Appendix Cancer Treatment in India

Appendix cancer or appendiceal cancer takes place when the healthy cells of appendix grow uncontrollably after mutation and form tumor. The tumors are often discovered during appendicitis or during diagnosis process of an unrelated ailment. Smaller the tumors are, lesser is the chance for them to spread across the body. Large tumors often require aggressive form of treatment.

Appendix is a part of the digestive system. It looks like a small pouch, somewhat tube-like and located on the lower right abdomen, at the very junction of small and large intestine. The function of appendix is still not known till date. Some believe it plays an important part in immunology of the body while many believe it turned into a vestigial organ during evolutionary process.

Who Gets Affected By Appendix Cancer?

Appendix cancer may develop at any age, but more likely to develop after 50 years of age. It is more prevalent in women than men.

How Common Is The Occurrence Of Appendix Cancer?

Appendix cancer, as per global figures, occurs in 1 or 2 people out of 1 million people.

What Is The Survival Rate Of Appendix Cancer In India?

Appendix cancer is a rare disease. Appendix survival rate are average estimates and varies from person to person depending on factors like type of cancer, treatment response, overall health, age, etc. Historical data reflects on the data which says that five-year survival rate is around 35%-60%.

What Are The Signs & Appendix Cancer Symptoms?

Many a times, people carrying cancerous appendix do not develop any symptoms. Symptoms during the warning phase varies from person to person, which may include:

• Fertility problems
• Increased waist size
• Vomiting & nausea
• Change in bowel movement
• Fluid build-up in abdominal area
• Pain in pelvic area
• Pain in abdominal area
• Bloating
• Appendicitis
• Ovarian masses
• Non-specific abdominal discomfort in lower right part
• Bowel obstruction, constipation or diarrhea
• Hernia Early satiety
• Sudden weight loss

How Does Someone Get Affected By Appendix Cancer?

Appendix cancer takes place when the appendix cells mutate and grow uncontrollably. Experts do not know still as to what triggers the disease. There are, although, the following risk factors that might trigger it:

• Gender – As mentioned earlier, women get affected by Appendix Cancer more than men
• Age – As a person gets older, the risk of appendix cancer also increases
• Medical History – Certain health risks and conditions like atrophic gastritis, pernicious anemia etc. may trigger appendix cancer development
• Tobacco Abuse – Tobacco products consumption like smoking can trigger not only appendix but all sorts of cancer

What Are The Grades & Stages Of Appendix Cancer?

Doctors seldom use the TNM system of staging for describing extent of appendix cancer. This stands for Tumor, Node & Metastasis. Here’s the significance:

• Tumor: The size of the tumor on appendix
• Node: Whether the cancer has spread across lymph nodes
• Metastasis: Determining the extent of the cancer’s spread beyond pancreas

Each of the stages play a crucial role in determining the stage of appendix cancer. Here are the tabular details of the same:

Tumor

Stage	Description
T0	Cancer not evident
Tis	Cancer found in SITU or cancer cells found on the 1st layer of appendix
T1	Cancer cells found to have spread in the next layer of appendix known as Submucosa
T2	Cancer entered in the deep layer of appendix called Muscularis Propria
T3	Cancer has already spread into the layer of connective tissue also known as subserosa or the region of blood supply for appendix called mesoappendix
T4	Cancer has spread across the lining of the abdominal cavity and nearby organs
T4a	Tumor found to be evident across visceral peritoneum, a tissue that covers outer surface of the organs
T4b	Cancer cells are present in other organs as well as structures like colon

Node

Stage	Description
N0	No cancer in lymph nodes adjacent to the appendix
N1	Cancer is present in 1 to 3 lymph nodes
N2	Cancer is present in 4+ lymph nodes

Metastasis

Stage	Description
M0	Cancer did not spread in any part of the body
M1	Cancer has spread across other parts of the body
M1a	Cancer has spread to the region called intraperitoneal acellular mucin
M1b	Cancer has spread within peritoneum further than stage M1a
M1c	Cancer has spread beyond peritoneum

Grading

Grade	Description
G1	Tumor cells appear as healthy as normal cells
G2	Tumor cells appear different from healthy cells
G3	Tumor cells appear to be very different from healthy cells
G4	Tumor cells appear to be entirely different from healthy cells

TNM Staging Procedure

Stage	Description
Stage 0	Tis+M0+N0
Stage 1	T1 or T2+M0+N0
Stage 2A	T3+N0+M0
Stage 2B	T4a+N0+M0
Stage 3A	T1 or T2+N1+M0
Stage 3B	T3 or T4+N1+M0
Stage 3C	Any T+N2+M0
Stage 4A	Any T+N0+M1a or T+Any N+M1b+G1
Stage 4B	Any T+Any N+M1b+G2+G3
Stage 4C	Any T+Any N+M1c+Any G

Can Appendix Cancer Be Deemed As Hereditary?

