Appendiceal cancer and pseudomyxoma peritonei
Prepared with OnCo (onco.cc/prep/appendiceal/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
14 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example PSOGI histologic grade, Peritoneal cancer indexand completeness of cytoreduction, GNAS, KRAS, TP53, SMAD4, CEA, CA19-9, CA-125, MSI), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (localised lamn / adenocarcinoma), which of the standard options do you recommend and why?
- 6.Am I a candidate for FOLFOX (5-FU, leucovorin, oxaliplatin), CAPOX (capecitabine, oxaliplatin), and what side effects should I expect?
- 7.For my situation (pseudomyxoma peritonei / peritoneal disease), which of the standard options do you recommend and why?
- 8.For my situation (high-grade or unresectable peritoneal disease), which of the standard options do you recommend and why?
- 9.Am I a candidate for FOLFOX (5-FU, leucovorin, oxaliplatin), CAPOX (capecitabine, oxaliplatin), Bevacizumab, and what side effects should I expect?
- 10.Are there clinical trials I could join, for example of HIPEC / PIPAC (intraperitoneal chemotherapy), FOLFOX (5-FU, leucovorin, oxaliplatin)?
- 11.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 12.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 13.I read that “No effective systemic therapy for high-grade or signet-ring disease”. How does that affect my plan?
- 14.I read that “Selection for CRS-HIPEC and management of recurrence after maximal surgery”. How does that affect my plan?
The words I may hear
- Colectomy: Removing the part of the colon containing the cancer along with its blood supply and lymph nodes, then joining the ends.
- Peritoneal metastasis: Spread across the lining of the abdomen, the most common way stomach cancer recurs and the hardest to treat.
- Rare cancers: Rare cancers are those with fewer than about 6 new cases per 100,000 people per year.
Tests and results to bring
Biomarker results to ask for: PSOGI histologic grade, Peritoneal cancer index (PCI) and completeness of cytoreduction (CC score), GNAS (low-grade), KRAS, TP53, SMAD4, CEA, CA19-9, CA-125, MSI (rare).
Scans and tests linked to this cancer: CEA surveillance after colorectal cancer surgery, CT (computed tomography), MRI.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Localised LAMN / adenocarcinoma: Appendicectomy (LAMN without perforation) or right hemicolectomy (adenocarcinoma, goblet cell); adjuvant chemotherapy for node-positive adenocarcinoma by colorectal analogy. (FOLFOX (5-FU, leucovorin, oxaliplatin), CAPOX (capecitabine, oxaliplatin))
- High-grade or unresectable peritoneal disease: FOLFOX/CAPOX ± bevacizumab; systemic chemotherapy has no proven benefit in low-grade disease (randomised 2024). (FOLFOX (5-FU, leucovorin, oxaliplatin), CAPOX (capecitabine, oxaliplatin), Bevacizumab)
- Pseudomyxoma peritonei / peritoneal disease: Cytoreductive surgery with HIPEC at a peritoneal-surface-malignancy centre; repeat CRS for recurrence when feasible. (HIPEC / PIPAC (intraperitoneal chemotherapy))
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.