The pain was so sharp that Chris Williams took him to the hospital.
It was on a Tuesday evening in September 2021 that Williams began to drive stomach pains and nausea. By the next morning, it had gotten worse.
“I had to go to the ER,” said Williams, who lives in Brooklyn.
At the hospital, he was diagnosed with appendicitis and his appendix was surgically removed. About a week later, he met with the medical team to remove Staples and discuss the next steps. That’s when I received the shocking news.
“They discovered that the tumor was sitting in my appendix, and they biopsied the tumor and determined it was cancer,” said Williams, who was 48 at the time.
“It was actually a blessing,” he said. “This was truly a godly grace in my eyes and a blessing to detect tumors. They discovered it was stage III, so it stayed in me for a while.
Williams is now cancer after finishing The November 2022 treatment is one of the growth groups of US Appendix cancer patients diagnosed at a young age.
“Anxiety and worry”
The appendix that plays a role in supporting the immune system is a small pouch-like organ attached to the large intestine on the lower right side of the abdomen.
New research shows that cancer in the appendix is rare, but is estimated to affect approximately one to two people per million people each year in the US, but diagnosis is rising rapidly between X and millennial generations.
Compared to those born between 1941 and 1949, the incidence of appendix cancer has more than tripled among those born between 1976 and 1984, and more than four times more among those born between 1981 and 1989. These increases incidences were found to occur between 1975 and 2019.
“It’s generally surprising,” said Andreana Holowatij, PhD, principal research author at Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center and an assistant professor of hematology and oncology.
“We’ve seen some of these generational effects of colon, rectal and stomach cancer, so that’s one of the reasons why we were interested in exploring this with rare appendix cancer. But even so, the rates and trends we observed were surprisingly worried,” she said.
Researchers in new research at Vanderbilt University Medical Center, West Virginia University and the University of Texas Health Science Center analyzed data from 4,858 US people diagnosed with appendix cancer between 1975 and 2019.
The data were divided into age groups of five years, showing an increase in the incidence of appendix cancer by birth cohort, particularly among those born after 1945, the researchers wrote in the study.
While the new study did not specifically examine why this incidence is increased, researchers say it is “impossible” to be explained by advances in screening diseases and diagnostic tools.
“There is no standardized screening techniques for appendix cancer, many of which are discovered by chance after the presentation of something like acute appendicitis,” says Holowatyj.
Rather, the trend may be linked to “environmental exposure that could increase the risk of generations entering the mid-middle-to-middle-to-national total.” Similar trends have also been reported in colon, rectal and gastric cancers.
For example, obesity has been identified as a risk factor for the appendix cancer diagnosis and is recognized as a risk factor for colon cancer, Holowatyj said, adding that identifying risk factors that may promote these trends in cancer incidence can help clarify ways to prevent disease.
“The fact that we see these trends in parallel in other cancers of the gastrointestinal tract informs us or suggests that there may be both shared risk factors and different risk factors that may contribute to the development of cancer in the younger generation of gastroilia bone,” said Holowatii.
“It’s important to understand – what are those shared factors, or how these risk factors differ in both the size and absolute risk of these gastrointestinal cancer types – we aim to help develop effective preventive strategies and ultimately reduce this burden or reverse these trends,” she said.
Although there are no specific screening recommendations for appendix cancer, symptoms of the disease usually include abdominal or pelvic pain, bloating, nausea and vomiting. Appendix cancer may be treated surgically, and the appendix is removed. If the cancer is spreading, patients often receive chemotherapy.
“This is a disease in which tumor cells frequently disperse throughout the abdominal cavity if the appendix is not caught before it ruptures,” Holowatij said. “That’s why up to one in two patients is diagnosed with a metastatic disease,” or spreading cancer.
Research showing an increase in the incidence of appendix cancer in young adults is not surprising to Dr Andrea Cerseck, co-director of the Center for Early Onset Colorectal and Gastrointestinal Cancer at Memorial Sloan Kettering Cancer Center, which treated Williams.
“Early onset appendix cancer has been found to be part of the larger story of early onset GI cancer, including colorectal cancer,” said Cercek, who was not involved in the new study.
She has seen this trend firsthand among her patients, but certain factors that drive these increases remain unclear.
“There are a lot of suspects, lifestyle changes, diet changes, and so on. People talk about obesity, less activity. But there’s nothing that fits in at all. And there’s a change in the environment,” Celsek said. “I think it’s probably some sort of combination, something multifactorial, but I haven’t identified it yet. Thankfully there’s a lot of work. There’s a lot of research into this.”
Despite the increased incidence, Cercek emphasized that appendix cancer remains rare.
“Even though it’s rising, it’s very rare,” she said. “But that’s an important part of this comprehensive story about the rise in cancer in young adults.”
Williams’ journey after cancer diagnosis was not easy, he said, but he is grateful to his care team. After he was diagnosed, he sought treatment at Memorial Sloan Kettering Cancer Center in New York, where he underwent additional surgeries and chemotherapy.
“For me, I could see it in a few different ways. I could moan. I could complain. I could say, ‘Sadness is me.’ Or I was able to thank them for finding this and for the solution from a therapeutic point of view,” Williams said. “It could have been what killed me. I didn’t, so I feel like there’s something I should be grateful for in everything.”
Before the cancer diagnosis, Williams thought he was doing everything right. He was eating mostly healthy food and exercised regularly, but at the time he was working out as a project manager. In New York, he was also experiencing a lot of stress.
At 42, he had his first heart attack, he said. He suffered a second heart attack a few weeks after his appendix cancer diagnosis. He said a third of the cases then happened shortly after the surgery at Memorial Sloan Kettering Cancer Center. And last year, Williams had his fourth heart attack. The blockage was found in his heart and he said he was treated with a stent. There, flexible tubes were placed in the arteries to increase blood flow to the heart.
“Many of the things I went through have been due to stress,” Williams said.
“My personality was something I internalized a lot, especially among men, because we feel we have to carry the weight of the world on our shoulders,” he said. “But by doing so, when you’re internalizing, you’re making yourself sick. That internalization can lead to stress, which can lead to heart disease, stroke, which can lead to cancer.”
Inspired by his own health challenges, Williams launches a Brooklyn-based nonprofit mind, “body and soul,” which will help communities of color, especially black men from underserved communities, along with physical and mental health tools, to increase communication with healthcare providers and improve overall health.
“We are also teaching you how to defend yourself, as most of the challenges you face, especially when talking to men of color, are concerns that you won’t see or hear when you enter the hospital,” added Williams, who emphasized the importance of hearing your body and having a major doctor.
“I think it’s really important to start prioritizing putting together care teams,” he said, especially in times of times when men and women are diagnosed with a variety of illnesses at previous ages.” “We need to take a more holistic approach to how we treat ourselves and take care of ourselves.”