Experts believe that the chances of Appendix cancer being a hereditary ailment is less. Research is still going on in this area but most experts believe that this cancer is not at all hereditary.

How Is Appendix Cancer Diagnosed?

People are mostly diagnosed with appendix cancer after an appendectomy due to appendicitis. Sometimes imaging tests like CT scans and X-rays also reveal presence of existing tumors.

Which Tests Can Detect Appendix Cancer?

If the healthcare expert suspects presence of appendix cancer, then he or she may recommend more testing, which generally includes:

• Blood Test – If biopsy of appendix comes positive for appendix cancer, the next tests given by the healthcare provider is blood test to check the protein levels, to determine the stage of cancer.
• Laparoscopy – A slender and long fiber optic instrument called Laparoscope is inserted through an abdominal incision. The camera captures images of appendix and then reflects on the screen.
• Biopsy – During the procedure of Biopsy, the healthcare provider takes a sample of the affected tissue and then sends to the pathology lab for analysis. It is difficult to conduct appendix biopsy, and hence, if the cancer is spread to another area, the healthcare expert takes sample from the area.
• Imaging Tests – Imaging tests provide a detailed diagnosis and staging support to the appendix cancer treatment by providing detailed images. The tests are Computed Tomography Scan or CT Scan, Ultrasound, Positron Emission Tomography or PET Scan, Angiography, Magnetic Resonance Imaging Scan or MRI Scan & Endoscopic Ultrasound.

How Do Experts Treat Appendix Cancer?

To treat appendix cancer, healthcare providers take many things into account, like size of the temple, stage of tumor, preferences and overall health of the patient. The treatment of appendix cancer includes:

• Targeted Drug Therapy – The goal of this procedure is targeting cancer cells and limiting their attack on healthy cells. Specific drugs focus on specific genes as well as proteins which boost cancer growth. Common drugs that are used in the targeted appendix cancer therapy are:
• Panitumumab
• Ramucirumab
• Bevacizumab
• Cetuximab
• HIPEC Or Hyperthermic Intraperitoneal Chemotherapy – This treatment includes heating of the chemotherapy drugs and then circulating them within the abdominal cavity. HIPEC is performed at the same time as the surgery while the patient is still under general anesthesia. This approach is intense, more than traditional chemotherapy.
• Chemotherapy – This procedure involves treating with drugs for killing cancer cells. These medications are either given in pill-form or injected directly to the bloodstream.
• Surgery – Surgery involves appendectomy or removal of the appendix for treating small tumors. There are two types of surgery, viz, primary and secondary. The secondary appendectomy involves removal of more tissue. There are also other procedures like partial removal of your colon or hemicolectomy and debulking surgery where the surgeon removes tumor as much as possible, removal of abdominal lining. Debulking’s side-effects may not be suitable for all.
• Adjuvant Therapy – Refers to the additional treatment that is given after the primary therapy to lower the risk of recurrence. Chemotherapy and radiation are considered as adjuvant therapies in appendix cancer. Drugs including FLUOROURACIL (5-FU) or capecitabine for targeting remaining cancer cells after surgery, thus reducing the chances of recurrence. Radiation therapy includes high-energy beams for destroying cancer cells, even beyond appendix in certain cases. Adjuvant therapies aim at improving long-term outcomes and reducing the chances of cancer coming back.
• Minimally Invasive Therapy – Minimally invasive therapies procedures include micro surgeries in place of larger and open surgeries. These result in quicker healing and recovery from post-surgery-discomfort. Appendix cancer has various options of minimally invasive surgeries like robot assisted surgeries, laparoscopy, etc. These surgeries can be used for appendectomy or surgeries for a mor extensive cases. Minimal surgeries have benefits like reduced scarring, shorter stays at hospital and quicker return to normal life.

