The appendix is normally located in the lower-right quadrant of the abdomen, has been thought to be a reservoir of good bacteria that support our digestive health and wellbeing, and is a small tube open to the cecum, which is the pouch-like initial segment of the large intestine. Cancers of the appendix, alternatively referred to as “appendiceal cancers,” are rare, but cancers that originate in other tissues of the body may also metastasize to the appendix.

Appendiceal cancer develops as a result of changes to the genetic material within appendiceal cells. These changes result in the pattern of cell growth and division characteristic of appendiceal cancer. Although the increased likelihood of developing appendiceal cancer is associated with the following factors, in most cases, physicians and scientists are still trying to determine what causes appendiceal cancer to develop:

• Aging
• Family history of certain cancers
• Personal history of certain cancers
• Exposure to certain chemical substances
• Genetic mutations
• Smoking

Our specialists collect information regarding medical history, surgical history, social history, and family history; conduct laboratory testing, and review radiological studies to approach patient care in the most comprehensive and personalized manner.

If appendix cancer is suspected, a doctor will likely order imaging to help arrive at a diagnosis. Imaging might include a CT scan, PET scan, PET-CT scan, ultrasound, or MRI. A CT (computed tomography) scan uses X-rays to generate a three-dimensional picture of the body whereas a PET (positron emission tomography) scan uses a small amount of radioactive tracer to locate any cancer cells by how readily they take up the radiotracer. A PET-CT combines the features of a CT scan with those of a PET scan. An MRI (magnetic resonance imaging) uses magnetic fields to generate a detailed representation of the body. Lastly, an ultrasound sends sound waves through the body to generate images of the body’s organs and tissues.

If upon review of your results your doctor notices a mass suspicious for appendix cancer, he or she will likely order a biopsy in order to make a diagnosis and plan treatment, if necessary.

The following may be indicative of appendiceal cancer but may also be indicative of other illnesses:

• Abdominal bloating, discomfort, and pain
• Abnormal, unexplainable weight loss
• Appendiceal inflammation
• Change in bowel movements
• Fever
• Increased waistline
• Nausea and/or vomiting
• The sensation of a mass
• The sensation of fullness or pressure in the abdomen and/or pelvis

It is important you tell your doctor if you have any of these signs and symptoms, so he or she may determine their cause and plan treatment, if necessary.

“Staging” occurs when a physician uses to test and scan results to determine which parts of the body are involved by cancer, in this case, appendix cancer. Staging is important because different stages of appendix cancer are better addressed with treatments that may differ in amount, combination, or type. According to the American Joint Committee on Cancer (AJCC), the stages for appendiceal carcinomas (a type of appendiceal cancer) are as follows:

Stage 0

In this stage, cancer only includes the inside surface layer of the appendix.

Stage I

This stage describes appendiceal cancer that has grown deeper into the appendix tissue than the surface layer but remains isolated to the appendix.

Stage II

Cancer has either grown larger than in Stage I appendiceal cancer to involve organs and/or tissues surrounding the appendix but does not involve lymph nodes near the appendix.

Stage III

Cancer has grown beyond the surface layers of the appendix and has spread to lymph nodes in the same region of the body as the appendix.

Stage IV

In this stage, cancer has spread to parts of the body distant from where it began, such as lymphatic structures in other areas of the abdomen or beyond the abdomen to different organs systems.

Treatment of appendiceal cancer, depending on the stage and type, may include chemotherapy, radiation therapy, and/or surgery. These treatments may be used individually or in combination based on your doctor’s recommendations. It’s important to discuss all of your treatment options with your doctor to help make the decision that best fits your needs. Some important factors to consider when deciding on an appendiceal cancer treatment plan include

• Your age, health, and lifestyle.
• The stage of your cancer.
• Any other serious health conditions you have.
• Your feelings about the need to treat cancer right away.
• Your doctor’s opinion about if you need to treat cancer right away.
• The likelihood that treatment will help fight or cure your cancer.
• Possible side effects of each treatment method.

You may feel the need to make a quick decision, but it is very important to ask questions if there is anything about which you’re not entirely sure. It is very important for you and your doctor to communicate and work together to weigh the benefits of each treatment option against the possible adverse effects in order to ultimately determine which treatment option is best for you.