Appendix Cancer

Appendix cancer is often difficult to diagnose. Doctors use different tests to find, or diagnose, cancer. They also use tests to learn if cancer has spread to another part of the body from where it started.

Your doctor may plan for you to have any of the following to confirm a diagnosis:

• CT scan (short for computerized tomography scan): Takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these images into a detailed, cross-sectional view 3-dimensional or 3-D that shows any abnormalities or tumors. CT scan images provide more detailed information than plain X-rays do.
• Biopsy: A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. A pathologist then analyzes the sample(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cealls, tissues, and organs to diagnose disease.
• Appendectomy: Removal of your appendix through surgery.

In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams include a variety of other health care professionals, such as physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Your team will work with you to create the best personalized care plan based on your situation. This may include any of the following:

• Updated imaging: This could include repeat CT scans or other forms of imaging if current imaging is outdated.
• Pathology review: If you had a previous surgery or biopsy at another hospital, we may ask for a sample of this tissue to be sent to Mount Sinai Hospital for review by one of our pathologists to confirm your diagnosis.
• No follow up: In some cases, follow up is not required or you may have follow up with your local physician.
• Surveillance: Patients who have had most or all of their cancer removed. CT scans will be done on a schedule set by your surgeon for monitoring.
• Systemic chemotherapy: This type of chemotherapy gets into the bloodstream to reach cancer cells throughout the body. This can be done using an intravenous (IV) tube, which is a tube placed into a vein using a needle or in a pill that is swallowed (orally). This may be recommended if surgery is not possible or as a first step before surgery.
• Surgery: This is the removal of the tumor and some surrounding healthy tissue during an operation. It is the most common treatment for appendix cancer.
• Surgical debulking: This is the removal of mucin and bulky disease to relieve symptoms.(Mucin is a gel-like substance and in appendix cancer, mucin may be overproduced causing it to accumulate or collect in the abdominal cavity. This may cause symptoms of abdominal bloating and discomfort.)
• Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy (HIPEC): This is a very specialized surgical technique used in the treatment of some cases of appendix cancers. Intraperitoneal chemotherapy is chemotherapy that is given directly into the abdominal cavity. Typically, the surgeon will try to remove as much of the tumor as possible (debulking surgery, see above) and then insert a tube in the abdomen through which chemotherapy can be given after the operation. The chemotherapy is warmed above body temperature to increase its ability to penetrate the tissue that may be lined with tumor cells; this is called hyperthermic (or heated) intraperitoneal chemotherapy (referred to as HIPEC). Once chemotherapy is completed, the tube is removed. Mount Sinai Hospital is one of the few centres in Canada that offers this treatment.

Other helpful websites with more information about Appendix Cancer:

• The PMP Pals Network: Volunteer run organization for patients and caregivers living with appendix cancer.
• Pseudomyxoma Survivor: Support network for those affected by appendix cancer.
• Cancer.Net: More information on appendix cancer.

Looking for more information about community resources for those living with cancer? See the community resources page.