What Are The Possible Side-Effects Of Appendix Cancer Treatment?

During appendix cancer treatment, the side-effects that occur, affects patient variably – all dependent on the treatment they receive, cancer stage or the healing capacity of the body. Some of the most common side-effects are:

• Nail and skin change
• Hair loss
• Vomiting & nausea
• Constipation
• Fatigues
• Anemia

Is There Any Way To Prevent Appendix Cancer?

There is no such way known to prevent appendix cancer.

What Pose As The Risk Factors Of Appendix Cancer?

As mentioned earlier, we still don’t know the cause of appendix cancer and there are no known avoidable risk factors identified. But it becomes common with people with age and very rare among children. But current researches have pointed out certain potential risk factors like:

• Smoking
• Family history involving endocrine neoplasia type 1 (MEN1) – a disorder that gradually leads to formation of tumors within glands producing hormones
• Zollinger-Ellison syndrome, a medical condition of digestive tract
• Long-term inflammation of stomach lining called atrophic gastritis
• Vitamin B12 deficiency
• Prior abdominal surgery
• Appendiceal masses

The Different Types Of Appendix Cancer & Tumor

There are many malignant and benign tumors that can grow in the appendix that include:

• Appendiceal Adenocarcinoma

Adenocarcinoma cancer develope in the glandular tissue lining of the organs. There are many categories of appendiceal mucinous adenocarcinoma which include:

• Signet Ring Cell Adenocarcinoma
  
  This is an aggressive tumor type and is very rare, and occasionally form in appendix. Cancer cells store and secrete large amounts of mucin. The tumor is called so because of its appearance in microscope.
  
• Colonic-Type Adenocarcinoma
  
  The tumors grow at the very base of appendix. These are like colorectal cancer tumors, carrying same symptoms.
  
• Mucinous Adenocarcinoma
  
  One of the most common appendix cancer type right after the carcinoid tumors. Mucinous adenocarcinoma starts growing at the appendix lining and then release mucin.
  
• Mucinous Cystadenoma

These are non-cancerous tumors that develop in the epithelial lining of appendix. Mucinous cystadenomas do not spread across other parts of the body as long as the appendix is intact.

• Neuroendocrine Carcinoma

A typical cancer cell that forms tumor within certain cells of the bowel walls. About half of all the appendix cancers can metastasize or spread but can be treated successfully with surgery.

• Carcinoid Tumors

Nearly 50% of appendix cancers are carcinoid tumors. They affect the neuroendocrine cells that receive signals from nervous systems and then release hormones. In most of the cases, carcinoid tumors are slow-growing.

• Goblet Cell Carcinoma

Also known as GCC, the cancer cells grow inside both neuroendocrine cells and also a type of epithelial cell that secrete a jell-texture substance, also known as mucin. It onsets between ages fifty to fifty-five.

What Are The Different Stages Of Appendix Cancer & Treatments In Each Stage?

Stage 0

This is an early stage where the growth of abnormal cells is limited to the lining of appendix. The cells are often discovered incidentally. This stage is treatable with close monitoring and surgery and the risk of complications is low.

Stage I

At this stage, the cancerous tumor is confined to the appendix. Treatment involves appendectomy surgery. If the tumor is small and has not spread, it may deem to be curative. If the tumor spreads beyond appendix, addition options of treatment like radiation or chemotherapy or both is recommended for preventing recurrence. Regular examinations and follow-ups are suggested for monitoring metastasis or recurrence. With prompt diagnosis and medical intervention, Stage I appendix cancer patients can live good quality life and long-term survival.

Stage II

This stage indicates the spread of tumor beyond appendix but localized within the abdominal area. The primary treatment option here surgical resection of the tumorous growth as well as the affected tissues. In certain cases, adjuvant therapies, chemotherapy can be recommended for reducing the risk of cancer recurrence. Despite its local spread, many patients in this stage can live long-term with proactive treatment. Close monitoring with regular follow-ups and appointments are crucial for detecting progression or recurrence.

Stage III

Stage III appendix cancer reflects on the tumor, one of the appendix mass causes, which has spread to the adjacent lymph nodes and organs. For treatment, doctors prescribe combination of radiation, chemotherapy and surgery. The surgery aims at removing tumor, affected lymph nodes and involved organ tissues. Chemotherapy is then given to target any residual cancer cell for reducing the recurrence risk. Prognosis depends on factors like response to treatment, grade and tumor size.

