Cecal cancer is a special type of cancer that can first occur in the colon. Signs and symptoms can be difficult to detect until the cancer is advanced, but may include abdominal pain, bloating, weight loss, and tarry stools.
Historical studies show that up to 20% of colorectal cancers occur in the cecum (though some studies say it’s much less common). Cecal cancer is usually detected during a colonoscopy. However, the prognosis for this type of colon cancer is worse because the test cannot always reach the cecum.
This article describes the signs and symptoms of appendix cancer, as well as how to diagnose and treat it.
Very Well / Brianna Gilmartin
Anatomy and function of the cecum
To better understand the symptoms to expect from cecal cancer, it is helpful to review the anatomy and function of the colon during the digestive process.
After food is broken down into liquid by the stomach, it enters the small intestine, where most of the nutrients are absorbed into the bloodstream. The digested material then moves to the large intestine, which includes the colon. The function of the colon is to absorb remaining nutrients from digested material and reabsorb water to create stool (poo).
The colon is divided into five parts.
- cecum: The cecum is the first part of the colon, located in the lower right abdomen near the appendix, and is the first point of entry for digestive fluids from the small intestine. The cecum and ascending colon make up what is known as the “right colon.”
- Ascending colon: The ascending colon extends along the right side of the abdomen to the transverse colon.
- transverse colon: This part of the colon runs horizontally across the upper abdomen from right to left.
- descending colon: The descending colon runs along the left side of the abdomen from the top to the bottom.
- sigmoid colon: The sigmoid colon connects the descending colon to the rectum and anus.
The location of the cecum may make it more difficult to detect cancer than in other areas of the colon.
Symptoms of appendix cancer
Common symptoms of colorectal cancer overall include changes in bowel movements, rectal bleeding, and frequent urges to defecate that do not subside with bowel movements. With appendix cancer, you may not experience these obvious symptoms. Symptoms of cecal cancer can be nonspecific and often differ from traditional colon cancer symptoms.
The waste that passes through the cecum is mushy and can easily bypass the lumps in this part of the large intestine, so inflammation of the cecum does not make you feel the urge to defecate or disrupt your bowel habits (although it may be accompanied by diarrhea). ).
Unfortunately, most of the symptoms of appendix cancer go unnoticed until the disease is advanced. Potential symptoms include:
- anemia: Bleeding from this area of the colon is often visible under a microscope and goes unnoticed until your health care provider discovers iron deficiency anemia on a complete blood count (CBC). Symptoms associated with anemia may include fatigue, shortness of breath, weakness, and increased heart rate. Anemia should always be tested, especially in men and postmenopausal women.
- black tarry stool (melena): Bleeding in the cecum and ascending colon usually results in black stool that looks tarry, rather than the bright red stool seen with bleeding further down the gastrointestinal tract.
- gas and bloating: Gas and bloating may occur, but are often nonspecific. This means that it can have many different causes and is often initially thought to be caused by something else.
- abdominal pain: If pain is present, it may be located at the McBurney points, which are known for appendicitis pain. This point can be found by drawing a line from your right hipbone to your belly button and finding its midpoint. Abdominal pain can be diffuse and difficult to identify.
- nausea and vomiting: Large tumors on the right side of the colon can cause food to “reflux” into the small intestine and stomach, causing vomiting. Biliary vomiting (yellow color) is common.
- weight loss: Unintentional weight loss is common in advanced tumors and should always be checked. Unintentional weight loss is defined as losing 5% or more of your body weight without effort over a period of 6 to 12 months. This is equivalent to a 150-pound person losing 7.5 pounds without taking any action.
diagnosis
Colonoscopy is the best test for visually detecting cecal cancer. During a colonoscopy, a health care professional advances a colonoscope through the colon and into the cecum to look for polyps or suspicious growths that may be cancerous. If polyps are found, they can be removed during surgery.
Because most colon cancers start like this: pre-cancerous Colonoscopy can not only detect cancer by removing polyps, but it can also prevent cancer.
Approximately 10% of the time during a colonoscopy, the colonoscope will not be able to penetrate the cecum and will miss this area. This can be caused by adhesions or other problems that make the colon tortuous or difficult to move.
You can also give a barium enema, but it can be inaccurate. In this case, virtual colonoscopy may be able to detect cecal cancer even if other tests fail.
Other tests, such as a computed tomography (CT scan) of the abdomen, may also be done to explore the area of the appendix and look for evidence of cancer spread.
Unfortunately, flexible sigmoidoscopy, a test sometimes used to screen for colon cancer, evaluates only the left side of the colon and misses cancers in the cecum and right colon.
Differential diagnosis
Just because you have the above symptoms does not mean you have appendix cancer. There are several different conditions that have similar symptoms. These include:
cecal torsion
A rare condition, cecal torsion occurs when the cecum and ascending colon twist, creating an obstruction that prevents the passage of stool through the intestines. This twisting can cause abdominal pain, swelling, cramping, nausea, and vomiting.
It may be caused by pregnancy, a severe coughing fit, or abdominal adhesions (scar tissue in the abdomen from previous surgery). It most often occurs in people between the ages of 30 and 60.
inflammatory bowel disease
Inflammatory bowel disease (IBD), which includes diseases such as Crohn’s disease and ulcerative colitis, can cause abdominal pain, swelling, and irregular bowel movements, among other symptoms. IBD not only mimics the symptoms of colon cancer but is also a risk factor for the development of colon cancer.
acute appendicitis
Because the appendix is connected to the cecum, the symptoms of appendicitis are very similar to those of cecum cancer, including nausea, vomiting, and abdominal pain that is most severe in the lower right quadrant. However, cecal cancer can cause inflammation of the appendix, and as a result, it may be diagnosed earlier than cecal cancer.
process
During your colonoscopy, your health care provider may perform a polypectomy. However, if the cancer is too large to be removed with polypectomy, additional surgery may be needed to remove the cancer. The most common surgery for cecal cancer is called cecal cancer. right colectomy. This surgery involves removing the right side of the colon and reattaching the remaining part to the small intestine.
Depending on the stage and aggressiveness of your cancer, your health care provider may also recommend adjuvant treatments such as chemotherapy or radiation therapy.
prognosis
The prognosis for cecal cancer is slightly worse than for other colon cancers, but this is probably related to the fact that the disease is more difficult to diagnose in its early stages.
Cecal cancer can be more difficult to diagnose because the symptoms are different from colon cancer, which is located further in the colon, and because this area is difficult to visualize on screening tests. Compared to left-sided colon cancer, survival rates for right-sided colon cancers, such as those of the cecum, are slightly lower.
Despite this prognosis, right-sided colon cancer is less likely to spread (metastasize) to the liver or lungs than left-sided colon cancer.
A word from Berrywell
Tell your doctor if you have signs or symptoms that suggest appendix cancer. Some of these symptoms may raise concerns about other serious symptoms.
Fortunately, screening colonoscopies for colon cancer are saving lives and are expected to improve survival rates in the future.