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  • KRAS G12D appendix cancer patient education graphic on a dark teal background
    • Appendix Cancer 101Your guide to understanding a rare disease, appendix cancer. Learn about types, symptoms, diagnosis, staging, and treatment options like surgery, HIPEC, and chemotherapy—all in one accessible, patient-friendly resource.
      • What is Appendix Cancer?Appendix cancer is a rare abdominal cancer. Learn how appendiceal cancer develops, how it’s diagnosed, and what treatment options exist. APPENDICURE raises awareness for research, recognizing symptoms, diagnosis, surgery, chemotherapy, HIPEC and PIPAC treatment options.
      • Glossary of Medical TermsDecode complex medical terms with our easy-to-understand glossary. Designed for patients and caregivers, this section explains the language used in appendix cancer diagnosis, treatment, surgery, and recovery. Decipher acronyms such as CRS, HIPEC, PIPAC, SRCC.
      • Types of Appendix CancerUnderstand the different forms of appendiceal cancer—from slow-growing tumors to aggressive variants—and what each diagnosis means for treatment and care of this rare appendix cancer. Become familiar medical terms – LAMN Low-grade Appendiceal Mucinous Neoplasm, HAMN High-grade Appendiceal Mucinous Neoplasm, HIPEC Hyperthermic Intraperitoneal Chemotherapy, CRS Cytoreductive Surgery, and SRCC Signet Ring Cell Adenocarcinoma.
      • Pseudomyxoma Peritonei (PMP)
      • Diagnosis & TreatmentFacing a rare gastric cancer can be overwhelming. This section offers clear, compassionate guidance on how appendix cancer is identified and the treatment paths available to you. Learn about chemo, hemicolectomy surgery, cytoreductive surgery CRS, HIPEC, clinical trials, and immunotherapy.
      • CDK4/6 Inhibitors and GNAS-Mutated Appendiceal Cancer
      • Research & InnovationsExplore the latest breakthroughs in appendix cancer—from emerging treatments to promising clinical trials. We spotlight progress that brings hope to patients, caregivers, and advocates. We share research on LAMN Low-grade Appendiceal Mucinous Neoplasm, HAMN High-grade Appendiceal Mucinous Neoplasm, HIPEC Hyperthermic Intraperitoneal Chemotherapy, CRS Cytoreductive Surgery, SRCC Signet Ring Cell Adenocarcinoma, PIPAC Pressurized Intraperitoneal Aerosolized Chemotherapy, Hemicolectomy, and more.
    • Patient & Caregiver ResourcesAPPENDICURE supports appendix cancer patients and caregivers with resources for medical centers, appendiceal surgical oncologists, and HIPEC certified specialists. From diagnosis to survivorship, explore resources designed to inform, uplift, and guide. Whether you’re a rare abdominal cancer patient or caregiver, you’re not alone—and you don’t have to figure it out alone.
      • Medical Centers & ProvidersFind hospitals, specialists, and care teams experienced in treating appendix cancer. We help connect you to the rare abdominal cancer and HIPEC expertise you deserve—because where you go matters. Appendiceal cancer medical and surgical oncologists will discuss diagnosis, treatment plans, and surgery options that align with current research.
      • Support NetworksYou’re not alone. Connect with others who understand the appendix cancer journey—through peer groups, online communities, and caregiver circles built around empathy and shared experience. Explore resources created by appendiceal cancer oncologists, research teams, and cancer awareness advocates that offer guidance on treatment options, financial assistance programs, emotional support groups, and survivorship tips.
      • WebinarsJoin expert-led sessions that break down complex topics, share lived experiences, and offer guidance for patients, caregivers, and advocates navigating appendix cancer. Ask questions about diagnosis, treatment, chemotherapy, hemicolectomy surgery, CRS surgery, HIPEC, PIPAC, caregiver roles, support groups, recovery processes, and spreading awareness.
      • Appendix Cancer Web ResourcesAccess trusted appendix cancer information, downloadable guides, caregiver tools, and appendiceal cancer advocacy materials—all in one place. These resources are designed to educate, empower, and support your cancer journey. We’ve collected resources for you covering treatment, and support on one convenient page.
      • Mental Health Support
      • Patient & Caregiver StoriesReal voices. Real journeys. Discover powerful stories from those affected by appendix cancer—offering hope, insight, and connection for every step of the appendiceal cancer path. Listen to our community of appendiceal cancer survivors as they share their journey through symptoms, diagnosis, treatment, surgery, HIPEC, and recovery.
    • Appendix Cancer Registry
    • For Researchers & Clinicians
      • Standard of Care: 2025 Guidelines
      • Clinician Guides by Specialty
      • Appendix Cancer for Pathologists
      • Registry for Investigators
      • Refer a Patient
      • Clinical Trials
    • Stay ConnectedSubscribe for updates on appendix cancer research, support resources, awareness, and upcoming events. Join our email list and follow us on social media to stay informed and inspired.
      • Blog PostsRead expert insights, patient stories, and the latest updates on appendix cancer care, research, and advocacy. Our blog is a source for appendiceal cancer education and community connection. Share our blog to spread appendix cancer awareness.
      • Data Registry & AI
    • Meet the TeamThe people behind APPENDICURE. Patients, caregivers, survivors, and advocates working to support the appendix cancer community.
      • Board of Directors
      • CUREator Crew
    • Contact UsConnect with the APPENDICURE team to learn more about appendix cancer, share your story, or get involved. We welcome inquiries from patients, caregivers, researchers, and anyone passionate about rare appendiceal cancer advocacy.
    Amanda Moore Avatar
    Amanda Moore

    KRAS G12D and Appendix Cancer – New Developments

    June 26, 2026

    If you have the KRAS G12D mutation, you already know these drugs are being tested in other cancers. Two big announcements today tell me we’re that much closer to them being tested in appendix cancer too.

    What KRAS G12D actually is

    KRAS is a gene. In a healthy cell, it works like a switch that turns on to tell the cell to grow, then turns back off. When KRAS is mutated, the switch can get stuck on, and the cell keeps getting a grow signal it can’t shut off. G12D is one specific version of that stuck switch. It’s also the most common KRAS change in mucinous appendix tumors, which is why it’s the one your care team watches for.

    Two ways to hit the same target

    Diagram comparing KRAS G12D inhibitors that block the switch and degraders that remove it

    For a long time, no one could build a drug that hit this switch. That’s changed, and there are now two ways to do it. The first is an inhibitor. It sits on the stuck switch so it can’t send its grow signal. The second is a degrader. Instead of just blocking the switch, it tags the switch so the cell clears it out completely. Both go after the same mutation, just in different ways.

    The drugs to watch

    A few of these are getting the most attention right now. Two are inhibitors. One is VS-7375, from Verastem. Another is zoldonrasib, from Revolution Medicines. The third is a degrader called setidegrasib, from Astellas. Those three are among the furthest along.

    They aren’t the only ones. Other companies are testing their own G12D drugs, some inhibitors and some degraders, with more in early trials. Here’s the wider list worth keeping an eye on.

    KRAS G12D drugs to watch, inhibitors VS-7375 zoldonrasib INCB161734 and HRS-4642 and degraders setidegrasib ARV-806 and ASP4396

    What these drugs are doing in other cancers

    In pancreatic and lung cancer, these drugs are working. In early trials, tumors have shrunk, and some people who had run out of other options have responded. The results were strong enough that two of the three have already moved into large, late-stage trials, and one earned an FDA Fast Track designation, which is the FDA’s way of saying a drug matters enough to push it along faster. One of them had its early results published in the New England Journal of Medicine, one of the most respected journals in medicine. It’s early, but it’s real.

    Where KRAS G12D appendix cancer research stands today

    So far, all of this has happened in other cancers, mostly pancreatic and lung. For KRAS G12D appendix cancer, the work is still in the lab. Researchers have tested these same ideas in appendix cancer organoids, which are tiny tumors grown from real patient tissue, and in mice. That early work looks promising, but it’s not the same as a person with appendix cancer taking one of these drugs and getting better. Don’t change anything about your treatment based on this. These drugs are not approved or available for appendix cancer yet.

