Diagnosing Cancer of the Appendix

The appendix is a small organ in your abdomen, attached to the beginning of the large intestine (the cecum). It’s unclear what function the organ serves, and you can live a normal, healthy life without it.

Appendiceal cancer is usually found after an appendectomy (surgery to remove an inflamed appendix) or during tests for other conditions. However, if your physician suspects that you have cancer in or near the appendix, they may order tests, such as:

• Blood tests, which may reveal tumor markers (substances that indicate certain types of cancer)
• Imaging tests, such as CT or MRI scans, which can provide pictures of your appendix and other internal structures
• Laparoscopic biopsy, a minor procedure that allows a surgeon to explore and take a small tissue sample (biopsy) for testing. A specialist then examines those cells under a microscope. Biopsy is the only way to confirm appendiceal cancer.

Types of Appendiceal Cancer

No matter how appendiceal cancer is diagnosed, it’s important to identify the type of cancer and whether it is spreading. This information helps your oncology team decide which treatments will be most effective.

The two main types of appendiceal cancer are:

• Appendiceal adenocarcinoma: These tumors start in the lining of the appendix. This tumor type includes mucinous adenocarcinoma, which is one of the most common forms of appendix cancer.
• Neuroendocrine tumors (NETs): NETS, also called carcinoid tumors, start in neuroendocrine cells. These cells communicate with your nervous system and release hormones into the blood. It is the most common type of appendiceal cancer.

Some appendiceal tumors are not cancerous. Your test results will reveal whether a tumor is cancerous or benign. Your oncologist and a specially trained physician called a pathologist will examine the cells under a microscope. They will identify whether the cells are cancerous and invading the appendix wall. This information helps us determine the best treatment options and understand your prognosis.

Appendix Cancer Treatment

Your oncology experts will recommend a treatment plan based on many factors. We consider the appendix cancer type, tumor size, your overall health and your priorities. We may recommend:

• Surgery: If the cancer is only in the appendix, surgery may cure this disease. A small appendix tumor can often be removed during a single surgery. A larger tumor or cancer that has spread (metastasized) may require a second surgery. Surgery may also remove part of the colon, peritoneum (lining of the abdomen) or other nearby affected tissue.
• Chemotherapy: Chemotherapy (chemo) involves oral or injected medications that destroy cancer cells. You may receive chemo if the cancer has spread.
• HIPEC: Hyperthermic intraperitoneal chemotherapy (HIPEC), also called hot chemo, injects heated chemotherapy directly into your belly. The chemo circulates for about 90 minutes, killing microscopic cancer cells that remain after surgery. We drain the medication before closing the incision(s).
• Targeted therapy: Certain types of appendix cancer may respond well to targeted therapy. This approach attacks particular proteins or genes related to cancer but limits damage to healthy cells. Depending on your test results, there are several medications we may recommend.

Supportive Care for Appendix Cancer

In addition to providing cancer treatments based on the latest research, we provide exceptional supportive care. Care may include:

• Nutritionists to maximize your health
• Pain management experts to keep you comfortable
• Palliative care specialists to help you manage symptoms and make treatment decisions
• Psychologists to help you cope with diagnosis and treatment

Appendix Cancer Care: Why Choose Memorial Cancer Institute?

When you come to Memorial for appendix cancer diagnosis and treatment, you’ll find:

• Expert care: Our board-certified, fellowship-trained oncologists and surgeons stay current on the latest treatments for this rare disease.
• Team approach: Our multispecialty team approach means that oncologists and surgeons collaborate throughout your diagnosis and treatment. This is particularly important if appendix cancer spreads to the digestive or reproductive system.
• Advanced treatments: We offer treatment options not available at every cancer center, including HIPEC and targeted therapies.
• High-volume center: Memorial treats many rare cancer cases every year. Research shows that high-volume centers achieve the best outcomes.
• Center of Excellence: Memorial is one of only a few institutions in Florida designated as a Cancer Center of Excellence by the Department of Health.
• Care for the whole person: Your care team includes support staff who can help you feel and function better. At Memorial, you have access to integrative medicine specialists, including psychologists, social workers and nutritionists.