Well-known actor dies at the age of 42! This type of cancer is easily misdiagnosed and missed, so middle-aged and elderly people should be especially vigilant!

Recently, 42-year-old Hollywood actor Adan Canto died of appendix cancer, which attracted widespread attention from the media and the public. Adan Canto was well-known for playing the role of Sunspot in "X-Men: Days of Future Past". The celebrity effect has aroused everyone's attention to this rare tumor.

Many people said that this is the first time they have heard of appendix cancer. Everyone knows that the appendix can get inflamed, but few have heard that the appendix can also get cancer. What exactly is this disease? Let's learn about it today.

Image source: Internet screenshot

Appendix, except appendicitis

Malignant tumors may also develop!

Everyone should be familiar with appendicitis, but few people have heard of appendix cancer.

Let’s first take a brief look at the appendix: the appendix is ​​located in the lower right abdomen, at the junction of the ileum and cecum. It has a slender structure and looks like an earthworm. It is generally about 5 to 6 cm long, about the same length as an adult’s little finger, but the specific size of each person’s appendix varies due to different body shape and congenital anatomical morphology.

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When the appendix becomes infected and inflamed, it is appendicitis. Then, if a tumor grows in the appendix, is it appendix cancer?

It is not so simple to say that appendix cancer is definitely appendix tumor, but conversely, appendix tumor is not necessarily appendix cancer. From the classification point of view, appendix tumors are roughly divided into epithelial appendix tumors and non-epithelial appendix tumors.

① Epithelial appendix tumors include non-invasive tumors and invasive tumors. Non-invasive tumors (benign) include serrated polyps with or without atypical hyperplasia, adenomas, low-grade mucinous tumors of the appendix, and high-grade mucinous tumors. Invasive tumors (malignant) mainly include mucinous adenocarcinoma, adenocarcinoma (similar to colon adenocarcinoma), poorly differentiated adenocarcinoma with signet ring cells, and goblet cell adenocarcinoma.

② Most non-epithelial appendix tumors are appendix neuroendocrine tumors, and very rare ones include appendix lymphoma, gastrointestinal stromal tumor, leiomyoma, etc.

Strictly speaking, appendix cancer refers specifically to epithelial malignant tumors of the primary appendix, namely, appendiceal mucinous adenocarcinoma, adenocarcinoma, goblet cell adenocarcinoma, etc.

In addition, sometimes there are appendix metastatic tumors, that is, other malignant tumors metastasize to the appendix, which are mostly invasion/metastasis of ovarian cancer. They do not belong to appendix cancer and are essentially ovarian cancer.

Compared with other cancers such as lung cancer, breast cancer, stomach cancer and liver cancer, appendix cancer is very rare and has a very low incidence rate. However, in recent years, the incidence rate has shown an upward trend.

According to the National Cancer Institute, one to two people in a million are diagnosed with this disease each year in the United States. It was this cancer that took the life of Audrey Hepburn.

Appendiceal cancer is easily missed or misdiagnosed

These people should pay special attention!

In traditional cognition, the appendix was once considered a "burden" and a dispensable organ. However, this seemingly unimportant place can also become cancerous, and appendix cancer is easily missed or misdiagnosed in clinical practice. It is basically regarded as appendicitis at the initial diagnosis. The possible reasons are:

① The incidence of appendix cancer is low and very rare, which leads to insufficient clinical attention and experience in diagnosis and treatment of this disease. When related symptoms appear, it is not easy to think of the possibility of this disease.

②The main reason is that this type of cancer has an insidious onset. There are often no symptoms in the early stages, or the symptoms are not obvious. Even if there are symptoms, they lack specificity and are atypical. The first thing that comes to mind is often appendicitis or other abdominal organ diseases.

Therefore, appendix cancer is usually difficult to diagnose before surgery. Most patients are misdiagnosed as appendicitis before surgery and undergo appendectomy. It is only during intraoperative freezing or postoperative pathological examination that appendix tumors are accidentally discovered and diagnosed, which may lead to some patients needing to undergo remedial surgery again. Sometimes, appendix tumors may be accidentally discovered during other abdominal and pelvic surgeries.

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Who is more likely to get appendix cancer? Due to the low incidence rate, there are few studies on the risk factors related to appendix cancer. The cause is still unclear. Usually, it is referred to colon cancer. Possible risk factors mainly include:

First, age: people over 40 years old have a higher risk of developing the disease;

The second is an unhealthy lifestyle, such as smoking, drinking, overwork, lack of physical activity, and long periods of sitting;

The third is dietary factors, such as irregular diet, overeating, etc.;

Fourth, there are other factors, such as genetic factors and family history of malignant tumors.

It can be seen that middle-aged and elderly people (especially those around 50 years old), people with bad habits, people with irregular diets and overeating, and people with a family history of cancer (especially a family history of gastrointestinal cancer) have a relatively higher risk of cancer.

How to prevent appendix cancer?

Since the cause of appendix cancer is unclear, there are currently no targeted primary etiology prevention measures. Based on the risk factors for cancer mentioned above, the following measures can be taken, such as:

①Quit smoking, stay away from secondhand smoke, and don’t drink alcohol.

②Avoid overwork and don’t stay up late.

③ Actively participate in physical activities and avoid sitting for long periods of time.

④ Arrange meals reasonably, develop good eating habits, eat regularly, do not overeat, avoid high-animal protein and high-fat diets, do not be addicted to red meat, try to eat less/no processed meat, eat more vegetables, fruits and other foods rich in crude fiber; pay attention to food hygiene.

⑤Control your weight and avoid obesity.

⑥Maintain a good attitude.

So, in order to prevent appendix cancer, can we avoid appendix cancer by preventively removing the appendix?

The incidence rate of appendix cancer is low, which means that the probability of getting this cancer is quite low. In this case, it is not worthwhile, necessary, or medically recommended to have a preventive surgery.

Can appendix cancer be detected early through screening? The incidence of appendix cancer is low, and the onset is insidious. There is still a lack of effective early detection measures. There are currently no recommended early screening measures. If you experience any discomfort, go to the hospital for further examination in time.

This article is a work of Science Popularization China-Starry Sky Project

Produced by: Science Popularization Department of China Association for Science and Technology

Producer｜China Science and Technology Press Co., Ltd., Beijing Zhongke Xinghe Culture Media Co., Ltd.

Author: Pan Zhanhe, Chief Physician, Master's Supervisor, Department of Oncology, Zhongshan Hospital, Xiamen University

Reviewer: Tang Qin, Director and Researcher of the Science Popularization Department of the Chinese Medical Association