For larger carcinoid appendix tumors (>2 cm) and other appendix cancers, surgeons may recommend removal of the appendix and the adjacent or nearby portion of the colon as well as the associated lymph nodes. This is to ensure that cancer cells are not left behind and to sample the lymph nodes for spread.

This specialized surgery is typically recommended for patients with later-stage appendix cancer that may have spread to the abdominal lining. During this procedure, specially trained surgeons will remove all the visible cancer and then perform a “washing” of the abdominal cavity with chemotherapy that has been heated to increase its effectiveness. Surgeons at the Markey Cancer Center are part of a team that performs a large number — more than 50 — of these complex cases every year.

Depending on the stage of your tumor, your surgeon may perform one of the following procedures:

Appendectomy. This is surgical removal of the appendix, often done thru small 3 mm incisions, and may be curative for small (<1.5 cm) carcinoid appendix tumors that have not spread. Healthy patients may be discharged on the same day of surgery.

Hemicolectomy. For larger carcinoid appendix tumors (>2 cm) and the other appendix cancers, surgeons may recommend removal of the appendix and the adjacent or nearby portion of the colon as well as the associated lymph nodes. This is to ensure that cancer cells are not left behind and to sample the lymph nodes for spread.

Cytoreductive surgery. This specialized surgery is typically recommended for patients with later-stage appendix cancer which may have spread to the abdominal lining. During this procedure, specially trained surgeons will remove all of the visible cancer, and then perform a “washing” of the abdominal cavity with chemotherapy that has been heated to increase its effectiveness. Surgeons at the Markey Cancer Center are part of a team that perform a high volume of these complex cases every year (>50).

The use of drugs to destroy cancer cells as they divide and grow. When appendix cancer has spread into the lymph nodes or other organs, your medical oncologist may recommend chemotherapy. Systemic chemotherapy refers to drugs that enter the bloodstream to kill cancer cells throughout the body. These drugs are administered or given by mouth (orally) or through an IV (intravenously). Depending on your specific circumstance, chemotherapy may be given before or after surgery.

A one-time administration of chemotherapy directly into the abdominal cavity, this treatment is most often combined with cytoreductive surgery. This specialized cutting-edge procedure allows your team to deliver a higher dose of chemotherapy directly onto the tissue and directly target microscopic cancer cells that are not visible on scans or to the eyes. Markey Cancer Center is a high-volume center for Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and has several experienced surgical oncologists trained in the procedure.