How is small bowel cancer diagnosed?

Blood tests – including a full blood count to measure your white blood cells, red blood cells, platelets, and liver function tests to measure chemicals that are found or made in your liver. You may also have a chromogranin A (CgA) blood test to help diagnose a carcinoid or other neuroendocrine tumour.

Urine test – to examine if there is any cancer ‘waste’ products excreted into the urine.

Immunochemical faecal occult blood test (iFOBT) – to examine a stool sample for traces of blood.

Endoscopy – a procedure where a flexible tube with a camera on the end (endoscope) is inserted under sedation down the throat into the stomach to view your gut.

Capsule endoscopy – a procedure where you swallow a small capsule that contains a tiny camera that takes pictures of your digestive tract that are then transmitted to a recorder you wear around your waist. The camera is passed out in your stools about 24 hours later.

CT (computerised tomography) or MRI (magnetic resonance imaging) scans – special machines are used to scan and create pictures of the inside of your body. Before the scan you may have an injection of dye (called contrast) into one of your veins, which makes the pictures clearer. During the scan, you will need to lie still on an examination table. For a CT scan the table moves in and out of the scanner which is large and round like a doughnut; the scan itself takes about 10 minutes. For an MRI scan the table slides into a large metal tube that is open at both ends; the scan takes a little longer, about 30–90 minutes to perform. Both scans are painless.

PET (positron emission tomography) scan – before the scan you will be injected with a small amount of radioactive glucose (sugar) solution. Many cancer cells will show up brighter on the scan. You will be asked to sit quietly for 30–90 minutes to allow the glucose to move around your body, and the scan itself will take around 30 minutes to perform. Sometimes a Dotatate-PET scan will be needed to find and diagnose neuroendocrine tumours. In this test you will be injected with a small amount of a radioactive drug call Dotatate rather than a radioactive glucose.

Biopsy – removal of some tissue from the affected area for examination under a microscope. In the small bowel, a biopsy can be done during an endoscopy or if it can’t be reached a surgical biopsy is done under general anaesthesia. The surgeon will cut through the skin and use a tiny instrument with a light and camera (laparoscope) to view the affected area and use another instrument to take a tissue sample.

Barium x-ray – also called upper GI series with small bowel follow-through, you will be given a chalky barium liquid to drink which coats the inside of the bowel and can show any signs of cancer when an x-ray is taken. X-rays may be taken over a few hours as the barium travels to the end of the small bowel.