    Why this still matters for you

    So many appendix tumors carry the exact same KRAS G12D mutation these drugs are built to hit. When a drug keeps working in one cancer, researchers start asking which other cancers it could help. Appendix cancer is near the top of that list, because so many of us carry G12D. Every new result makes the case stronger for testing these drugs in us too.

    One more reason I’m hopeful

    We aren’t watching this from the outside. I’ve started talking with people inside this work about what it would take to bring appendix cancer into these trials, and those conversations are happening right now. I can’t share details yet, and nothing is promised. But our community is being represented where these decisions get made, and I’ll tell you more the moment I can.

    What you can do now

    There are two things worth doing right now. First, know your own mutation status. Ask your oncologist whether your tumor has had molecular or genetic testing, and whether KRAS showed up. If it did, ask which exact change it is. Knowing whether you carry G12D puts you a step ahead if a matched trial ever opens. Second, get counted. Appendix cancer is rare, and researchers often can’t find enough patients to study or to fill a trial. The Patient-Led Global Appendix Cancer Registry exists to fix that. When you add your information, you help us show researchers there’s a real group of patients ready and waiting.

    You can join the registry here. It takes a few minutes, it’s open to patients and caregivers anywhere in the world, and every entry makes our community easier to find and harder to overlook.

    None of this is a promise yet. But after years with no targeted options, having real drugs aimed right at our mutation is something to hold onto. And if you can chip in to help us move faster, you can support Appendicure here. Every dollar goes toward education, research, and finding the patients who still need to be found.

    Read next: Appendix Cancer Drug Discovery: KRAS Inhibitors & Registry

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  • Appendicure patient interview graphic about appendix cancer misdiagnosed as ovarian cancer
    • Appendix Cancer 101Your guide to understanding a rare disease, appendix cancer. Learn about types, symptoms, diagnosis, staging, and treatment options like surgery, HIPEC, and chemotherapy—all in one accessible, patient-friendly resource.
      • What is Appendix Cancer?Appendix cancer is a rare abdominal cancer. Learn how appendiceal cancer develops, how it’s diagnosed, and what treatment options exist. APPENDICURE raises awareness for research, recognizing symptoms, diagnosis, surgery, chemotherapy, HIPEC and PIPAC treatment options.
      • Glossary of Medical TermsDecode complex medical terms with our easy-to-understand glossary. Designed for patients and caregivers, this section explains the language used in appendix cancer diagnosis, treatment, surgery, and recovery. Decipher acronyms such as CRS, HIPEC, PIPAC, SRCC.
      • Types of Appendix CancerUnderstand the different forms of appendiceal cancer—from slow-growing tumors to aggressive variants—and what each diagnosis means for treatment and care of this rare appendix cancer. Become familiar medical terms – LAMN Low-grade Appendiceal Mucinous Neoplasm, HAMN High-grade Appendiceal Mucinous Neoplasm, HIPEC Hyperthermic Intraperitoneal Chemotherapy, CRS Cytoreductive Surgery, and SRCC Signet Ring Cell Adenocarcinoma.
      • Pseudomyxoma Peritonei (PMP)
      • Diagnosis & TreatmentFacing a rare gastric cancer can be overwhelming. This section offers clear, compassionate guidance on how appendix cancer is identified and the treatment paths available to you. Learn about chemo, hemicolectomy surgery, cytoreductive surgery CRS, HIPEC, clinical trials, and immunotherapy.
      • CDK4/6 Inhibitors and GNAS-Mutated Appendiceal Cancer
      • Research & InnovationsExplore the latest breakthroughs in appendix cancer—from emerging treatments to promising clinical trials. We spotlight progress that brings hope to patients, caregivers, and advocates. We share research on LAMN Low-grade Appendiceal Mucinous Neoplasm, HAMN High-grade Appendiceal Mucinous Neoplasm, HIPEC Hyperthermic Intraperitoneal Chemotherapy, CRS Cytoreductive Surgery, SRCC Signet Ring Cell Adenocarcinoma, PIPAC Pressurized Intraperitoneal Aerosolized Chemotherapy, Hemicolectomy, and more.
    • Patient & Caregiver ResourcesAPPENDICURE supports appendix cancer patients and caregivers with resources for medical centers, appendiceal surgical oncologists, and HIPEC certified specialists. From diagnosis to survivorship, explore resources designed to inform, uplift, and guide. Whether you’re a rare abdominal cancer patient or caregiver, you’re not alone—and you don’t have to figure it out alone.
      • Medical Centers & ProvidersFind hospitals, specialists, and care teams experienced in treating appendix cancer. We help connect you to the rare abdominal cancer and HIPEC expertise you deserve—because where you go matters. Appendiceal cancer medical and surgical oncologists will discuss diagnosis, treatment plans, and surgery options that align with current research.
      • Support NetworksYou’re not alone. Connect with others who understand the appendix cancer journey—through peer groups, online communities, and caregiver circles built around empathy and shared experience. Explore resources created by appendiceal cancer oncologists, research teams, and cancer awareness advocates that offer guidance on treatment options, financial assistance programs, emotional support groups, and survivorship tips.
      • WebinarsJoin expert-led sessions that break down complex topics, share lived experiences, and offer guidance for patients, caregivers, and advocates navigating appendix cancer. Ask questions about diagnosis, treatment, chemotherapy, hemicolectomy surgery, CRS surgery, HIPEC, PIPAC, caregiver roles, support groups, recovery processes, and spreading awareness.
      • Appendix Cancer Web ResourcesAccess trusted appendix cancer information, downloadable guides, caregiver tools, and appendiceal cancer advocacy materials—all in one place. These resources are designed to educate, empower, and support your cancer journey. We’ve collected resources for you covering treatment, and support on one convenient page.
      • Mental Health Support
      • Patient & Caregiver StoriesReal voices. Real journeys. Discover powerful stories from those affected by appendix cancer—offering hope, insight, and connection for every step of the appendiceal cancer path. Listen to our community of appendiceal cancer survivors as they share their journey through symptoms, diagnosis, treatment, surgery, HIPEC, and recovery.
    • Appendix Cancer Registry
    • For Researchers & Clinicians
      • Standard of Care: 2025 Guidelines
      • Clinician Guides by Specialty
      • Appendix Cancer for Pathologists
      • Registry for Investigators
      • Refer a Patient
      • Clinical Trials
    • Stay ConnectedSubscribe for updates on appendix cancer research, support resources, awareness, and upcoming events. Join our email list and follow us on social media to stay informed and inspired.
      • Blog PostsRead expert insights, patient stories, and the latest updates on appendix cancer care, research, and advocacy. Our blog is a source for appendiceal cancer education and community connection. Share our blog to spread appendix cancer awareness.
      • Data Registry & AI
    • Meet the TeamThe people behind APPENDICURE. Patients, caregivers, survivors, and advocates working to support the appendix cancer community.
      • Board of Directors
      • CUREator Crew
    • Contact UsConnect with the APPENDICURE team to learn more about appendix cancer, share your story, or get involved. We welcome inquiries from patients, caregivers, researchers, and anyone passionate about rare appendiceal cancer advocacy.
    Amanda Moore Avatar
    Amanda Moore

    Appendix Cancer Misdiagnosed as Ovarian Cancer 2 Times: Connie’s Story

    June 26, 2026

    Connie Zickler felt a sharp pain under her sternum in 2016. She thought her bra was the wrong size. It took five years and two wrong diagnoses before anyone said the words appendix cancer. Twice she was told she had ovarian cancer, and she had surgery to remove her ovaries before anyone found the real source. An appendix cancer misdiagnosed as ovarian cancer is more common than people think, and it happens to women a lot.

    Appendix cancer misdiagnosed as ovarian cancer: a common story for women

    Appendix cancer often shows up low in the belly and near the ovaries. On a scan it can look like ovarian cancer, so that is the call doctors make. Connie had her ovaries removed and was told she did not have cancer, just some strange fatty deposits. When her disease came back, a scan showed lesions and she was told her ovarian cancer had returned. None of it was ovarian cancer.

