Appendix Cancer

Both cooler than the other side of the pillow

by Marcus Cimino

Due to the recent passing of Stuart Scott I thought I would use Janurary 4th to show how medicine really does permeate through life. Even when watching Sportscenter, medicine is there in the background, behind the scenes. Behind the “Booyahs” and suits and ties, behind the Iconic quotes and little black dresses.

Sometimes human biology is so covert, you don’t know it’s happening until it’s too late. Such is the case with appendix cancer.

appendix cancer picture

An accessory organ that has not had a known use for a really, really, long time (Source: http://www.shootoutcancer.org/ originally from WebMD)

 

To start, appendix (or appendiceal) cancer is an extremely rare form of cancer. How rare? Of just intestinal tumors, it only makes up 0.5%. Additionally, it is often asymptomatic. As its name implies, it grows inside the appendix, and only when it is large enough to block the opening of the appendix(or it has already metastasized) does it cause symptoms. The majority of these start in the distal portion, far away from the opening, so you can imagine that it could grow for a while before being a problem.

These most common type of (these extremely rare) tumors are classified as carcinoid, which means they grow somewhere in the intestines. You can test a patient’s 5-HIAA level in their urine(higher specificity) and CGA level in their blood(higher sensitivity). However other things like appendicitis must be rule out first.

Accuracy of “non-essential” can be debated (Source: Pinterest.com)

 

So how is it treated? Well it depends on its size and whether or not it has metastasized. Most tumors less than 2-3 cm* without metastasis can be removed by performing an appendectomy and that’s it. Others will need some combination of chemotherapy and surgery(e.g. right colectomy if the tumor has spread through multiple layers of the appendix).

Not proper sterile technique, patient still clothed. (Source: original work from The Simpons, image found on imgur.com)

 

 

As you can imagine, prognosis also depends on this. Simple and small tumor – 100% survival. Larger with some local metastasis – 78%  and larger with distant metastasis and lymph node involvement – 32%**

So as you can see, if not caught early, it can spread and become a very serious illness. Unfortunately, we have recently lost Stuart Scott, a prominent and influential sportscaster on Sportscenter. What may be less known is that Audrey Hepburn, famously known for her role in Breakfast at Tiffany’s, also suffered from and succumbed to appeniceal cancer. It is unfortunate two people who were so commonly known had such a rare disease.

So with that said, here is Stuart Scott’s speech from the 2014 ESPY’s for those who have yet to see it. Powerful Stuff.

*Th actual size of the tumor for staging and risk profile depend on who you ask/what research you read

**These numbers are from this paper.

*** While writing this I found a charity dedicated to appendix cancer, check it out for more information. I Also found this charity started in Audrey Hepburn’s name that tackles several causes. I don’t know much about them so any comments on them are appreciated!

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