Stage IV

Stage IV is considered to be the most advanced stage, reflecting on the cancer that has already metastasized to the organs beyond abdomen. The treatment for this stage focuses on palliative care for improving the quality of life and slowing the progression of the disease. Surgery is recommended for removing the metastasized tumors. Chemotherapy is given to shrink the tumors and control their growth. Other treatments like targeted immunotherapy are considered based on the response of individual patients. Despite all the challenges, advancements in treatment options as well as supportive care can have better outcomes and quality of life in patients can be improved.

Which country is best for Appendix cancer treatment?

Western countries come with a plethora of oncology care options but the biggest challenge is the cost. In that case, India stands as one of the most reliable countries that offers comprehensive, 360-degree appendix cancer care to patients hailing from all parts of the world. And the best part about seeking medical care in India is the cost. India, an emerging medical giant of the world has been a trusted haven for global patients seeking crucial cancer treatment options at economical packages. In the recent years, India’s healthcare industry has witnessed outstanding improvements and developments, leading to better outcomes for patients battling appendix cancer and all other cancers. Some of the benefits are:

• Advanced surgical procedures
• Multi-disciplinary approach
• Better diagnosis
• Better targeted therapy
• Precision medicine
• Early detection
• Increased awareness
• Internation collaboration (with healthcare professionals and organizations)
• Rehabilitation programs
• Supportive care

Tips For Selecting The Finest Appendix Cancer Treatment Hospital In India

Choosing the best appendix cancer care hospital in India requires careful consideration for ensuring desired outcomes and optimal care. Here are a few tips on selecting the best appendix cancer treatment hospital in India:

• The hospitals must have reliable reputation for cancer care and cancer research. Must be recognized by bodies like National Accreditation Bard For Hospitals & Healthcare Providers.
• The hospitals must follow an interdisciplinary approach and must give comprehensive care to the patients. The team must have care providers, pathologists, radiologists, surgeons and oncologists.
• Verify the track records, credentials and qualifications of the medical team.
• Choose hospitals that are well-equipped with state-of-the-art facilities, HIPEC, immunotherapy, targeted therapy, minimally invasive surgery etc.
• The hospitals must have proven track record in providing patient-centric care, compassionate support programs, personalized plans of treatment and holistic wellness programs.
• Look through the available patient feedback and testimonials.
• The hospital must have diverse specialists who collaborate for reviewing complex cancer cases. Come out with new treatment plans and provide expert suggestions.

How To Choose The Best Oncologist For Your Appendix Cancer Treatment In India?

Here are the considerations for choosing the best oncologist for appendix cancer in India:

• Research the best oncologist for appendix cancer in India and verify their certifications, qualifications and credentials. Choose the ones that have proven track record in successfully treating appendix cancer patients.
• Choose an oncologist who has expertise in treating gastrointestinal malignancy. He or she must have familiarity and in-depth knowledge of the latest treatment protocols and innovations in the field.
• The chosen or oncologist in consideration must be associated with reputed hospitals and cancer care centers.
• Choose an oncologist who collaborate with multidisciplinary team of surgeons, supportive care givers, pathologists, radiation oncologists, medical oncologists and surgeons.
• Choose an oncologist who works under patient-centric framework and prioritizes decision-making, empathy and clear communication. AN oncologist listens to patient and patient relatives, provides explanations, ideal plans for better quality of life and most importantly, foster confidence, hope and trust.
• The considered oncologist must have proven success record in the field of appendix surgery care.
• Seek referrals from trusted sources like family members with similar experience, friends, other healthcare professionals, etc.
• Ensure that the chosen oncologist is transparent always open and present for communication.

What Are The Details Of Appendix Cost In India?

Here’s a detailed break-down of the appendix cancer in India

Appendix Cancer Treatment	Minimum INR	Maximum INR	Average INR
Consultation	500	1500	1000
Diagnosis	1000	5000	3000
Surgery	75000	350000	175000
Chemotherapy	20000	100000	60000
Radiation	30000	150000	90000
Targeted Drug Therapy	15000	75000	45000
HIPEC	150000	500000	300000
Follow-Up	500	1500	1000
Total	292500	1278000	774000