    A specialist at Fred Hutch heard her story and knew what it was over the phone. Her diagnosis was a low grade appendiceal mucinous neoplasm, or LAMN, that had spread in her abdomen. The appendix was the only place they found actual cancer cells. An appendix cancer misdiagnosed as ovarian cancer can cost a patient years, and it cost Connie five.

    Connie had cytoreductive surgery with heated chemotherapy, known as CRS and HIPEC. In 2024 her tumor markers started to climb, which told her team the cancer was back.

    The drug she had to ask for by name

    Connie reads about her own cancer. She learned she carries two mutations that matter, called KRAS and GNAS, along with a third rare one her team is still trying to understand. She asked her oncologist for palbociclib, also sold as Ibrance. It is a CDK4/6 inhibitor, a drug better known in breast cancer. Researchers at UC San Diego, including Dr. Andrew Lowy, have studied this kind of drug in patients with GNAS mutated mucinous appendiceal disease. The work is early and the studies are small, and her oncologist was cautious for exactly that reason.

    Whether you can get a drug that fits your tumor should not depend on whether your doctor is good at fighting insurance companies. That is the gap Appendicure is working to close.

    Connie got the drug. Many patients with the same mutations get denied. Her oncologist is known for getting these approvals, and her insurance said yes. That is rare, and it should not be.

    Connie has been on palbociclib for close to a year now, and her tumor markers, including her CEA and CA 19-9, have come down a lot. That is real, and it matters. It does not mean the drug is a cure, or that it will work the same way for anyone else. I am sharing what one patient chose, why she fought for it, and what has happened for her so far.

    Watch for the full interview

    There is much more to Connie’s story. I recorded a full conversation with her, and it goes up on appendicure.com tomorrow. Check back here to watch it. She talks about the years of being dismissed, the specialist who finally listened, and what she would tell anyone still searching for answers.

    If your appendix cancer was first called something else, you are not alone. An appendix cancer misdiagnosed as ovarian cancer happens more than the numbers show, and your experience matters. You can add it to the patient led registry so researchers can see how often this happens. Share your story in the registry.

    If you would like to share your own story, on a Zoom call or a blog post, email me at info@appendicure.com.

    Appendicure is a nonprofit. Every dollar goes directly toward research, patient education, and the registry. If this work matters to you, you can donate here.

    Read next

    Your CDK4/6 Story, Ibrance, Verzenio, or Kisqali, Could Change the Guidelines

    The Data That Could Help Doesn’t Exist Yet. We’re Building It.

    MSI Testing in Appendix Cancer: The Rare 3% That Matters

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  • Teal graphic stating the appendix cancer once called goblet cell carcinoid is now goblet cell adenocarcinoma, GCA, under WHO 2019
    • Appendix Cancer 101Your guide to understanding a rare disease, appendix cancer. Learn about types, symptoms, diagnosis, staging, and treatment options like surgery, HIPEC, and chemotherapy—all in one accessible, patient-friendly resource.
      • What is Appendix Cancer?Appendix cancer is a rare abdominal cancer. Learn how appendiceal cancer develops, how it’s diagnosed, and what treatment options exist. APPENDICURE raises awareness for research, recognizing symptoms, diagnosis, surgery, chemotherapy, HIPEC and PIPAC treatment options.
      • Glossary of Medical TermsDecode complex medical terms with our easy-to-understand glossary. Designed for patients and caregivers, this section explains the language used in appendix cancer diagnosis, treatment, surgery, and recovery. Decipher acronyms such as CRS, HIPEC, PIPAC, SRCC.
      • Types of Appendix CancerUnderstand the different forms of appendiceal cancer—from slow-growing tumors to aggressive variants—and what each diagnosis means for treatment and care of this rare appendix cancer. Become familiar medical terms – LAMN Low-grade Appendiceal Mucinous Neoplasm, HAMN High-grade Appendiceal Mucinous Neoplasm, HIPEC Hyperthermic Intraperitoneal Chemotherapy, CRS Cytoreductive Surgery, and SRCC Signet Ring Cell Adenocarcinoma.
      • Pseudomyxoma Peritonei (PMP)
      • Diagnosis & TreatmentFacing a rare gastric cancer can be overwhelming. This section offers clear, compassionate guidance on how appendix cancer is identified and the treatment paths available to you. Learn about chemo, hemicolectomy surgery, cytoreductive surgery CRS, HIPEC, clinical trials, and immunotherapy.
      • CDK4/6 Inhibitors and GNAS-Mutated Appendiceal Cancer
      • Research & InnovationsExplore the latest breakthroughs in appendix cancer—from emerging treatments to promising clinical trials. We spotlight progress that brings hope to patients, caregivers, and advocates. We share research on LAMN Low-grade Appendiceal Mucinous Neoplasm, HAMN High-grade Appendiceal Mucinous Neoplasm, HIPEC Hyperthermic Intraperitoneal Chemotherapy, CRS Cytoreductive Surgery, SRCC Signet Ring Cell Adenocarcinoma, PIPAC Pressurized Intraperitoneal Aerosolized Chemotherapy, Hemicolectomy, and more.
    • Patient & Caregiver ResourcesAPPENDICURE supports appendix cancer patients and caregivers with resources for medical centers, appendiceal surgical oncologists, and HIPEC certified specialists. From diagnosis to survivorship, explore resources designed to inform, uplift, and guide. Whether you’re a rare abdominal cancer patient or caregiver, you’re not alone—and you don’t have to figure it out alone.
      • Medical Centers & ProvidersFind hospitals, specialists, and care teams experienced in treating appendix cancer. We help connect you to the rare abdominal cancer and HIPEC expertise you deserve—because where you go matters. Appendiceal cancer medical and surgical oncologists will discuss diagnosis, treatment plans, and surgery options that align with current research.
      • Support NetworksYou’re not alone. Connect with others who understand the appendix cancer journey—through peer groups, online communities, and caregiver circles built around empathy and shared experience. Explore resources created by appendiceal cancer oncologists, research teams, and cancer awareness advocates that offer guidance on treatment options, financial assistance programs, emotional support groups, and survivorship tips.
      • WebinarsJoin expert-led sessions that break down complex topics, share lived experiences, and offer guidance for patients, caregivers, and advocates navigating appendix cancer. Ask questions about diagnosis, treatment, chemotherapy, hemicolectomy surgery, CRS surgery, HIPEC, PIPAC, caregiver roles, support groups, recovery processes, and spreading awareness.
      • Appendix Cancer Web ResourcesAccess trusted appendix cancer information, downloadable guides, caregiver tools, and appendiceal cancer advocacy materials—all in one place. These resources are designed to educate, empower, and support your cancer journey. We’ve collected resources for you covering treatment, and support on one convenient page.
      • Mental Health Support
      • Patient & Caregiver StoriesReal voices. Real journeys. Discover powerful stories from those affected by appendix cancer—offering hope, insight, and connection for every step of the appendiceal cancer path. Listen to our community of appendiceal cancer survivors as they share their journey through symptoms, diagnosis, treatment, surgery, HIPEC, and recovery.
    • Appendix Cancer Registry
    • For Researchers & Clinicians
      • Standard of Care: 2025 Guidelines
      • Clinician Guides by Specialty
      • Appendix Cancer for Pathologists
      • Registry for Investigators
      • Refer a Patient
      • Clinical Trials
    • Stay ConnectedSubscribe for updates on appendix cancer research, support resources, awareness, and upcoming events. Join our email list and follow us on social media to stay informed and inspired.
      • Blog PostsRead expert insights, patient stories, and the latest updates on appendix cancer care, research, and advocacy. Our blog is a source for appendiceal cancer education and community connection. Share our blog to spread appendix cancer awareness.
      • Data Registry & AI
    • Meet the TeamThe people behind APPENDICURE. Patients, caregivers, survivors, and advocates working to support the appendix cancer community.
      • Board of Directors
      • CUREator Crew
    • Contact UsConnect with the APPENDICURE team to learn more about appendix cancer, share your story, or get involved. We welcome inquiries from patients, caregivers, researchers, and anyone passionate about rare appendiceal cancer advocacy.
    Amanda Moore Avatar
    Amanda Moore

    Goblet Cell Adenocarcinoma: What the New Name Means for Patients

    June 26, 2026

    If you or someone you love has goblet cell cancer of the appendix, you’ve probably heard it called more than one thing. One doctor says “goblet cell carcinoid.” A pathology report says “adenocarcinoma.” A support group post calls it “GCA.” A second opinion uses a word you’ve never seen. That’s confusing, and it isn’t your fault. This cancer has carried more than ten names over the years. In 2019 the World Health Organization settled on one. The current name is goblet cell adenocarcinoma, or GCA.

