Gallbladder cancer is an abnormal growth of cells that begins in the gallbladder.
Gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder stores bile, a digestive fluid produced by your liver.
Gallbladder cancer is not uncommon now a days. When gallbladder cancer is discovered at its earliest stages, the chance for a cure is very good. But most gallbladder cancers are discovered at a late stage when the prognosis is often very poor.
Gallbladder cancer may not be discovered until it’s advanced because it often causes no specific signs or symptoms. Also, the relatively hidden nature of the gallbladder makes it easier for gallbladder cancer to grow without being detected.
Gallbladder cancer signs and symptoms may include:
It’s not clear what causes gallbladder cancer.
Doctors know that gallbladder cancer forms when healthy gallbladder cells develop changes (mutations) in their DNA. A cell’s DNA contains the instructions that tell a cell what to do. The changes tell the cells to grow out of control and to continue living when other cells would normally die. The accumulating cells form a tumor that can grow beyond the gallbladder and spread to other areas of the body.
Most gallbladder cancer begins in the glandular cells that line the inner surface of the gallbladder. Gallbladder cancer that begins in this type of cell is called adenocarcinoma. This term refers to the way cancer cells appear when examined under a microscope.
Risk factors
Factors that can increase the risk of gallbladder cancer include:
Tests and procedures used to diagnose gallbladder cancer include:
Once your doctor diagnoses your gallbladder cancer, he or she works to find the extent (stage) of your cancer. Your gallbladder cancer’s stage helps determine your prognosis and your treatment options.
Tests and procedures used to stage gallbladder cancer include:
In a procedure called laparoscopy, the surgeon makes a small incision in your abdomen and inserts a tiny camera. The camera allows the surgeon to examine organs surrounding your gallbladder for signs that the cancer has spread.
These tests may include magnetic resonance cholangiography and endoscopic retrograde cholangiopancreatography (ERCP).
What gallbladder cancer treatment options are available to you will depend on the stage of your cancer, your overall health and your preferences.
The initial goal of treatment is to remove the gallbladder cancer, but when that isn’t possible, other therapies may help control the spread of the disease and keep you as comfortable as possible.
Surgery may be an option if you have an early-stage gallbladder cancer. Options include:
If your gallbladder cancer is very small and can be removed completely with cholecystectomy, you may not need additional treatments. If there’s a risk that cancer cells may remain after surgery, your doctor may recommend chemotherapy or other treatments.
Biliary drainage done by either ERCP OR EUS guided.
We put various types of stents to drain the bile duct.
Sometimes the biliary drainage procedure may be extended with the placement of a permanent plastic or metal stent across the site of the bile duct blockage. Stents are usually inserted a few days after the initial drainage procedure and they keep the narrowed duct open without the need for a catheter.
Stenting may be preceded or followed by biliary dilatation, which involves dilating a segment of bile duct with a balloon to open up the stricture.
In recent years, endoscopic ultrasonography-guided biliary drainage (EUS-BD) in patients with failed ERCP has been reported to be an alternative method to PTBD or surgical interventions.
EUS-BD is presently classified into 3 techniques as follows:
(1) EUS-guided choledocoduodenostomy (EUS-CDS);
(2)EUS-guided hepatogastrostomy (EUS-HGS); and
(3) EUS-guided antegrade (EUS-AG) approach.
Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. Chemotherapy can be administered through a vein in your arm, in pill form or both.
Chemotherapy might be recommended after surgery if there’s a risk that some gallbladder cancer cells might remain. It can also be used to control the cancer if surgery isn’t an option.
Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. The energy beams come from a machine that moves around you as you lie on a table.
Radiation therapy is sometimes combined with chemotherapy after surgery for gallbladder cancer if the cancer couldn’t be removed completely. Radiation therapy can also control gallbladder cancer that’s causing pain if surgery isn’t an option.
Targeted drug treatments focus on specific weaknesses present within cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die. Targeted drugs might be an option for people with advanced gallbladder cancer.
Your doctor may test your cancer cells to see which targeted drugs are most likely to work for you.
Immunotherapy is a drug treatment that helps your immune system to fight cancer. Your body’s disease-fighting immune system might not attack cancer because the cancer cells produce proteins that make it hard for the immune system cells to recognize the cancer cells as dangerous. Immunotherapy works by interfering with that process.
Immunotherapy might be an option for treating advanced gallbladder cancer.
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