“Is there any hope for my husband with Appendix Cancer?”

Today’s question comes from Diane in the USA…

“I'm scared. My husband, who has been in perfect health before now, had an appendectomy in March and the pathology report indicated appendix cancer. My husband is 61 the most upbeat human on this planet. We are willing to allow this bully called cancer to win. Please tell me stories that are similar, which will give me strength. I'm so lost now.”

PMP Pals responds…

Diane, please have hope. We (the PMP Pals) have HOPE for your husband! Virtually every Pal Patient and every Pal Caregiver can relate to how you and your husband feel right now. We felt that way when we were initially diagnosed too.

Please take a look at these photo galleries of our "Pal" members who were in your husband’s shoes a few years ago. As these photos show, are doing very well today...

Men's Support

HIPEC Patient Profiles

Couples Support Group

If your husband is not currently under the care of one of the specialists listed on www.pmppals.orghere is our listing of specialists to consider for a consultation.

Get the best possible medical care for your husband; then the two of you can move forward with his treatment plan, and then on to resuming your active and fulfilling lives!

Articles posted in PMP Pals and on www.pmppals.org are written from the perspectives of patients and their families and are not intended to substitute for licensed, professional legal or medical advice. Each patient is unique and should seek specific counsel from their own licensed healthcare professional. Copyright © 2012 by the PMP Pals’ Network. All rights reserved. Derechos de PMP Pals Network@2012. Todos los derechos reservados.

Diagnostic CT Scans for Appendix Cancer

Several diagnostic tools, including scans and laboratory tests, are utilized to detect and monitor cancer. Among the tools most commonly used are those that utilize imaging techniques. Physicians use X rays, CT Scans, MRIs, Nuclear Scanning, PET Scans and Ultrasonography as tools for diagnosing cancer and metastasis.

In general, CT scans are most commonly ordered for Appendix Cancer and Pseudomyxoma Peritonei patients, however, MRI scans are now being considered for pre and post treatment monitoring. Consult with your physician about which type of scan is most appropriate for your particular medical care.

Prior to the scheduled day of the scan, ask your physician or radiologist the following questions:

Why is this scan being ordered?

Are any risks associated with this test?

Will the test be taken on an outpatient basis?

What “preparations” if any, are required prior or following this test? Fasting? Bowel cleansing?

Can I drive myself home following the test?

How much will the test cost?

Is the cost covered by my healthcare insurance?

Will the test be performed locally?

Who will administer the test?

When will the results be available to me?

What will I feel during the test?

Is the test uncomfortable in any way?

Will I feel claustrophobic in taking this test?

Can I take this test if I have a pacemaker, implants or hearing aids?

How long does the test take?

Does the test have any side effects?

How often should a patient be scanned?

General guidelines differ for American patients, who are generally monitored (including scans) quarterly during their first year, post treatment, as compared with patients in Australia, Canada and Europe. These differences in schedules may possibly be based on individual healthcare (insurance) plans.

Due to recent concerns about radiation exposure from CT scans, some patients have opted to reduce the number of scans during their first and subsequent years post treatment. These concerns are best discussed with your radiologist and/or surgical oncologist.

Regardless of your testing schedule, be cognizant of any changes in physical symptoms, i.e., bloating, unexplained pain, indigestion, elimination, etc.

Generally, if you remain disease free, your monitoring schedule will be reduced to annual tests, years five through ten, post treatment. After the tenth year, annual monitoring is often discontinued.

Once again, each patient’s case differs; therefore, it is necessary to address questions about your needs for scans to your surgical oncologist specialist.

Articles posted in PMP Pals and on www.pmppals.org are written from the perspectives of patients and their families and are not intended to substitute for licensed, professional legal or medical advice. Each patient is unique and should seek specific counsel from their own licensed healthcare professional. Copyright © 2012 by Gabriella Graham/PMP Pals’ Network. All rights reserved.

Patients Need Patience!

It’s not unusual for patients to become discouraged when we feel we aren’t recuperating as quickly as anticipated, especially during this time of year when we see others out and about, enjoying summer sports and activities.

Recently a fellow appendix cancer patient told me, that, six weeks after CRS and HIPEC, her recovery was taking longer than she had hoped for. She was disappointed that she still lacked energy; truly this is one of the most challenging situations that we experience during medical treatment!

It’s common for those of us who are used to living active and productive lives, to feel discouraged when our bodies don’t appear to cooperate with all the goals we have set for ourselves! Some days it feels like we take a step forward, only to take a step back in the recovery process, the very next day!

Gradually, during the recuperation period, we notice that we are experiencing more “good” days than “not so good” days and eventually our stamina increases!

As patients we must be “patient” with the recovery process from treatment, especially when treatment extends for several weeks or months.

The often mundane days of recuperation are a good opportunity to make plans for the future! We can use, what appears to be “idle time”, to reflect on all the many goals we want to accomplish.

Whether we plan to expand our career, raise our children, or plan for future vacations and holidays, setting goals will help us to look ahead towards the many opportunities for the longer lifespan that our cancer treatment has provided for us!

In the long run, we are, in effect, exchanging these temporary weeks or months of treatment and recuperation for years of extended life.

This is what I envision for my fellow cancer patients, and why I am optimistic for your future!


Articles posted on www.pmppals.org are written from the perspective of patients and family caregivers and are not intended to substitute for professional legal or medical advice. Individuals should seek the counsel of licensed professionals for their specific needs.

Copyright© 2011 by Gabriella Graham/PMP Pals’ Network. All rights reserved.

Visit the “Pals” at www.pmppals.org. We have HOPE for YOU!


