The appendix is a small pouch-like tubular structure about 3 to 6 inches in length. It is attached to the first section of the large intestine, in the lower right area of the abdomen. No one knows the function of the appendix.

Cancer of the appendix is rare. The organization, People Living with Cancer, estimates fewer than 100 Americans are diagnosed with the condition each year. The cause is unknown. Average age at diagnosis is about 40.

Patients with appendix cancer often don't have any symptoms. Signs that occur can be attributed to other conditions. Patients may experience accumulation of fluid in the abdomen, bloating, an increasing waistline, changes in bowel function, infertility and appendicitis.

Appendix cancer is one of several types of carcinoid tumors that can occur in the gastrointestinal tract. By the time of diagnosis, about half of the cancers have already spread beyond the appendix. The American Cancer Society estimates about 75 percent of patients with gastrointestinal carcinoid tumors die within 5 years.

Intraperitoneal Chemotherapy

The standard treatment for appendix cancer is surgery to remove as much of the cancer as possible. Patients may also receive chemotherapy.

Some hospitals are offering a different kind of treatment for appendix cancer, called intraperitoneal hyperthermic chemotherapy (IPHC, or "heated" chemo). First, doctors perform surgery to remove as much of the tumor as possible. The incision is temporarily closed. Then, while the patient is still under anesthesia, four catheters are inserted into the abdominal area. Next, a heated saline solution passes through a special circulating pump, through two of the catheters and into the abdomen. The solution circulates through the abdominal cavity and is drained through the two remaining catheters. Once the saline reaches about 107.6 degrees F chemotherapy agents are added to the solution. Circulation of the heated chemo drugs continues for about 90 minutes. Once the treatment is finished, the catheters are removed. Any remaining solution is drained from the body and the abdominal area is thoroughly irrigated with more saline solution. The surgical incisions are then permanently closed.

There are several advantages of IPHC over traditional chemotherapy. First, heat, by itself, has a killing effect on cancer cells. It also improves the ability of medications to get into the cancer cells. Since the drugs only circulate in a confined area of the body, doctors can use much higher concentrations of the drugs. Treatment is also completed in just one session, rather than several weeks or months of traditional chemotherapy.

Armando Sardi, M.D., Surgical Oncologist at Mercy Medical Center, says IPHC is best for patients with appendix cancer and other types of gastrointestinal cancers. About half of patients who otherwise have no hope of survival are living five or more years longer. In fact, one of his appendix cancer patients, who was not expected to live very long, has now survived almost 12 years after getting IPHC.

Experts warn, IPHC is not an easy treatment. Patients need vigilant monitoring to avoid overheating of the body, dangerous changes in fluid and electrolyte levels, and blood loss.

Information about intraperitoneal hyperthermic chemotherapy (IPHC) is available on the hospital's website at http://www.mdmercy.com.

For general information on appendix cancer or IPHC:

American Cancer Society

National Cancer Institute

People Living with Cancer

PMP Awareness Organization

PMP Pals