    The name change wasn’t a small edit. It changed how doctors think about the disease.

    A tumor that looks like two things at once

    GCA is a rare cancer that starts in the appendix. It almost never starts anywhere else. Under the microscope it looks unusual. The cells carry two different looks at the same time. Some look like the mucus-making goblet cells that line the gut. Some look like neuroendocrine cells, which are hormone-type cells. A tumor that shows both is called amphicrine. That double look is the reason this cancer was so hard to name.

    The old name made it sound gentler than it is

    For decades the most common name was goblet cell carcinoid. The word carcinoid is the problem. Carcinoid usually means a slow-growing neuroendocrine tumor, the kind that often behaves in a calm and predictable way. Goblet cell tumors don’t behave that way. They act like an adenocarcinoma, which is a more serious cancer that can spread. Calling it a carcinoid made it sound milder than it really is. Some patients were told their tumor was a calm one when it wasn’t. Some were staged and treated using the wrong playbook.

    The confusion didn’t stop at one wrong word. Over the years this same cancer was also called adenocarcinoid, mucinous carcinoid, crypt cell carcinoma, microglandular carcinoma, mixed adenoneuroendocrine carcinoma (or MANEC), and adenocarcinoma ex goblet cell carcinoid. Same disease. Many labels. When the labels don’t agree, patients and doctors end up talking past each other.

    List of retired names for goblet cell adenocarcinoma including goblet cell carcinoid and MANEC, all replaced by goblet cell adenocarcinoma GCA in WHO 2019.

    What WHO changed in 2019

    In 2019 the World Health Organization updated its cancer classification, the reference book pathologists use around the world. It dropped carcinoid from the name. It chose goblet cell adenocarcinoma. The point of the change was simple. This is an adenocarcinoma. It should be named like one, graded like one, and staged like one. Today’s consensus guidelines for appendix cancer treat GCA the same way, which lines up with the 2019 name.

    For patients, the new name is good news, even though “adenocarcinoma” sounds scarier than “carcinoid.” A clear name means your care team is more likely to take the tumor seriously and to use the staging and treatment approach that fits it. It also means fewer mixed messages. When your records, your pathologist, and your oncologist all use the same term, your care gets easier to coordinate.

    The three grades, in plain terms

    The 2019 system did one more useful thing. It gave GCA a clear way to be graded. Grade describes how the cells look under the microscope, and it’s sorted into three tiers. Grade 1 is low grade. Most of the tumor keeps the orderly, gland-forming pattern. Grade 3 is high grade. Most of the tumor has lost that order and looks disorganized, often growing as single cells. Grade 2 sits in the middle, a mix of both. The grade is based on how much of the tumor still looks orderly versus how much looks disorganized.

    Three-tier grading of goblet cell adenocarcinoma showing grade 1 low grade, grade 2 intermediate, and grade 3 high grade.

    Grade matters because it helps your team understand how the cancer is likely to behave. A higher grade usually calls for a closer watch. Grade is not the same as stage. Stage is about how far the cancer has spread. A tumor has both a grade and a stage, and your team uses them together.

    What to do with this if it’s your diagnosis

    A few things are worth doing. Pull up your pathology report and look for the exact words. If it still says goblet cell carcinoid, that’s not wrong, it’s just an older term, and it helps to know the current one. If your report and your doctor use different words, it’s fair to ask which term they mean and what grade was assigned. Appendix cancer is rare, and many general oncologists see it only a handful of times. A specialist who treats appendix cancer often will know this naming history cold.

    The name on a report can feel like a small thing next to everything else you’re carrying. It isn’t small. A shared name is how patients, pathologists, and oncologists end up rowing in the same direction. That’s the whole reason the change was made.

    We’re building a picture of this disease from the people living it. If you have GCA, adding your story to the Patient-Led Global Appendix Cancer Registry helps researchers see patterns that single clinics can’t. You can find it here: Patient-Led Global Appendix Cancer Registry.

    If you found value here and you’re able to give, please consider it. Appendicure is a 501(c)(3) nonprofit, and every donation goes toward funding research for new appendix cancer treatments. Donate to Appendicure.

    Read next: Newly Diagnosed with Goblet Cell Adenocarcinoma (GCA) of the Appendix

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    Back to top arrow
  • Bold teal and gold graphic with the words when the data doesn't exist, we build it, promoting the patient-led appendix cancer registry.
    • Appendix Cancer 101Your guide to understanding a rare disease, appendix cancer. Learn about types, symptoms, diagnosis, staging, and treatment options like surgery, HIPEC, and chemotherapy—all in one accessible, patient-friendly resource.
      • What is Appendix Cancer?Appendix cancer is a rare abdominal cancer. Learn how appendiceal cancer develops, how it’s diagnosed, and what treatment options exist. APPENDICURE raises awareness for research, recognizing symptoms, diagnosis, surgery, chemotherapy, HIPEC and PIPAC treatment options.
      • Glossary of Medical TermsDecode complex medical terms with our easy-to-understand glossary. Designed for patients and caregivers, this section explains the language used in appendix cancer diagnosis, treatment, surgery, and recovery. Decipher acronyms such as CRS, HIPEC, PIPAC, SRCC.
      • Types of Appendix CancerUnderstand the different forms of appendiceal cancer—from slow-growing tumors to aggressive variants—and what each diagnosis means for treatment and care of this rare appendix cancer. Become familiar medical terms – LAMN Low-grade Appendiceal Mucinous Neoplasm, HAMN High-grade Appendiceal Mucinous Neoplasm, HIPEC Hyperthermic Intraperitoneal Chemotherapy, CRS Cytoreductive Surgery, and SRCC Signet Ring Cell Adenocarcinoma.
      • Pseudomyxoma Peritonei (PMP)
      • Diagnosis & TreatmentFacing a rare gastric cancer can be overwhelming. This section offers clear, compassionate guidance on how appendix cancer is identified and the treatment paths available to you. Learn about chemo, hemicolectomy surgery, cytoreductive surgery CRS, HIPEC, clinical trials, and immunotherapy.
      • CDK4/6 Inhibitors and GNAS-Mutated Appendiceal Cancer
      • Research & InnovationsExplore the latest breakthroughs in appendix cancer—from emerging treatments to promising clinical trials. We spotlight progress that brings hope to patients, caregivers, and advocates. We share research on LAMN Low-grade Appendiceal Mucinous Neoplasm, HAMN High-grade Appendiceal Mucinous Neoplasm, HIPEC Hyperthermic Intraperitoneal Chemotherapy, CRS Cytoreductive Surgery, SRCC Signet Ring Cell Adenocarcinoma, PIPAC Pressurized Intraperitoneal Aerosolized Chemotherapy, Hemicolectomy, and more.
    • Patient & Caregiver ResourcesAPPENDICURE supports appendix cancer patients and caregivers with resources for medical centers, appendiceal surgical oncologists, and HIPEC certified specialists. From diagnosis to survivorship, explore resources designed to inform, uplift, and guide. Whether you’re a rare abdominal cancer patient or caregiver, you’re not alone—and you don’t have to figure it out alone.
      • Medical Centers & ProvidersFind hospitals, specialists, and care teams experienced in treating appendix cancer. We help connect you to the rare abdominal cancer and HIPEC expertise you deserve—because where you go matters. Appendiceal cancer medical and surgical oncologists will discuss diagnosis, treatment plans, and surgery options that align with current research.
      • Support NetworksYou’re not alone. Connect with others who understand the appendix cancer journey—through peer groups, online communities, and caregiver circles built around empathy and shared experience. Explore resources created by appendiceal cancer oncologists, research teams, and cancer awareness advocates that offer guidance on treatment options, financial assistance programs, emotional support groups, and survivorship tips.
      • WebinarsJoin expert-led sessions that break down complex topics, share lived experiences, and offer guidance for patients, caregivers, and advocates navigating appendix cancer. Ask questions about diagnosis, treatment, chemotherapy, hemicolectomy surgery, CRS surgery, HIPEC, PIPAC, caregiver roles, support groups, recovery processes, and spreading awareness.
      • Appendix Cancer Web ResourcesAccess trusted appendix cancer information, downloadable guides, caregiver tools, and appendiceal cancer advocacy materials—all in one place. These resources are designed to educate, empower, and support your cancer journey. We’ve collected resources for you covering treatment, and support on one convenient page.
      • Mental Health Support
      • Patient & Caregiver StoriesReal voices. Real journeys. Discover powerful stories from those affected by appendix cancer—offering hope, insight, and connection for every step of the appendiceal cancer path. Listen to our community of appendiceal cancer survivors as they share their journey through symptoms, diagnosis, treatment, surgery, HIPEC, and recovery.
    • Appendix Cancer Registry
    • For Researchers & Clinicians
      • Standard of Care: 2025 Guidelines
      • Clinician Guides by Specialty
      • Appendix Cancer for Pathologists
      • Registry for Investigators
      • Refer a Patient
      • Clinical Trials
    • Stay ConnectedSubscribe for updates on appendix cancer research, support resources, awareness, and upcoming events. Join our email list and follow us on social media to stay informed and inspired.
      • Blog PostsRead expert insights, patient stories, and the latest updates on appendix cancer care, research, and advocacy. Our blog is a source for appendiceal cancer education and community connection. Share our blog to spread appendix cancer awareness.
      • Data Registry & AI
    • Meet the TeamThe people behind APPENDICURE. Patients, caregivers, survivors, and advocates working to support the appendix cancer community.
      • Board of Directors
      • CUREator Crew
    • Contact UsConnect with the APPENDICURE team to learn more about appendix cancer, share your story, or get involved. We welcome inquiries from patients, caregivers, researchers, and anyone passionate about rare appendiceal cancer advocacy.
    Amanda Moore Avatar
    Amanda Moore

