If you have symptoms that may signal appendix cancer, your doctor will examine you and ask you questions about your health, lifestyle, and family medical history. However, appendix cancer often does not have symptoms in the early stages. In these instances, appendix cancer may be discovered during abdominal surgery for another condition, like acute appendicitis, or during tests for another condition.
If your doctor suspects or discovers cancer, one or more of the following tests may be used to diagnose appendix cancer and determine if it has spread. These tests also may be used to find out if treatment is working.
Blood and urine tests: Although no single blood or urine test can diagnose appendix cancer, they can help your doctor understand what is happening in your body. Urine tests may be used to rule out other conditions, track progression of your cancer, and indicate whether treatment is effective. Blood tests can also be used to rule out other conditions, such as infection. Additionally, certain types of blood tests can detect proteins produced by cancer cells, called tumor markers. Tumor markers may indicate the presence of cancer, and this information can help your doctor decide what other diagnostic tests to undertake.
Biopsy: if you are presenting symptoms of appendiceal cancer, or if your doctor finds a tumor while performing abdominal surgery for another condition, he or she may remove a small sample of tissue (a biopsy) from the appendix to undergo further testing. Looking at the tissue under a microscope allows your doctor to determine if there are cancer cells present.
Sometimes, appendix cancer is diagnosed after an appendectomy - the surgical removal of your appendix. If you present to the hospital with symptoms of acute appendicitis, your doctor may perform a minimally invasive procedure, such as a laparoscopic appendectomy, to remove your appendix. The appendix tissue can then be examined by a specialist. If tumor cells are found, your doctor may perform additional surgery in order to take a biopsy of the surrounding intestines. This can help determine if your cancer has spread.
Imaging tests can be paired with other lab tests to help confirm a diagnosis. Additionally, imaging tests may be used to determine if your cancer has spread and track the spread over time. Imaging tests may include:
- CT scan or CAT (computer axial tomography) scan: a CT scan creates detailed, 3D cross-sectional images of various parts of your body. In some cases, appendix cancer is found during a CT scan for another condition. Your doctor may use the scan to measure the size of appendix tumors and to see if your cancer has spread to other organs, like your intestines.
- MRI (magnetic resonance imaging) scans: Using strong magnets and radio waves, an MRI scan creates a detailed, static image of the body. This helps your doctor visualize the presence, size, and spread of tumors.
- PET (positron emission tomography) scans: PET scans can help your doctor locate cancerous cells. Prior to the scan, you will be given a safe form of radioactive sugar. Because tumors grow rapidly, they require a lot of energy. This means they will take up more of the radioactive sugar. The PET scan creates a picture showing where the radioactive sugar is being used in the body. Bright spots on the image indicate areas where there is significant sugar uptake, which can indicate the location of malignant tumors. If a malignant appendiceal tumor has metastasized to other parts of the body, like your colon, this may appear in the PET scan.
If you are diagnosed with appendix cancer, your doctor will determine the stage of the disease.
Staging is a way of classifying cancer by how much disease is in the body and where it has spread when it is diagnosed. This helps the doctor plan the best way to treat the cancer.
Once the staging classification is determined, it stays the same even if treatment is successful or the cancer spreads.
(source: National Cancer Institute)
Localized: Cancer is found in the appendix, colon, rectum, small intestine and/or stomach only.
Regional: Cancer has spread from the appendix, colon, rectum, stomach and/or small intestine to nearby tissues or lymph nodes.
Metastatic: Cancer has spread to other parts of the body.
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