adminl Appendiceal Cancer
THE appendix is a thin pouch that is attached to the large intestine and sits in the lower right part of the stomach.
Appendix cancer occurs when healthy cells in the appendix change and grow out of control.
The tissue growth formed from the cells is called a tumour (commonly identified as malignant or benign). A tumour can be cancerous or benign. A cancerous tumour is malignant, meaning it can grow and spread to other parts of the body.
Another name for appendix cancer is appendiceal cancer. A benign tumour means the tumour can grow but will not spread. The malignant tumours are the ones that medical practitioners are mainly concerned with as they are life-threatening conditions.
Benign tumours (growth) may be removed by surgery for cosmetic reasons or when the growth is causing discomfort or pain due to pressure on other nearby organs.
There are different types of appendiceal tumours some of which are benign while the others are more aggressive and malignant.
Neuroendocrine Tumors (Carcinoid/hormone-secreting tumours), Mucinous Neoplasms, Appendix adenocarcinoma and Goblet cell carcinomas/adenocarcinomas.
Carcinoid tumours or neuroendocrine tumours are a very rare type of tumour, growing very slowly (about 50percent of appendix cancers are carcinoid tumours).
A lot of people live with this rare tumour without having problems caused by it and before it is detected.
Mucinous neoplasms are generally benign (they usually do not become malignant or cancerous). When these cells are contained in the appendix, they can be easily removed through a surgery called appendicectomy (an operation carried out to remove the appendix).
Appendix adenocarcinoma usually begins as cells that line the inside of the appendix and Signet-ring cell adenocarcinoma is one very rare subset and it is usually very aggressive (i.e. can become cancerous).
Finally, Goblet cell carcinomas are tumours that have both features of adenocarcinomas and carcinoids. These tend to be more aggressive than carcinoid tumours.
Several signs and symptoms can be related to appendix cancer although these are not entirely related to appendix cancer alone.
One can feel pain in the stomach usually being felt in the lower abdomen on the right or in the pelvis area.
One can also complain of a distended abdomen usually caused by fluid collecting in the abdomen (ascites) and this can cause pain and discomfort. In some instances, a bloated stomach (feeling tight, full and painful) is also a symptom that can worsen the pain. A diagnosis (tests to confirm the presence of appendix cancer) of appendix cancer may be confirmed by a biopsy (a minor operation carried out to collect very small cell tissue from the body for examination).
However, other tests may be performed such as a CT scan, an MRI scan or an Ultrasound scan. The doctor may request one or more of these tests to confirm whether one has developed appendix cancer.
Treatment options usually depend on the type and stage (the extent of cancer growth) of cancer.
The doctor usually decides on the best possible treatment option which can be surgery (the most common treatment for appendix cancer).
Sometimes the appendix and part of the colon (large intestines) may be removed during the operation a procedure referred to as Hemicolectomy.
Cytoreductive surgery may also be performed where the tumour and surrounding fluid is removed. Chemotherapy (treatment using medicines that kill cancer cells or rapidly dividing cells including some healthy cells) may also be given to patients with appendix cancer.
Several risk factors are associated with appendix cancer and these include smoking where it has been observed that people who smoke have a higher risk of developing appendix cancer than non-smokers.
Patients who have a family history of appendix cancer are more likely to develop appendix cancer.
This means that appendix cancer is one of the cancers that tend to run in families (hereditary cancers). Some patients with conditions such as pernicious anemia have a risk of developing appendix cancer.
People between the ages of 55-65 years of age are more likely to develop appendix cancer meaning the condition is rare in the younger generations below the age of 55years. Women are said to be more likely to develop carcinoid tumours than men.
However, because appendix cancer is rare, about 1-2 people in a million develop appendix cancer.
It is essential thus, to avoid risk exposures that can lead to increased chances of developing appendix cancer, especially for persons with conditions that can increase their chances of developing cancer or those with a family history of appendix cancer.
l Compiled by Bhodheni Chenjerai
Palliative care nurse (Island Hospice and Healthcare, Marondera Branch)
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Mathew Masinge
Online Reporter