    The Data That Could Help Doesn’t Exist Yet. We’re Building It.

    June 25, 2026

    Appendix cancer data is scarce. Not hard to find. Scarce. For most of the questions that matter to patients and the doctors treating them, the numbers that would point to an answer were never collected in the first place.

    That scarcity is the quiet reason this disease keeps falling behind. It isn’t that researchers don’t care. It’s that the raw material they work from, real records from real patients, barely exists for a cancer this rare. When the data isn’t there, even the best minds and the smartest tools have nothing to learn from.

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  • Appendicure digital toolkit banner with Find, Share, and Organize icons for following appendix cancer research
    • Appendix Cancer 101Your guide to understanding a rare disease, appendix cancer. Learn about types, symptoms, diagnosis, staging, and treatment options like surgery, HIPEC, and chemotherapy—all in one accessible, patient-friendly resource.
      • What is Appendix Cancer?Appendix cancer is a rare abdominal cancer. Learn how appendiceal cancer develops, how it’s diagnosed, and what treatment options exist. APPENDICURE raises awareness for research, recognizing symptoms, diagnosis, surgery, chemotherapy, HIPEC and PIPAC treatment options.
      • Glossary of Medical TermsDecode complex medical terms with our easy-to-understand glossary. Designed for patients and caregivers, this section explains the language used in appendix cancer diagnosis, treatment, surgery, and recovery. Decipher acronyms such as CRS, HIPEC, PIPAC, SRCC.
      • Types of Appendix CancerUnderstand the different forms of appendiceal cancer—from slow-growing tumors to aggressive variants—and what each diagnosis means for treatment and care of this rare appendix cancer. Become familiar medical terms – LAMN Low-grade Appendiceal Mucinous Neoplasm, HAMN High-grade Appendiceal Mucinous Neoplasm, HIPEC Hyperthermic Intraperitoneal Chemotherapy, CRS Cytoreductive Surgery, and SRCC Signet Ring Cell Adenocarcinoma.
      • Pseudomyxoma Peritonei (PMP)
      • Diagnosis & TreatmentFacing a rare gastric cancer can be overwhelming. This section offers clear, compassionate guidance on how appendix cancer is identified and the treatment paths available to you. Learn about chemo, hemicolectomy surgery, cytoreductive surgery CRS, HIPEC, clinical trials, and immunotherapy.
      • CDK4/6 Inhibitors and GNAS-Mutated Appendiceal Cancer
      • Research & InnovationsExplore the latest breakthroughs in appendix cancer—from emerging treatments to promising clinical trials. We spotlight progress that brings hope to patients, caregivers, and advocates. We share research on LAMN Low-grade Appendiceal Mucinous Neoplasm, HAMN High-grade Appendiceal Mucinous Neoplasm, HIPEC Hyperthermic Intraperitoneal Chemotherapy, CRS Cytoreductive Surgery, SRCC Signet Ring Cell Adenocarcinoma, PIPAC Pressurized Intraperitoneal Aerosolized Chemotherapy, Hemicolectomy, and more.
    • Patient & Caregiver ResourcesAPPENDICURE supports appendix cancer patients and caregivers with resources for medical centers, appendiceal surgical oncologists, and HIPEC certified specialists. From diagnosis to survivorship, explore resources designed to inform, uplift, and guide. Whether you’re a rare abdominal cancer patient or caregiver, you’re not alone—and you don’t have to figure it out alone.
      • Medical Centers & ProvidersFind hospitals, specialists, and care teams experienced in treating appendix cancer. We help connect you to the rare abdominal cancer and HIPEC expertise you deserve—because where you go matters. Appendiceal cancer medical and surgical oncologists will discuss diagnosis, treatment plans, and surgery options that align with current research.
      • Support NetworksYou’re not alone. Connect with others who understand the appendix cancer journey—through peer groups, online communities, and caregiver circles built around empathy and shared experience. Explore resources created by appendiceal cancer oncologists, research teams, and cancer awareness advocates that offer guidance on treatment options, financial assistance programs, emotional support groups, and survivorship tips.
      • WebinarsJoin expert-led sessions that break down complex topics, share lived experiences, and offer guidance for patients, caregivers, and advocates navigating appendix cancer. Ask questions about diagnosis, treatment, chemotherapy, hemicolectomy surgery, CRS surgery, HIPEC, PIPAC, caregiver roles, support groups, recovery processes, and spreading awareness.
      • Appendix Cancer Web ResourcesAccess trusted appendix cancer information, downloadable guides, caregiver tools, and appendiceal cancer advocacy materials—all in one place. These resources are designed to educate, empower, and support your cancer journey. We’ve collected resources for you covering treatment, and support on one convenient page.
      • Mental Health Support
      • Patient & Caregiver StoriesReal voices. Real journeys. Discover powerful stories from those affected by appendix cancer—offering hope, insight, and connection for every step of the appendiceal cancer path. Listen to our community of appendiceal cancer survivors as they share their journey through symptoms, diagnosis, treatment, surgery, HIPEC, and recovery.
    • Appendix Cancer Registry
    • For Researchers & Clinicians
      • Standard of Care: 2025 Guidelines
      • Clinician Guides by Specialty
      • Appendix Cancer for Pathologists
      • Registry for Investigators
      • Refer a Patient
      • Clinical Trials
    • Stay ConnectedSubscribe for updates on appendix cancer research, support resources, awareness, and upcoming events. Join our email list and follow us on social media to stay informed and inspired.
      • Blog PostsRead expert insights, patient stories, and the latest updates on appendix cancer care, research, and advocacy. Our blog is a source for appendiceal cancer education and community connection. Share our blog to spread appendix cancer awareness.
      • Data Registry & AI
    • Meet the TeamThe people behind APPENDICURE. Patients, caregivers, survivors, and advocates working to support the appendix cancer community.
      • Board of Directors
      • CUREator Crew
    • Contact UsConnect with the APPENDICURE team to learn more about appendix cancer, share your story, or get involved. We welcome inquiries from patients, caregivers, researchers, and anyone passionate about rare appendiceal cancer advocacy.
    Amanda Moore Avatar
    Amanda Moore