Dr. Brian Loggie Answers Questions: Is Appendix Cancer Hereditary?

Brian W. Loggie, MD, CM, FRCSC, FACS is a Professor of Surgery and is Chief, Division of Surgical Oncology and Director, Cancer Biology Program at Creighton University School of Medicine in Omaha, NE.

Dr. Loggie’s expertise includes the treatment of peritoneal carcinomatosis, peritoneal mesothelioma, pseudomyxoma peritonei and all peritoneal surface malignancies, abdominopelvic and retroperitoneal sarcomas, cutaneous malignant melanoma, sphincter-preserving treatment for rectal tumors, and management of complex primary or recurrent solid tumors.

Dr. Loggie recently answered questions presented by members of the PMP Pals' Network who are concerned about the possibility of hereditary or environmental factors that may possibly be associated with Appendix Cancer/Pseudomyxoma Peritonei.

Is there any evidence that appendiceal cancer/Pseudomyxoma Peritonei, is a hereditary or familial disease?

“We have investigated this issue closely here at Creighton University School of Medicine.Dr Henry Lynch, for whom Lynch Syndrome (familial colorectal cancer) was named, is a colleague and is Chair of Preventive Medicine here in our Hereditary Cancer Center.

To our surprise, we have NOT found a familial association for appendix neoplasms and Pseudomyxoma Peritonei. In fact, we have seen a rate of “familiality” (family history of colon or appendix tumors suggesting an inherited pattern in the family) that is less than expected by one fifth (based on risk from right sided colon cancer: about 1% versus 5%). Overall, I think this is good news for families!”

How often does appendiceal cancer occur?“The relative estimate for incidence of appendix neoplasms is typically estimated at about 1% the incidence of colorectal cancer. I think that is reasonable; if you take the average size of the appendix, extrapolate to mucosal area, and then compare that to the average size/area of the colon, you get a ratio of about 1%.”

Where does Pseudomyxoma Peritonei originate?

“Ninety nine per cent of Pseudomyxoma Peritonei cases originate with the appendix.

My sense is that a big difference between appendix neoplasms or “PMP”, and colon cancer is their location. The appendix arises embryologically as a diverticulum (out pouching) of the right colon, and is histologically similar to colon.”

What are some of the differences between appendiceal and colorectal cancer?

“We see appendix tumors diagnosed typically earlier than for colorectal cancer. Small adenomas progress sooner in the appendix, where they can rupture or infiltrate causing problems leading to diagnosis based on the small size of the appendix.”

What are the causes of colon cancer?

“The current thoughts are that colon tumors develop out of a series of changes (cumulative mutations occurring in specific genes) occurring over a number of years, whereby adenomas (early non-malignant polyps) develop and grow, and can further evolve into cancers including malignant polyps or adenocarcinomas.

An adenoma, or cancer, growing in the colon has a lot more space (and therefore time) in order to grow before causing problems that lead to diagnosis.

Again, supportive of this is the earlier age of diagnosis of appendix cancer/Pseudomyxoma Peritonei patients and the approximate relative incidence (about 1% rather than ten times less or ten times more) seem to match in terms of an estimated percentage for the mucosal areas at risk.”

What are some of the some of the similarities between appendiceal and colon cancer?

“We see a similar mutation rate for the Ras gene in Pseudomyxoma Peritonei as we see for colon cancer (about 40-45%).

Thus, in a sense, my view is that Pseudomyxoma Peritonei represents a “juvenile” form of colon cancer. This may explain a tendency to be better differentiated and explain some of the characteristics of PMP.

The appendix is a diverticulum (literally defined as a “way house of ill-repute!”) that is not likely exposed to the continuous stream of stool as is normal colon mucosa (and therefore perhaps less exposure to bile and environmental agents). This could also play a role in some observed differences.

These are my current observations; we have not seen an inherited or environmental pattern.”
* * * * * *
For more information about this article:
Dr. Brian Loggie

Dr. Brian Loggie’s contact information and professional bio are posted on the SURGEONS and SPECIALISTS link at www.pmppals.org

Information about Dr. Loggie’s research program is posted on the DONATE TO RESEARCH link at www.pmppals.org

Dr. Henry Lynch

Dr Henry Lynch is the Chair of Preventive Medicine in the Hereditary Cancer Center at Creighton University. Lynch has published more than 700 journal articles and books focused on diagnosis, prevention, and treatment of hereditary disorders, especially cancer. He has devoted much of his life to the study and research of family medical history data leading him to identify cancer syndromes and their patterns of inheritance among generations of families. Lynch Syndrome, aka hereditary nonpolyposis colorectal cancer (HNPCC), is an inherited cancer affecting the digestive tract, especially the colon and rectum.

Families with Lynch Syndrome have an increased risk of cancers of the stomach, small intestine, liver, gallbladder ducts, upper urinary tract, brain, skin, and prostate, and may be a cause of endometriosis.

For more information about Creighton University’s Hereditary Cancer Center, see the Hereditary and Familial Cancer section on the PSEUDOMYXOMA PERITONEI link at www.pmppals.org

For more information about the KRAS mutation, see the DIAGNOSTICS link at www.pmppals.org

For definitions of medical terminology, see the GLOSSARY link at www.pmppals.org.

Articles posted in PMP Pals and on www.pmppals.org are written from the perspective of patients and their families, unless otherwise noted, and are not intended to substitute for specific medical care. Patients should seek the counsel of their individual specialists regarding their specific personal needs.Copyright © 2011 by Gabriella Graham/PMP Pals’ Network/All rights reserved.Visit us on the web at www.pmppals.org