The appendix is a bag like structure that is attached to the large intestine. It is vestigial; it performs no function in the human body. Cancer of the appendix is relatively rare. About one in 200 patients is diagnosed with appendix cancer every year. Appendix cancer develops when the cells within the appendix become abnormal and replicate autonomously and uncontrollably.
Appendix Cancer Symptoms
Occasionally, the cancer is asymptomatic, i.e. it does not have any signs / symptoms in the initial stage
Swelling in the abdomen
Pain in the right side
Ascites or fluid accumulation in the abdomen
Altered bowel function
Protruding belly button
Appendix Cancer Causes
The exact cause of appendix cancer is unknown; also no avoidable risk factors have yet been recognized. However, doctors say that age is one risk factor linked to cancer of the appendix. The average age at which cancer of the appendix is diagnosed is approximately 40 years. Cancer is moderately rare in children.
Appendix Cancer Treatment
Physical examination and certain specific tests need to be carried out to diagnose appendix cancer:
Biopsy: a tiny tissue is excised and sent for examination.
From time to time, the cancer is discovered without warning, during or after surgery of the abdomen
CT scan: helps make the diagnosis and find out the extent of spread.
MRI: provides the doctor with detailed images.
USG: ultrasound waves generate an image of the internal organs.
Radio-nuclide scanning: a radio-active substance is administered and a camera is used to show where the radio-active substance collects.
Treatment of Appendix Cancer
Treatment for cancer of the appendix is a multidisciplinary approach. A team of doctors, oncologists, and counselors help manage the case successfully. The treatment regimen comprises of:
1. Appendectomy: excision of the appendix. It is used for tumors that are smaller than 1.5 cm.
2. Hemicolectomy: this procedure is used for tumors bigger than 2 cm. A segment of the colon adjacent to the appendix is excised; along with the close by blood vessels and lymph nodes.
3. Debulking surgery: is used for advanced cases. As much as possible, the tumor bulk is removed. Debulking is often combined with chemotherapy to destroy any remaining cancerous cells.
4. Removal of the peritoneum: some oncologists support an aggressive form of surgery that consists of the removal of the peritoneal lining the abdomen to eliminate the cancer.
Chemotherapy comprises of the administration of drugs to annihilate the cancer cells, characteristically, by impeding their ability to duplicate. Chemotherapy may be either local, i.e. the drugs are given locally on one particular area of the body; it is also called intra-peritoneal chemotherapy. Or else chemotherapy may be systemic, i.e. the chemical drugs are conveyed via the blood stream, so that they reach the cancer cells in the body. The regimen has definite number of cycles that are given to the patient over a fixed time period. One chemotherapy drug may be administered or multiple drugs may be given during the treatment.
Radiation therapy uses high energy X rays to annihilate the cancer cells. Radiation therapy includes a fixed number of treatments over an interval of time.
It is not often used in the management of appendix cancer.
Recurrent appendix cancer
Once the entire treatment plan is complete and there is a nonexistence of manifestations and clinical features of the cancer, you must confer with your oncologist about the likelihood of recurrences. In case of recurrences, the tumor may come back at the same place, or close by, or in a distant place. The management comprises of a permutation of the above mentioned procedures.
The outcome of the case depends up on how soon the diagnosis is made, the stage of the cancer, the extent of spread to other organs / structures and the line of treatment that is being started. You must stick to the follow up routine that your oncologist suggests. The prognosis also depends on regular physical exams and the medical screenings to keep an eye on the recovery. Follow the conventional guidelines for good health, i.e. you ought to maintain optimal weight, steer clear of smoking, eat a well balanced diet, and have cancer screening tests done. Also, follow a proper exercise plan based on your requirements, physical capacity, and your fitness level. Support groups and psychotherapy is also advocated, since they provide several benefits.