    How to Follow Appendix Cancer Research: Toolkit for Patients and Caregivers – Part 1

    June 22, 2026

    You don’t need a medical degree to follow appendix cancer research, and you don’t need to wait for someone to hand it to you. A handful of free tools let you find new studies as they come out, understand what they actually say, share the ones that matter, and keep the whole pile organized. This is a plain toolkit for doing all of that. None of it replaces your care team. Think of these as ways to find and understand information, not ways to make medical decisions.

    Where to find appendix cancer research

    Google Alerts is the easiest place to start. It watches the web for words you choose and emails you when something new shows up. Go to google.com/alerts, sign in with a free Google account, type a search term in the box at the top, click Show options to choose how often you want emails, and pick your email as the delivery spot. Then save. Set up several of these, not just one.

    Appendix cancer is not one disease, so a single alert misses things. Set up a separate alert for each type your situation touches, and put quotation marks around each phrase so Google looks for those exact words together. Useful ones are “appendiceal adenocarcinoma,” “mucinous appendiceal neoplasm,” “low-grade appendiceal mucinous neoplasm” and its short form LAMN, “high-grade appendiceal mucinous neoplasm” or HAMN, “goblet cell adenocarcinoma,” “signet ring cell appendiceal,” and “pseudomyxoma peritonei” or PMP. If appendiceal neuroendocrine tumors, sometimes called carcinoids, are part of your picture, add “appendiceal neuroendocrine tumor” as well. Use the exact name your pathology report uses, since that is the language the research will use.

    A few simple tricks make these searches far sharper, and they work the same in Google Alerts, Google Scholar, and plain Google. Quotation marks hold words together, so “appendiceal cancer” finds that exact phrase instead of pages where the two words drift apart. Typing AND in capital letters between two terms narrows the results to pages that mention both, so “appendiceal cancer” AND KRAS surfaces only the overlap and cuts a lot of noise. Typing OR widens things to either term, which helps when one thing has two names, like “goblet cell adenocarcinoma” OR GCA. And a minus sign pressed right against a word removes it, so appendiceal cancer -appendicitis drops the appendicitis pages that would otherwise bury what you want. The simple rule is that AND means both of these and narrows your results, while OR means either of these and widens them, so reach for AND when you want to zero in and OR when one thing has two names.

    You can also point an alert at a person. The researchers who study appendix cancer publish often, so an alert on a specialist’s name, paired with a topic to keep it clean, is a quiet way to catch their new work. Something like “John Paul Shen” appendiceal will email you when that name shows up alongside appendix research. Build one for any specialist whose work you want to follow.

    Go deeper with Google Scholar, and follow the specialists

    Google Scholar searches the actual research literature instead of the general web. Go to scholar.google.com and use the same terms and the same tricks. Save a search and turn on its alert, and Scholar will email you when new papers match. Under each result, the Cited by link shows every newer paper that built on that one, which is a fast way to see whether a finding held up or moved forward.

    Scholar also lets you follow a person. Search a specialist’s name, open their profile, the page with their photo and a list of their papers, and click Follow. From then on, Scholar emails you when they publish something new or when someone cites their work. This is one of the best ways to keep up, because the people who study appendix cancer are a small group, and their new papers are often the ones that matter most to us. A few names to start with are Dr. John Paul Shen, Dr. Andrew Lowy, Dr. Kiran Turaga, and Dr. Patrick Wagner, and our Find a Specialist directory lists many more.

    Get your own records first

    The most useful research is sometimes your own file. Your patient portal lets you download your actual pathology and imaging reports, not just the short summaries, and most portals let you give a caregiver proxy access so they can see results too. In the United States, the most common portal is MyChart, and you can learn how it works at mychart.org. Many hospitals use other systems, so if yours is not MyChart, search your hospital’s name plus the words patient portal, or ask at the front desk. Outside the United States, the United Kingdom has the NHS App and Australia has My Health Record. Other countries usually have their own version, which you can find by searching your country’s name along with national health record.

    When a report only exists on paper, your phone can turn it into a clean PDF, no scanner needed. On an iPhone, the Notes app does this, and Apple’s steps are here. On Android, the Google Drive app does the same, and Google’s steps are here. Having your real reports saved and organized makes everything else in this toolkit more useful.

    Understand it with AI, carefully

    This is where a tool like Claude or ChatGPT earns its keep, as long as you use it for the right job. Paste in a dense paragraph from a pathology report or a study abstract and ask it to explain it in plain words. Ask what a term like GNAS or HIPEC means. Ask it to turn your worries into a clean list of questions for your next appointment. Used this way, AI is a translator and an organizer, and a good one.

    AI has one serious flaw, and ignoring it is dangerous. It sounds confident even when it’s wrong, and it’s worse on rare cancers like ours because there’s so little reliable material behind it. Here is a real example from my own work. I was reading about daraxonrasib, a KRAS drug that has been getting a lot of attention. The exciting results everyone was passing around, the ones in actual patients, are all in pancreatic cancer. For appendix cancer, the only evidence so far is early lab work, not people. An AI summary that blurred those two together would have handed this community false hope about a drug that has not been tested in us. That is exactly why I read the original source on everything before it goes on this blog. So use AI to understand and to organize, never to decide. Anything that could change a medical choice goes to your care team, not the chatbot. And watch what you paste, since you should treat anything you type into one of these tools as something that could be stored.

    Cream callout reading use AI as a translator not a doctor, with cautions that AI can invent studies, trial numbers, and survival statistics on rare cancers

    Share what you find, and the honest limit

    People ask me all the time to make a post shareable from our private Facebook group, and I have to give the same honest answer every time. You can’t. A private group is private on purpose, so posts inside it can’t be shared out to the public. That’s a feature, not a glitch, and it’s what keeps the group safe to be open in.

    The fix is to share the public version instead. About 90% of what I post in the private group, I also post on appendicure.com and on our public Appendicure Facebook Page, and those public versions are built to be shared. At the bottom of every post on appendicure.com there is a row of share buttons, the Share it! row. Tap the Facebook button to send the post to your own timeline, to a friend, or into another group, and right beside it are buttons for text, email, WhatsApp, and more. So when you want to spread the word, open the post on the website and use those buttons, instead of trying to share the version locked inside the group.

    See messages from people you don’t know

    Facebook hides messages from people who aren’t your friends, and a lot of people never find them. When someone you’re not friends with sends you a note, it doesn’t ring the normal bell. It lands in a separate spot called Message Requests, and some go one layer deeper into a filtered folder that Facebook treats almost like spam. For a community like ours, that matters, because a scared newcomer reaching out for the first time often isn’t your friend yet. Open Messenger, look for Message Requests, and check both that list and the filtered one every so often. You may find someone who’s been waiting for an answer.

    If typing is hard on a rough day, let your phone do it. Both iPhone and Android have a small microphone on the keyboard. Tap it and just talk, and it types for you. It’s a little thing that makes staying connected a lot less tiring.

    Keep it organized

    Once appendix cancer research starts coming in, it piles up fast, and a simple log beats trying to hold it all in your head. I keep a tracker for Appendicure, and I made a clean, blank version you can copy and use for yourself. It’s just a spreadsheet with a row for each study: the date you found it, the title, where it came from, what it’s about in plain words, whether it’s actually about appendix cancer, and a column for your own notes and questions. Grab the free template here.

