Appendix Cancer

Appendix cancer sounds scary, but it's actually very rare, happening to only about one thousand people each year in the United States. However, it can be very frightening, whether the tumors that grow are benign or malignant. A significant problem with cancer of the appendix is called pseudomyxoma peritonei, which happens when a tumor emerges from the appendix and allows thick mucin to flow through the abdomen. This can lead to problems with the functioning of other organs.

What Is Appendix Cancer?

Appendiceal cancer is extremely rare. It is the formation of tumors on or inside the appendix. Fortunately, most tumors are benign and grow very slowly, causing no symptoms. These tumors need only monitoring on a regular basis. Cancerous tumors, however, are also common. There are four main types, but the most common is the carcinoid tumor, which makes up about 65% of all cases.

Symptoms of Appendix Cancer

In most cases, appendix cancer isn’t detected until someone develops appendicitis. During the removal of the appendix, cancer is found. However, there are other symptoms that might show up if the cancer has spread and is causing problems in other parts of the body. If you are suffering from bloating of the abdomen, vague abdominal discomfort, pelvis discomfort, bowel obstruction, hernias that suddenly appear, masses on the ovaries, or chronic abdominal pain that doesn’t go away, it’s time to get checked out.

Sometimes appendix cancer also affects the liver. This can quickly lead to carcinoid syndrome, which is characterized by shortness of breath, possibly wheezing, flushing of the skin (as though you are having a hot flash), diarrhea, a feeling of pain or fullness in your abdomen, and heart valve disease on the right side of the heart. These are all very serious signs that indicate appendix cancer might have progressed to a more dangerous stage.

Diagnosis of Appendix Cancer

Any cancer diagnosis is very frightening. It is important to remember that most appendix tumors are benign and will not cause long-term problems. However, any sign of a tumor calls for a proper diagnosis.

• Your doctor will begin with blood work and a biopsy, where tissue is examined underneath a microscope.
• A CT scan or MRI might be conducted to look at the larger area around the appendix and try to spot any unusual areas.
• An ultrasound can use sound waves to visualize the area, giving further detail.
• Finally, a radionucleotide scan is conducted. During this scan, a radioactive material is injected into your body, and then traced with a special camera. This allows the doctor to see things that might not be visible with other imaging techniques.

Upon a firm diagnosis, the doctor will then determine how extensive the cancer is, and check to make sure it has not migrated to other organs in the body.

Treatments for Appendix Cancer

The treatment for appendix cancer depends on a wide variety of factors, including how serious the cancer is, how much it has progressed, the overall health of the person, and any adverse treatment effects. Here are the most common options for appendix cancer treatment:

Surgery

Surgery is almost always required for appendix cancer, and is in fact the most common treatment. There are numerous types of surgery that can be performed, depending upon the progression and other factors:

• Appendectomy: By far the most common surgery, this is the complete removal of the appendix.
• Hemicolectomy: For larger tumors, the appendix is removed, as well as blood vessels and lymph nodes that surround it.
• Debulking surgery: This is designed for later-stage cancers, and is performed by removing as much of the cancer as possible.
• Peritoneum removal: This controversial surgery removes the lining of the abdomen, and can be very complex, with serious side effects.

Chemotherapy

This procedure uses powerful drugs to stop cancer cells from growing and eliminate those that are already there. Chemotherapy can take many forms, including:

• Local chemotherapy includes medication delivered right to the site of the tumors, and is the most common therapy for appendix cancer.
• Systemic chemotherapy is delivered through the bloodstream, and is best for cancer that has advanced beyond the appendix.

Chemotherapy almost always has side effects that might be serious. These include higher risk of infections, increased fatigue, nausea and vomiting, hair loss, diarrhea, and lack of appetite.

Radiation Therapy

This is the use of high-energy rays to destroy cancer cells. It is a very targeted treatment that is rarely used in appendix cancer, though some patients might opt for it, depending upon their condition. If it is used, the common treatment is called P32, which calls for radioactive liquid to be inserted into the abdomen, right where the cancerous tumors are. This creates a very strong, targeted treatment in that particular area.