Appendix cancer (patient information)
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Appendix cancer |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]
Overview
Appendix cancer is a rare cancer, diagnosed in less than 1000 Americans each year, and less than one percent of all appendectomy pathology reports. Appendix is located close to where the large and small intestine meet. Tumors arise from this small part of gastrointestinal system might be whether malignant or benign. Nevertheless prognosis for malignant appendiceal tumors is also pretty good; specially tumors less than 2 centimeter are very unlikely to spread. Tumors larger than 2 centimeter generally need more aggressive approach.
What are the Symptoms of appendix cancer?
- Majority of appendix cancer patients present with acute appendicitis.
- Abdominal pain, loss of appetite, nausea, vomiting, constipation or diarrhea, inability to pass gas, low-grade fever are among sign and symptoms that rise cancer for acute appendicitis. For more details please refer to appendicitis.
- Patients with appendix cancer might also complaint of vague abdominal pain, change in abdominal size, or vague abdominal discomfort.
What Causes appendix cancer?
There is no established know cause for appendix cancer.
Who is at Highest Risk?
- Smokers, women (slightly), elderly, patients with certain medical conditions such as multiple endocrine neoplasia type 1 (MEN1), and hereditory nonpolyposis colon cancer (HNPCC), and patients with long standing ulcertive colitis.
- If you have symptoms that might raise concerns for appendix cancer your doctor might ask some questions about your life style, specially smoking and drinking habits, your family history of certain medical conditions (MEN 1, HNPCC other familial cancer syndromes) and personal history of inflammatory bowel disease like Crohn's disease or ulcerative colitis, which presents with long standing episodes of diarrhea plus/minus constipation and some other symptoms.
- Not that everyone with risk factors will not get appendix cancer; risk factors just increase likelihood of a given disease. If you have risk factors for appendix cancer, please discuss them with your doctor. Nevertheless, having a healthy, active life style is always recommended.
Diagnosis
- Since appendix cancer have no symptoms particularly in early stages, it usually diagnosed after pathology report of a patient with acute appendicitis, or is an accidental finding during imaging studies for some other reasons.
- The following tests may be used to study presence of a probable appendix cancer, or staging and determining treatment plan for a diagnosed cancer.
- Blood and urine tests
- Imaging studies such as MRI, CT scan or PET scan
When to Seek Urgent Medical Care?
- Abdominal pain
- No gas passing
- No stool passing
- Sever diarrhea
- Fever
- Shortness of breath or wheezing
Treatment Options
- Several factors determining treatment approaches in appendix cancer among them are:
- Tumor type
- Tumor size
- How much does the tumor spread
- Patient overall health status with emphasize on the following factors:
- Age
- Body mass index (BMI)
- Anesthesia and Surgery tolerances determined by anesthesia and surgery risk scores and
- Cardiopulmonary status
- Surgery is the main treatment for appendiceal cancers. With respect to the tumor size and spread to the surrounding area or distant metastasis surgeon may decide to choose one of the following approaches:
- Simple appendectomy
- Removing the appendix
- Generally recommended for small carcinoids
- Right hemicolectomy
- Removing appendix, right colon (also called Large intestine), and surrounding lymph nodes
- Recommended for large carcinoids and small adenocarcinomas
- Cytoreductive (tumor debulking) surgery
- Removing the tumor and abdominal mucin plus parts of the intestine, gallblader, uterus and ovaries and linings of the abdominal cavity
- Recommended for adenocarcinomas spread to abdominal cavity
- Systemic (delivering the chemotherapy agent through your veins or rarely mouth) chemotherapy before or after surgery
- Hypertermic intraperitoneal chemotherapy (HIPEC) during (in the operation room) or early after surgery, also known as heated chemotherapy:
- The abdominal cavity s filled with a preheated fluid (up to 104 degrees Fahrenheit) containing a chemotherapy agent, the abdomen will rocked gently for around 90 minutes, this will warrant delivery of the heat activated chemotherapy to all areas of the abdominal cavity.
- In the presence of Pseudomyxoma peritonei (a condition which abdominal cavity filled with mucous)., cytoreduction surgery with HIPEC is the recommended method of choice
Where to find Medical Care for (Disease name)?
Medical care for appendix cancer can be found here.
Prevention
- No prevention does exist for appendix cancer.
- Although a healthy, active life style is always warranted.
- Abstinence from alcohol and smoking is particularly important.
- If you have family or personal history of the above mentioned diseases your doctor may recommend some general diagnostic workups according to the recommended guidelines for each disease.
- For example patients with long standing ulcerative colitis or patients with history of HNPCC might benefit from colonoscopy work ups.
What to Expect (Outlook/Prognosis)?
- The followings play the key role in determining patients prognosis:
- Tumor type
- Tumor size
- How much does the tumor spread
- Most of appendix tumors are small and curable.
Possible Complications
- Patients with complicated specific types of appendix tumors called carcionids might complain of diarrhea, wheezing, facial flushing and palpitation.
Sources
http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm