Cancers of the appendix are rare, but not to the staff at the Moores UCSD Cancer Center. We are one of the few centers nationwide with expertise in the management of all types of appendiceal cancers. Some appendiceal cancers produce mucus until they burst and shed cells into the abdominal (peritoneal) cavity. Pseudomyxoma peritonei is another name for such cancers that produce large amounts of mucus within the abdominal cavity. These are most commonly from the appendix but can sometimes arise from the colon or ovary, as well.
Patients may notice right-sided abdominal discomfort that may have been present for several years prior to diagnosis, abdominal distension or sometimes have few symptoms at all. If the tumor is small when discovered, a standard appendectomy (removal of the appendix) may be the only treatment needed.
When appendiceal cancer has spread to the peritoneum, the smooth membrane that lines the cavity of the abdomen, your surgeon may perform cytoreduction (debulking) surgery, which removes the cancer in the abdomen. UCSD’s surgical oncologists (cancer surgeons) are experts in this complicated procedure. During the surgery, you may receive heated intraperitoneal chemotherapy (HIPEC), a technique performed by Dr. Andrew Lowy. Chemotherapy drugs are heated to about 105 to 110 degrees and circulated over a 90 minute period throughout the abdominal cavity and then removed. Studies have shown that hyperthermia (heat) works especially well with chemotherapy to kill tumor cells, which have an impaired ability to deal with heat. In normal chemotherapy, the drugs diffuse within a few millimeters; when administered within an open abdomen, the chemotherapy is able to penetrate deeper into bulky tissue.
Other types of appendiceal cancer include carcinoid, adenocarcinoid, and signet ring adenocarcinoma. Some of these may require treatment with systemic (intravenous) chemotherapy prior to consideration of surgery. Our experts will review your particular case in detail and advise you on the best approach to combat your cancer.