Treatments for Appendix Cancer

Appendix cancer refers to the abnormal growth of cancer cells in the appendix. The appendix is a part of the gastrointestinal tract, although its exact function in the body is unknown and it appears to serve no necessary purpose. It is located next to the cecum, which is a portion of the colon/large intestine, and is approximately 10 centimeters long. Primary appendix cancer is rare, and generally appendix cancer is considered to be a subset of colon cancer, which affects approximately 1 percent of those patients said to be diagnosed with colon cancer annually.

Diagnosis

• The first step in treating appendix cancer is diagnosis. Appendix cancer is most often discovered during or after abdominal surgery and/or a procedure to remove the appendix to treat what is believed to be appendicitis. However, it can also be diagnosed in an independent medical exam. Doctors who diagnose appendix cancer generally begin by taking a general medical history. Certain medical tests are then performed, among which may include a biopsy, (the removal of tissue to test for cancer cells) a CT scan, an MRI, an ultrasound, or an octreoscan (the injection of a radioactive substance which accumulates in tumors).

Treatment

• Treatment of appendix cancer depends on several factors, including the patient's health, the size and location of the tumor, the lymph node involvement or the possible spread of cancer to other organs both close to and distant from the appendix.

Surgery

• The removal of the appendix, or an appendectomy, is the most common form of treatment for appendix cancer and often may be the only treatment needed. Appendix cancer is often very slow growing, and tumors under 1.5 cm can simply be removed. Larger tumors (tumors over 2 cm) can also be removed by surgery, but this surgery is more complicated and usually involves removal of one-third of the colon nearest to the appendix and removal of blood vessels and lymph nodes local to the appendix. Advanced appendix cancer is treated by a surgical procedure called a right hemicolectomy in which one-half of the large intestine is surgically removed (patients in general are still able to empty their bowels normally after such a surgery).

Chemotherapy

• Chemotherapy used in the treatment of appendix cancer is usually delivered directly to the abdomen. This type of chemotherapy treatment is called intraperitoneal chemotherapy and is distinct from systemic chemotherapy, which is administered through an IV to the blood. Intraperitoneal chemotherapy is recommended after surgery if the cancer was found to have spread outside the appendix so any additional remaining cancer cells in the body can be destroyed.

Radiation

• Radiation is also used in the treatment of appendix cancer. In some instances a special type of radiation called P32 is used. This involves the dilution of radioactive phosphorus into a liquid, which is then inserted into the abdomen through a tube. This is a strong form of local radiation, which disappears a few hours after being administered.