look. Our page on anaemia as a first sign explains why.
"Intestine cancer is intestine cancer. The treatment will be the same."
The type decides almost everything. An adenocarcinoma, a NET, a lymphoma and a GIST are treated in four quite different ways, and none of them exactly as colon cancer is.
"An operation on the small bowel means living with a bag."
Usually the affected section is removed and the two ends are joined back together. A stoma is more likely after emergency surgery for a blockage, and is often temporary when it is needed.
"He must have eaten something wrong for years."
Most people with small bowel cancer have no cause anyone can point to. Crohn's disease, coeliac disease and a few inherited conditions raise the risk, but food is not something to blame a person for.
Being straight with you
What this page cannot tell you
It cannot tell you which type you have or what it means for you. That comes from the biopsy, the scans and a specialist who has read both. Because these tumours are rare, many doctors see few of them, and a tumour board review of the slides and scans is worth asking for before treatment starts.
It cannot give you an outlook
The four types behave so differently that no single statement about the future applies. The evidence is also thinner than for colon cancer, and much of it comes from small numbers of patients. Your oncologist will talk about your situation directly, not from an average.
Who this does not apply to
If your report names the colon, read our colon cancer pages instead. If the tumour sits at the ampulla, where the bile duct opens into the duodenum, it is classed separately and planned with a pancreatic team. An appendix tumour has its own appendix cancer page.
If a report has arrived and no one has explained it, call the helpline. A CION oncologist can read it with you.Questions we are asked
Common questions about small bowel cancer
Is small bowel cancer worse than colon cancer?
It cannot be compared as one disease. A slow NET and an adenocarcinoma in the duodenum are very different things. Small bowel cancers are often found later because symptoms are vague and the bowel is hard to see into, which is why early investigation of unexplained anaemia matters.
Can a colonoscopy find small bowel cancer?
Only at the very end of the ileum, where it joins the colon. The duodenum is seen with an upper endoscopy. The long middle part needs a CT scan, a capsule camera or an enteroscope, which CION arranges through its diagnostic partners.
Who is more likely to get it?
People with long-standing Crohn's disease or coeliac disease, and families with inherited conditions such as Lynch syndrome, carry a higher risk. Even so, most people with small bowel cancer have none of these, and most people with them never get it.
Is surgery always needed?
Not always. Adenocarcinoma, NETs and GISTs are usually removed where it is possible. Lymphoma is mainly treated with medicines. When surgery is advised, CION's surgical oncologists plan it and it is carried out at an accredited partner hospital.
Will I need chemotherapy?
It depends on the type and how far it has spread. Adenocarcinoma may be followed by chemotherapy. GIST is treated with targeted tablets rather than standard chemotherapy. Slow NETs often need neither. The tumour board advises, and CION gives the medicines at its centres.
Can I eat normally after small bowel surgery?
Most people return to ordinary meals once they have healed, starting soft and building up. Losing a long stretch, or the end of the ileum, can affect how some nutrients are absorbed. A dietitian can adapt rice, dal, curd and millets to what suits you.
Does it run in families?
Usually not. A small share happens in families with an inherited syndrome, often alongside colon or other cancers in relatives. If several relatives have had bowel or womb cancer, or one was diagnosed young, tell your oncologist and ask about genetic counselling.
What follow-up will I need after treatment?
Usually clinic visits with blood tests and periodic CT scans, at intervals set by the type and stage. NETs may also be followed with specific blood markers. CION plans and runs the follow-up, with scans arranged through diagnostic partners closer to home where possible.
Your Specialists
Meet CION's colon cancer specialists. Bring your colonoscopy, scan or biopsy report.
Our surgical and medical oncologists plan colon cancer care together: which operation, whether chemotherapy is needed, and the follow-up that comes after.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- National Cancer Institute — Small Intestine Cancer Treatment
- National Cancer Institute — Gastrointestinal Neuroendocrine Tumors Treatment
- American Cancer Society — What Is Colorectal Cancer?
- NIDDK (NIH) — Colonoscopy
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Colon cancer vs colorectal cancer vs bowel cancerSort out which name actually applies to your reportNeuroendocrine tumours of the colonThe slow-growing type that also turns up in the small bowelAppendix cancer and how it differsThe other rare tumour that sits where the small bowel meets the colonWhat is colon cancer?The common disease this page keeps comparing against
Talk to us
Not sure whether the report is about the small bowel or the colon?
Send us the report and a CION oncologist will explain which part of the bowel it describes and what usually happens next. One helpline serves every CION centre.