Depending on the stage of your tumor, your surgeon may perform one of the following procedures:
Appendectomy. This is surgical removal of the appendix, often done thru small 3 mm incisions, and may be curative for small (<1.5 cm) carcinoid appendix tumors that have not spread. Healthy patients may be discharged on the same day of surgery.
Hemicolectomy. For larger carcinoid appendix tumors (>2 cm) and the other appendix cancers, surgeons may recommend removal of the appendix and the adjacent or nearby portion of the colon as well as the associated lymph nodes. This is to ensure that cancer cells are not left behind and to sample the lymph nodes for spread.
Cytoreductive surgery. This specialized surgery is typically recommended for patients with later-stage appendix cancer which may have spread to the abdominal lining. During this procedure, specially trained surgeons will remove all of the visible cancer, and then perform a “washing” of the abdominal cavity with chemotherapy that has been heated to increase its effectiveness. Surgeons at the Markey Cancer Center are part of a team that perform a high volume of these complex cases every year (>50).
Chemotherapy is the use of drugs to destroy cancer cells as they divide and grow. When appendix cancer has spread into the lymph nodes or other organs, your medical oncologist may recommend chemotherapy. Systemic chemotherapy refers to drugs that enter the bloodstream to kill cancer cells thru-out the body. These drugs are administered or given by mouth (orally) or thru an IV (intravenous). Depending on your specific circumstance, chemotherapy may be given before or after surgery.
Hyperthermic intraperitoneal chemotherapy (HIPEC) is a one-time administration of chemotherapy directly into the abdominal cavity and is most often combined with cytoreductive surgery described above. This specialized cutting edge procedure allows your team to deliver a higher dose of chemotherapy directly onto the tissue and directly target microscopic cancer cells which are not visible on scans or to the human eyes.
Radiation therapy is not commonly used for appendix cancer, although in some cases, it may be used to treat a particular area where the cancer has spread to alleviate symptoms like pain.