When cancer spreads to the belly lining, it can block the small intestine and make eating impossible. Doctors tested a new procedure using a special camera to create a bypass around the blockage. In this study, 17 cancer patients with this serious problem received the new treatment. Most patients (94%) had successful procedures, could eat again, and felt much better. They also lived longer and could continue cancer treatment. Compared to patients who received an older procedure, those with the new treatment survived about 6 times longer on average. This suggests the new procedure might be a better option for very sick cancer patients who can’t eat.

The Quick Take

  • What they studied: Can a new ultrasound-guided procedure help cancer patients whose intestines are blocked by cancer spread, allowing them to eat again and feel better?
  • Who participated: 17 cancer patients with various types of cancer that had spread to their belly lining, causing intestinal blockage. They were compared to 29 similar patients who had received an older procedure.
  • Key finding: 94% of patients had successful procedures. Patients could eat again, their symptoms improved significantly, and they lived about 6 times longer (86 days vs. 14 days) compared to those who received the older treatment.
  • What it means for you: If you or a loved one has advanced cancer with intestinal blockage, this new procedure may offer better symptom relief and longer survival than traditional options. However, this is still a specialized treatment for very sick patients, and you should discuss it with your cancer care team.

The Research Details

Doctors treated 17 cancer patients with a new procedure called endosonographic coloenterostomy (CE). This procedure uses an ultrasound camera inserted through the mouth to create a new pathway around the blocked intestine, allowing food to bypass the blockage. The doctors carefully tracked how well the procedure worked, whether patients could eat, their pain levels, quality of life, and how long they survived. They compared these results to 29 similar patients who had received an older procedure called percutaneous endoscopic gastrostomy (PEG) that feeds patients directly into the stomach through the skin.

The researchers matched the two groups carefully so they were as similar as possible before treatment, making the comparison more fair. They measured success by looking at whether the procedure worked technically, whether patients’ symptoms improved (like vomiting and pain), whether they could eat normally, and how long they lived. They also checked if patients could continue their cancer treatment and manage their pain medication.

When cancer spreads throughout the belly, it often causes the small intestine to stop working, which is a serious problem that’s hard to treat. This study matters because it tests whether a newer, less invasive procedure might work better than older options. The results suggest doctors may have a better tool to help these very sick patients feel better and live longer.

This study has some strengths: it compared the new procedure to a similar group of patients treated with an older method, making the comparison more meaningful. The doctors carefully tracked patients over time and measured multiple important outcomes like symptoms, quality of life, and survival. However, the study is relatively small (only 17 patients with the new procedure), and it wasn’t a randomized trial where patients were randomly assigned to treatments. The follow-up time was also fairly short (average 83 days). These factors mean the results are promising but should be confirmed with larger studies.

What the Results Show

The new procedure worked successfully in 16 out of 17 patients (94%). This means the doctors were able to create the bypass around the blockage in almost all cases. Patients experienced significant improvement in their main symptoms: vomiting decreased, abdominal pain improved, and bowel function became more normal.

Most importantly, 14 out of 17 patients (82%) were able to eat food by mouth again after the procedure, which is a major improvement in quality of life. Patients’ overall quality of life scores improved significantly on standardized questionnaires that measure how well people feel and function.

When compared to the older procedure, patients who received the new treatment lived much longer. Those with the new procedure survived an average of 86 days compared to only 14 days for those with the older procedure—more than 6 times longer. Additionally, 9 out of 17 patients (53%) were able to continue or restart their cancer chemotherapy treatment after the procedure, which is important because it means they could continue fighting their cancer.

Another important finding was pain control. Six out of seven patients (85%) who needed strong pain medication were able to receive and tolerate their opioid pain medications again after the procedure. This suggests the procedure not only helps with eating but also helps the body work better overall. The procedure was also safe, with no major complications reported that would prevent patients from continuing their cancer treatment.

The older procedure (PEG) involves placing a feeding tube directly into the stomach through the skin. While this can help patients get nutrition, it doesn’t address the underlying intestinal blockage. The new procedure appears to work better because it actually bypasses the blocked area, allowing the intestine to function more normally. This may explain why patients with the new procedure could eat regular food and lived longer. The dramatic difference in survival (86 days vs. 14 days) suggests this new approach offers a real advantage for this difficult patient population.

The study is relatively small with only 17 patients receiving the new procedure, so results need to be confirmed in larger studies. The follow-up time was short (average 83 days, with some patients followed for only 2 days), so we don’t know long-term outcomes. This wasn’t a randomized controlled trial, meaning patients weren’t randomly assigned to treatments, which could introduce bias. The study included patients with different types of cancer, so results might vary depending on cancer type. Finally, this is a specialized procedure only available at certain medical centers, so it may not be accessible to all patients.

The Bottom Line

For cancer patients with advanced disease and intestinal blockage caused by cancer spread, this new procedure appears to be a promising option that may improve symptoms and survival compared to older treatments. Confidence level: Moderate (based on a small study, but with consistent positive results). Patients should discuss this option with their oncology and gastroenterology teams to determine if they’re candidates. This procedure is not appropriate for all patients and requires specialized expertise.

This research is most relevant for: (1) Cancer patients with advanced disease experiencing intestinal blockage from cancer spread, (2) Their family members and caregivers, (3) Oncologists and gastroenterologists treating these patients, (4) Palliative care specialists. This is NOT a treatment for early-stage cancer or for people without intestinal blockage. It’s specifically for very sick patients with advanced cancer who have limited other options.

Symptom improvement (like reduced vomiting and pain) can occur within days to weeks after the procedure. The ability to eat normally may take 1-2 weeks as the body adjusts. Survival benefits appear to develop over weeks to months. However, individual results vary greatly depending on overall health and cancer type.

Want to Apply This Research?

  • If you’ve had this procedure, track daily: (1) Ability to eat (none/liquids only/soft foods/regular foods), (2) Vomiting episodes (0-5+ times per day), (3) Abdominal pain level (0-10 scale), (4) Bowel movements (frequency and consistency). Log these daily to show your doctor how you’re progressing.
  • After the procedure, gradually introduce different foods as tolerated, starting with liquids and soft foods, then progressing to regular foods. Keep a food diary to identify which foods you tolerate best. Stay hydrated and eat small, frequent meals rather than large ones. Report any return of symptoms to your medical team immediately.
  • Weekly check-ins with your care team during the first month, then monthly thereafter. Track the four measurements above consistently. Monitor your ability to continue cancer treatment and pain medication effectiveness. Watch for warning signs like return of vomiting, severe pain, or inability to eat, and report these immediately to your doctor.

This research describes a specialized medical procedure for very sick cancer patients with intestinal blockage. This is NOT a cure for cancer and is only appropriate for patients with advanced disease who have exhausted other options. The procedure requires specialized expertise and should only be performed by trained gastroenterologists. If you or a loved one has advanced cancer with intestinal problems, discuss all treatment options—including this procedure—with your oncology team. Do not attempt to self-diagnose or self-treat based on this information. Individual results vary greatly, and this procedure is not suitable for everyone. Always consult with qualified medical professionals before making treatment decisions.