Gall Bladder Cancer

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What is gall bladder cancer surgery?
Gallbladder cancer is a cancer formed when the cells in the gallbladder starts to grow out control.

What leads to gall bladder cancer?

  • Chronic gallbladder inflammation formed due to gallstones.
  • There may be abnormalities in the ducts. Reflux of pancreatic juices might inflame and stimulate growth of the cells lining the gallbladder and bile ducts, which might increase the risk of gallbladder cancer.
  • DNA Mutations

How to diagnose gall bladder cancer?

  • Transabdominal ultrasound,
  • CT Scan,
  • endoscopic ultrasound,
  • MRI,
  • MR cholangio-pancreatography (MRCP)
  • A biopsy

What are the stages of gall bladder surgery?
The main system used to describe the stages of gallbladder cancer is the American Joint Committee on Cancer (AJCC) TNM system.
T is for how far the primary tumor has grown into the wall of the gallbladder or if it has grown in the nearby organs or tissues.
N is for the limitation of the spread of the cancer to the nearby lymph nodes
M indicates if the cancer has metastasized to other organs of the body.

What is the treatment for gall bladder cancer?
Surgery
The following are types of surgery used in the treatment of gallbladder cancer:

  • Cholecystectomy. This procedure involves the removal of the gallbladder. An extended cholecystectomy is the removal of the gallbladder, 1 inch or more of liver tissue located next to the gallbladder, and all of the lymph nodes in the region.Laparoscopic cholecystectomy provides improved patient satisfaction and improved cosmesis with open cholecystectomy.
  • Advantages:

    • The operation requires four small openings in the abdomen
    • Minimal postoperative pain
    • Faster recovery than open gallbladder surgery patients.
    • Shorter hospital stays and quicker return to normal activities.
  • Radical gallbladder resection. In this,the gallbladder,a section of liver,the common bile duct,all ligaments between the liver and intestine,lymph nodes around the pancreas and nearby blood vessels is removed.
  • Palliative surgery. The palliative surgery helps in relieving symptoms caused by gallbladder cancer,even if the tumor cannot be removed completely.

Radiation therapy

  • High energy x-rays or other particles is used in radiation therapy to destroy the cancer cells.External-beam radiation therapy is the most common type of the radiation treatment.The therapy consists of a specific number of treatments given over a set period of time.
  • This therapy may be used before a surgery to reduce the size of the tumor after surgery to destroy remaining cancer cells.Radiation Therapy is given during surgery to directly target the area of the tumor and protect healthy organs from the effects of traditional radiation therapy. This procedure is called intra-operative radiation therapy, or IORT.

Chemotherapy

  • It is the use of the drugs to destroy cancer cells.The therapy consists of a specific number of cycles given over set period of time.
  • Common ways to give chemotherapy include an intravenous tube placed into a vein with a needle by injection,or in a pill or capsule that can be swallowed.systemic chemotherapy gets into the bloodstream to reach the cancer cells throughout the body.It may also be combined with radiotherapy.
  • It is used as a palliative care treatment for gallbladder cancer and it may be recommended after the surgical removal of the tumor.It is used as an additional therapy after surgery which is called as adjuvant chemotherapy.

What are the recent advances in gall bladder cancer surgery?

  • Immunotherapy. Immunotherapy, also called biologic therapy, is designed to boost the body’s natural defenses to fight the cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function
  • Medication and radiation therapy improvements. The effectiveness of radiation therapy and chemotherapy for the treatment of gallbladder cancer is limited. So clinical trials are evaluating newer drugs for the gallbladder cancer and trying to increase the effectiveness of the radiotherapy. Drugs that target features specific to an individual cancer, such as certain genes or proteins, are called targeted therapies. The side effects of these drugs often differ from chemotherapy drugs.
  • Palliative care. Better ways of reducing symptoms and effects of current gallbladder cancer treatments are found out by doing clinical trials to improve patients comfort and quality of life.
  • Targeted therapy. Newer drugs are being developed that work in different ways from standard chemo drugs. Specific parts of cancer cells or their surrounding environments are targeted by these drugs.The newer drugs target cells with specific gene changes.This helps doctors determine which of the newer drugs might be effective.