Onset reveals potential cancer

DearDr. Roach: Recently I had a sudden onset of appendicitis and was operated on the following day laparoscopically. The surgeon explained to me that the surgery took longer than usual because of scar tissue from a total hysterectomy10 months earlier.

He said my appendix was enlarged and inflamed around the site and had some samples sent for testing on the chance of cancer. This blindsided me. He said if Iwerepositive for cancer, I wouldbe sent toanappendix oncology surgeon. This was totally unexpected and very upsetting.

The doctor said not to worry and that I would get the results in two weeks. Of course, I can’t stop worrying. Howcommonis this, and what is the likelihood of this coming to pass?— I.B.

Cancer of the appendix is very rare, found less than 1% of appendectomies. Sometimes, all the cancer cells have been completely removed in the appendectomy, while other times, further surgery is done tomake sure thecancer iscompletely gone. Many experts recommendfurther surgery on all patients with appendix cancer, but this is debated.

I.B. wrote back to say thetest result was negative for cancer and noted: “I have alwayswondered if patients need to know in advance if cancer is a possibility or if the doctor should wait until tests come back and break the bad news only if that comes to pass.

I’m not sure which way I lean.”

In general, I favor givingmy patients as much information as possible, and while in this case there was some reason to suspect cancerwasmore likely, I don’t feel telling people about aminuscule risk is helpful.

It certainly leads to greater anxiety. I’m curious what readers think and invite comments at my Facebook page, facebook. or by email.