    Use it the right way. A tracker organizes your reading so you can bring the good stuff to your team. It isn’t a tool for making decisions on your own, and it isn’t a crystal ball. The goal is to walk into an appointment with three things you read and the questions they raised, instead of a vague memory of something you saw online.

    The same template has a second tab for tracking your tumor markers over time, the CEA, CA 19-9, and CA-125 numbers if those are part of your follow-up. One reading rarely means much. The trend over months is what tells a story, and a simple record of your own numbers can be a useful thing to bring to your oncologist. You read it with them, not instead of them.

    All those reports add up to a lot of PDFs. On most phones and computers, the built-in tools already let you merge several files into one, so your whole record can travel as a single tidy file. That makes second opinions and new appointments far less stressful, because you can hand over everything at once instead of hunting for scattered pieces.

    Make it count

    If you want what you go through to count for more than just you, the patient registry is open and collecting now. It’s the data spine behind the research partnerships we’re building, and it’s normal and useful to start gathering this information early, before every approval is finished. Adding your story takes a few minutes and helps researchers see patterns that single cases never show. Add your story to the registry.

    Read more: This toolkit is the practical side of things. For the part that is harder to look up, Brook Sullivan wrote honestly about mental health and appendix cancer, and how to find the support you need.

    Amanda Moore founded Appendicure after her husband was diagnosed with appendix cancer. Read our story.

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  • Appendicure graphic, Getting Chemo Into the Belly, on PIPAC and bidirectional therapy for appendix cancer patients
    • Appendix Cancer 101Your guide to understanding a rare disease, appendix cancer. Learn about types, symptoms, diagnosis, staging, and treatment options like surgery, HIPEC, and chemotherapy—all in one accessible, patient-friendly resource.
      • What is Appendix Cancer?Appendix cancer is a rare abdominal cancer. Learn how appendiceal cancer develops, how it’s diagnosed, and what treatment options exist. APPENDICURE raises awareness for research, recognizing symptoms, diagnosis, surgery, chemotherapy, HIPEC and PIPAC treatment options.
      • Glossary of Medical TermsDecode complex medical terms with our easy-to-understand glossary. Designed for patients and caregivers, this section explains the language used in appendix cancer diagnosis, treatment, surgery, and recovery. Decipher acronyms such as CRS, HIPEC, PIPAC, SRCC.
      • Types of Appendix CancerUnderstand the different forms of appendiceal cancer—from slow-growing tumors to aggressive variants—and what each diagnosis means for treatment and care of this rare appendix cancer. Become familiar medical terms – LAMN Low-grade Appendiceal Mucinous Neoplasm, HAMN High-grade Appendiceal Mucinous Neoplasm, HIPEC Hyperthermic Intraperitoneal Chemotherapy, CRS Cytoreductive Surgery, and SRCC Signet Ring Cell Adenocarcinoma.
      • Pseudomyxoma Peritonei (PMP)
      • Diagnosis & TreatmentFacing a rare gastric cancer can be overwhelming. This section offers clear, compassionate guidance on how appendix cancer is identified and the treatment paths available to you. Learn about chemo, hemicolectomy surgery, cytoreductive surgery CRS, HIPEC, clinical trials, and immunotherapy.
      • CDK4/6 Inhibitors and GNAS-Mutated Appendiceal Cancer
      • Research & InnovationsExplore the latest breakthroughs in appendix cancer—from emerging treatments to promising clinical trials. We spotlight progress that brings hope to patients, caregivers, and advocates. We share research on LAMN Low-grade Appendiceal Mucinous Neoplasm, HAMN High-grade Appendiceal Mucinous Neoplasm, HIPEC Hyperthermic Intraperitoneal Chemotherapy, CRS Cytoreductive Surgery, SRCC Signet Ring Cell Adenocarcinoma, PIPAC Pressurized Intraperitoneal Aerosolized Chemotherapy, Hemicolectomy, and more.
    • Patient & Caregiver ResourcesAPPENDICURE supports appendix cancer patients and caregivers with resources for medical centers, appendiceal surgical oncologists, and HIPEC certified specialists. From diagnosis to survivorship, explore resources designed to inform, uplift, and guide. Whether you’re a rare abdominal cancer patient or caregiver, you’re not alone—and you don’t have to figure it out alone.
      • Medical Centers & ProvidersFind hospitals, specialists, and care teams experienced in treating appendix cancer. We help connect you to the rare abdominal cancer and HIPEC expertise you deserve—because where you go matters. Appendiceal cancer medical and surgical oncologists will discuss diagnosis, treatment plans, and surgery options that align with current research.
      • Support NetworksYou’re not alone. Connect with others who understand the appendix cancer journey—through peer groups, online communities, and caregiver circles built around empathy and shared experience. Explore resources created by appendiceal cancer oncologists, research teams, and cancer awareness advocates that offer guidance on treatment options, financial assistance programs, emotional support groups, and survivorship tips.
      • WebinarsJoin expert-led sessions that break down complex topics, share lived experiences, and offer guidance for patients, caregivers, and advocates navigating appendix cancer. Ask questions about diagnosis, treatment, chemotherapy, hemicolectomy surgery, CRS surgery, HIPEC, PIPAC, caregiver roles, support groups, recovery processes, and spreading awareness.
      • Appendix Cancer Web ResourcesAccess trusted appendix cancer information, downloadable guides, caregiver tools, and appendiceal cancer advocacy materials—all in one place. These resources are designed to educate, empower, and support your cancer journey. We’ve collected resources for you covering treatment, and support on one convenient page.
      • Mental Health Support
      • Patient & Caregiver StoriesReal voices. Real journeys. Discover powerful stories from those affected by appendix cancer—offering hope, insight, and connection for every step of the appendiceal cancer path. Listen to our community of appendiceal cancer survivors as they share their journey through symptoms, diagnosis, treatment, surgery, HIPEC, and recovery.
    • Appendix Cancer Registry
    • For Researchers & Clinicians
      • Standard of Care: 2025 Guidelines
      • Clinician Guides by Specialty
      • Appendix Cancer for Pathologists
      • Registry for Investigators
      • Refer a Patient
      • Clinical Trials
    • Stay ConnectedSubscribe for updates on appendix cancer research, support resources, awareness, and upcoming events. Join our email list and follow us on social media to stay informed and inspired.
      • Blog PostsRead expert insights, patient stories, and the latest updates on appendix cancer care, research, and advocacy. Our blog is a source for appendiceal cancer education and community connection. Share our blog to spread appendix cancer awareness.
      • Data Registry & AI
    • Meet the TeamThe people behind APPENDICURE. Patients, caregivers, survivors, and advocates working to support the appendix cancer community.
      • Board of Directors
      • CUREator Crew
    • Contact UsConnect with the APPENDICURE team to learn more about appendix cancer, share your story, or get involved. We welcome inquiries from patients, caregivers, researchers, and anyone passionate about rare appendiceal cancer advocacy.
    Amanda Moore Avatar
    Amanda Moore

    PIPAC for Appendix Cancer: What It Is, and 3 Trials Now Open

    June 18, 2026

    In February, Dr. Patrick Wagner and his physician assistant Shannon Altpeter, from Allegheny Health Network, walked our community through two ways of delivering chemotherapy straight into the abdomen: HIPEC and PIPAC. Most people with appendix cancer learn about HIPEC early. It’s the heated chemo that gets washed through the abdomen during cytoreductive surgery, and for many patients it’s the centerpiece of treatment. PIPAC for appendix cancer is the newer approach, still being studied in clinical trials, and it matters most for people who’ve been told cytoreductive surgery isn’t an option. Two terms worth understanding from that conversation are PIPAC and bidirectional chemotherapy.

