Just a day before World cancer day (celebrated on 4th Feb every year), doctors of Delhi successfully treated a 50-year-old man who was suffering from a rare mucinous tumor of the appendix. It was treated with the help of laparoscopic surgery. The patient complained of pain and fullness in the right lower abdomen for the last few days. An initial ultrasound followed by a CT scan of the abdomen indicated a burst appendix.
There was a large collection of fluid in the region of the appendix, around the liver with thickening of fat surrounding the intestines. The patient was further referred to Dr. Amit Javed, Director – Gastrointestinal Oncology and Laparoscopic Surgery, Fortis Hospital, Vasant Kunj.
The patient was stable and did not have signs of infection which mostly happens in a burst appendix, thus it was crucial to make a correct diagnosis.
On discussing with radiologists, the doctors at Fortis could not separately identify a perforated appendix, hence considering the possibility of a giant mucinous tumor of the appendix. The patient was planned for laparoscopic surgery.
The surgery involved removing the appendix (12 X 7 cms – ten times the size of a normal appendix), a portion of the small and large intestine along with the removal of the thickened fat surrounding the intestines.
Dr Amit Javed, Director Gastrointestinal Oncology and Laparoscopic Surgery, Fortis Hospital, Vasant Kunj said, “This was an extremely rare case, we were able to save the life of the patient owing to timely diagnosis and treatment. The challenge was that we had to be extremely careful and meticulous while doing this laparoscopic surgery. We had to avoid perforation of the appendix and any improper handling would have led to the rupture of the organ resulting in the spread of the tumor. We removed a part of the small intestine, the huge appendix, and a part of the large intestine along with the tumor deposits in the fat with a meticulous laparoscopic approach. This was definitely a life-threatening case as cancers of the appendix are very rare and the patient had minimal symptoms. Any delay in treatment would have led to the rupture of the appendix and further complications.”
Meanwhile speaking on World cancer day Dr JB Sharma, HOD, Sr Consultant, Medical Oncology, Action Cancer Hospital, Delhi, said’’ The third wave of covid was imminent; but with earlier exposures, vaccination coverage drives, and high low reported severity of omicron variant, I see this as a muted wave as compared to the earlier one. Though we are advising cancer patients with covid to hold on to their treatment for a week as and when they test positive and resume treatment as advised immediately after that. All cancer patients whether undergoing active treatment currently or not, as well as cancer care providers, must ensure timely vaccination and booster shot. Cancer patients are already low on their immunity, so we advise immunity boosters, high protein diet, and necessary local precautions such as saline gargles.’’
As the world faces the peak of the grip of the third wave of the Covid-19 pandemic, Delhi is reporting 3000 plus cases daily. The pandemic continues to have an impact on cancer patients, their families, and caregivers. Cancer cases in India too increased at an average annual rate of 1-2% from 2010-to 2019 (as per a report). The ongoing covid disease pandemic has certainly slowed down the cancer care progress (as per the IHME study). These delays and decreases in cancer diagnosis and treatment protocols have major impacts on the lives of cancer patients. As per Lancet’s study, all cancer services dropped significantly between 2020-2021 in India.
Dr Bhuvan Chugh, Consultant Oncologist-Max Gurgaon & Saket said that in 2020, 19.3 million people were diagnosed with cancer globally. Covid-19 has a tremendous impact on every aspect of life, but one of the biggest impacts related to human health and medical sciences is its effect on cancer. In the coming years, cancer rates will increase for a variety of reasons, including population growth. The major cancer cases will be in middle-income countries like India where late-stage diagnosis and lack of access to quality and affordable diagnosis and treatment are common.