    What PIPAC is

    PIPAC stands for pressurized intraperitoneal aerosol chemotherapy. Instead of bathing the abdomen in heated liquid the way HIPEC does, it turns the drug into a pressurized mist and sprays it into the abdomen through a laparoscope, the same kind of keyhole instrument used for minimally invasive surgery. The idea, first put into practice in 2011, is that an aerosol spreads more evenly and pushes a little deeper into tissue than liquid that simply sits in the cavity.

    The practical difference for patients is that PIPAC doesn’t require major surgery. It can be done on its own, and it can be repeated, usually every several weeks. That makes it a possible option for people who aren’t candidates for cytoreductive surgery, whether because the disease is too widespread, because an earlier operation didn’t clear it, or because they aren’t well enough for a long surgery. PIPAC for appendix cancer is still investigational, which is why it shows up mainly inside clinical trials rather than as routine care.

    What bidirectional chemotherapy means

    Bidirectional chemotherapy is simpler than it sounds. It means giving chemo two ways at the same time, into the abdomen and through the vein. The thinking is that the intraperitoneal drug hits the surface tumors directly while the intravenous drug reaches anything that has gotten into the bloodstream or deeper tissue. PIPAC is increasingly paired with systemic chemo in exactly this way, so the two ideas often travel together.

    Comparison of HIPEC, PIPAC, and bidirectional chemotherapy and how each delivers chemo to the peritoneum

    Where the proof actually is

    What matters for keeping expectations honest is where this evidence comes from. The strongest randomized results for putting chemo directly into the abdomen are in stomach cancer, not appendix cancer.

    The clearest example is the DRAGON-01 trial, a phase III study from China. It added intraperitoneal paclitaxel to standard chemotherapy in stomach cancer patients whose disease had spread to the peritoneum. Median survival rose to 19.4 months with the intraperitoneal drug added, compared with 13.9 months without it. That’s a real, statistically significant difference, and it’s the first large randomized trial to show this kind of benefit for the approach. An earlier Japanese phase III trial, PHOENIX-GC, tested a similar bidirectional regimen and did not meet its main goal, though patients with more fluid buildup in the abdomen appeared to do better with the intraperitoneal drug.

    None of this was studied in appendix cancer. Appendiceal tumors, especially the mucinous kind, behave differently from stomach tumors. They often grow slowly, produce large amounts of mucin, and respond to chemotherapy on their own terms. A result that holds up in gastric cancer can’t simply be assumed to hold up in appendiceal disease. It’s encouraging that the underlying idea is earning real evidence, but the proof you’d want for our disease specifically isn’t in yet.

    Where the evidence stands: the strongest randomized proof is in gastric cancer, while PIPAC for appendix cancer is still being tested in CHARLIE-2 and a City of Hope trial

    PIPAC for appendix cancer: the open trials

    Three trials are recruiting right now that include appendiceal patients, two in the United States and one in Europe.

    CHARLIE-2 is a new randomized trial from Patrick Wagner’s group at Allegheny Health Network. It compares HIPEC and PIPAC head to head in patients who aren’t candidates for cytoreductive surgery and still have disease after at least three months of standard chemotherapy. Both arms use the same drug, mitomycin C, so the trial is really testing the delivery method rather than the medicine itself. Patients are grouped by where their cancer started, with appendiceal as one of the three categories, so appendix patients are eligible. The design was just published and recruitment is underway. It runs at a single center in Pittsburgh, which matters if travel is a factor for you.

    During the webinar, Shannon Altpeter, the PA who runs the trial day to day, and Dr. Wagner filled in details that aren’t in the protocol paper. Enrollment is already underway, with about six patients enrolled since the start of the year. The trial takes appendiceal, colorectal, and other primaries, and goblet cell adenocarcinoma is included at every grade, so a goblet cell diagnosis doesn’t rule you out. What decides eligibility is whether the disease is unresectable and whether you’re safe for the procedure, not the subtype on the pathology report.

    Two points stood out for patients. First, resectability is judged by two surgeons independently at the first laparoscopy, not one. Dr. Wagner looks first, and if he says the disease can’t be cleared with surgery, a second surgeon makes the same call without knowing the first answer. Altpeter described it as a fair second look for people who arrive having been told elsewhere that surgery is off the table. Second, you can stay on your systemic chemotherapy while on the trial. The protocol asks for about two weeks off before each procedure and a week after, which usually leaves room for two systemic treatments in between. Screening and follow-up can be done remotely, enrollment can be scheduled the day before the first procedure for people traveling, and the treatments are done at West Penn Hospital in Pittsburgh, usually with a single overnight stay.

    Both doctors were direct about what the trial can and can’t promise. The assignment to HIPEC or PIPAC is random. As Altpeter put it, “I don’t get to pick and you don’t get to pick.” Wagner explained the reason is equipoise, meaning there’s genuinely no good evidence yet that one method beats the other. They do measure how often a patient becomes eligible for cytoreductive surgery after the trial treatments, which is the outcome many patients hope for, but Wagner was clear that it won’t happen for everyone and isn’t the main goal. The main questions are which method is safer, better tolerated, and more effective.

    We covered all of this with Dr. Wagner and Shannon Altpeter in our February webinar. You can watch the full conversation here.

    Shannon Altpeter, PA-C, a surgical oncology physician assistant at Allegheny Health Network, presented CHARLIE-2 with principal investigator Dr. Patrick Wagner.

    The other is a PIPAC trial led by City of Hope, the first multicenter PIPAC study in the United States. It enrolls appendiceal patients alongside ovarian, uterine, colorectal, and gastric cancers, and it runs in partnership with the National Cancer Institute, Mayo Clinic, and Northwell Health. Because it spans several sites, it may be easier to reach than a single-center study.

    Outside the United States, PIPAC is further along. It has been studied and offered at specialist peritoneal cancer centers across Europe and Asia for over a decade. One trial worth flagging for international readers is at Ghent University Hospital in Belgium, an early-phase study testing a newer aerosolized drug, nanoliposomal irinotecan, delivered by PIPAC. It is open to appendiceal and other gastrointestinal cancers and is recruiting now. Because it is a single-center safety study, the practical step for patients abroad is to ask a peritoneal surface specialist near them whether PIPAC, in a trial or through an established program, is an option.

    Two PIPAC trials you might find that don’t fit

    If you search the trial databases yourself, two PIPAC studies are likely to come up. Neither one fits appendix cancer, which is why they aren’t on the list above. The UK’s PICCOS trial is a randomized Phase II PIPAC study, but it covers colon, ovarian, and stomach cancer, not appendix. A trial in Guangzhou, China (NCT06743867) is recruiting for peritoneal metastatic adenocarcinoma in general, with no specific mention of appendiceal disease, so we don’t count it as an appendix trial.

    How to think about this

    PIPAC and bidirectional chemotherapy are real options, and the science behind them gets more solid every year. They aren’t a last resort that only desperate patients consider, and they aren’t a proven cure for appendix cancer either. They sit in the honest middle, promising enough to study carefully and unproven enough that the careful studying still has to happen.

    That gap is the whole reason CHARLIE-2 exists. As Rick Page wrote in Hope Is Not a Strategy, wanting something to work isn’t the same as showing that it does. For years these procedures have been done in single-arm settings where it’s hard to learn much. Running an actual head-to-head trial is how the field gets an answer instead of an impression, and it’s how PIPAC for appendix cancer moves from idea to evidence.

    If you’ve been told you aren’t a candidate for cytoreductive surgery, these trials are worth raising with your care team, and worth asking about by name. And if you want to help the next person get a faster, clearer answer, adding your history to the patient registry is one of the most useful things you can do.

    Read next

    Systemic chemotherapy for low-grade mucinous appendiceal cancer

    Understanding high-grade appendiceal mucinous neoplasms (HAMN)

    How ctDNA is changing the way we think about surgery in appendix cancer

    Related Guides on APPENDICURE

    PIPAC is one of several treatment paths. These guides cover the full picture, from the types of appendix cancer to how it is diagnosed and treated.

    Appendix Cancer 101
    Types of Appendix Cancer
    Diagnosis and Treatment

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