Gallbladder Cancer is a rare malignancy cancer. About 1.5% of the world population suffers from gallbladder cancer. It is 5th most common cancer and involves the gastrointestinal tract and the most common malignant tumor of the biliary tract. Over the years, there is a great improvement in patient recovery rate, on account of the radical surgical approach and surgical techniques. Early detection of this cancer is essential as it progresses silently and is diagnosed late. Gallbladder cancer is mostly common in Northern India.
CAUSES FOR GALLBLADDER CANCER:
- Chronic inflammation, causing irritation and swelling in the gallbladder
- Gallstones are the most common factor for gallbladder cancer.
- The gallstones are the collection of cholesterol and other substances and cause swelling.
- 4 out of 5 people who have gallbladder cancer have gallstones.
- Having gallbladder stones is common, but developing gallbladder cancer is rare or can never develop this disease.
- When the wall of the gallbladder is covered with calcium deposits is known as Porcelain gallbladder.
- It is mostly common in women than in men.
- Obesity is a common cause for this disease to develop.
- Old age is another cause most of them diagnosed are above 65 years.
- People who get Typhoid are prone to gallbladder cancer because the infection causes gallbladder inflammation.
- Family history, there may be a chance of getting the disease but not common if a person in the family has or had gallbladder cancer. The risk of getting is low since it is a rare disease.
- Smoking and exposure to chemicals used in rubber and textile industries are the other causes for developing gallbladder cancer.
TYPES OF GALLBLADDER CANCER:
The type of gallbladder depends on where the kind of cell began. There are various cells in the gallbladder that develop into the different types of gallbladder cancer. The different types are:
- GALLBLADDER ADENOCARCINOMA: The growth begins in the cells that line the inside of the gallbladder. 90% of the gallbladder cancers are adenocarcinoma. There are three types of adenocarcinoma of the gallbladder, they are:
- NON PAPILLARY ADENOCARCINOMA—It is the most common one.
- PAPILLARY ADENOCARCINOMA: – It is rare and may not spread to the liver and nearby lymph nodes.
- MUCINOUS ADENOCARCINOMA_ It starts in the cells that produce mucus and rarer.
The other types of gallbladder cancers which are very rare and more aggressive are:
- adenosquamous Carcinoma
- squamous cell carcinoma
STAGES OF GALLBLADDER CANCER:
According to the spread of the disease, it is staged by doctors, to help them to know the seriousness and the kind of treatment to be given. The stages are:
- STAGE O: The cancer is only in the inner layer of the gallbladder and has not spread into the deeper layers of the gallbladder.
- STAGE 1: The tumor has grown into the muscle layer and has not spread to the other parts or to the nearby lymph nodes.
- STAGE 11A: Cancer has grown through the muscle layer into the fibrous tissue of the abdominal cavity.
- STAGE 11B: Through the muscle layer it has grown into the fibrous tissue on the side of the liver, but has not spread inside the liver.
- STAGE 111A: Grown into the liver or nearby like the stomach, small intestine, colon, pancreas or the bile ducts. It has not spread near the lymph nodes or the other regions.
- STAGE IIIB: The cancer has grown into the blood vessels leading into the liver. It has spread to not more than 3 lymph nodes, but not to the other far regions in the body.
- IVA: The cancer/ tumor has grown into the main blood vessels leading into the liver. Not spread to the other regions.
- IV B: The cancer has spread to 4 or more lymph nodes and not to distant regions. Or might have spread to distant regions like liver, belly or lungs. May or may not spread to the nearby lymph nodes.
SYMPTOMS OF GALLBLADDER CANCER:
- abdominal pain, lump in the tummy.
- nausea or vomiting,
- weakness, loss of appetite, weight loss,
- presence of jaundice—skin or the whites of the eyes turn yellow.
If these symptoms are found consult a doctor, who can get a few tests and refer to a specialist. Within 2 weeks visit the specialist. All this does not mean one has cancer, but cannot ignore.
GALLBLADDER CANCER TREATMENT:
Locally advanced gallbladder cancer treatment includes the following:
1) SURGERY: Generally after surgery the patient gets cured. At the same time depends on the stage and where it has spread.
a) PALLIATIVE SURGERY: Biliary stent or a catheter is placed to allow the movement of bile.
Biliary bypass—depending on where the tumor is to remove the blockage and to drain the bile from the liver and gallbladder.
Alcohol injection—this is done during surgery to deaden the nerves and to relieve pain.
2) EXTERNAL-BEAM RADIATION THERAPY: Radiation therapy with or without Chemotherapy is administered. Generally high intensity of radiation is given to target the tumors and remove them, so that they don’t spread or recur.
3) CLINICAL TRIALS: Radiation Therapy with radiosensitizer drugs can also help.
4) NEOADJUVANT THERAPY: To shrink a gallbladder doctors may give Chemotherapy before Surgery. If the cancer has spread or to relieve the symptoms of gallbladder cancer Chemotherapy is given. Chemotherapy is suggested after surgery to kills the cancer cells from spreading or recurring.
5) IMMUNOTHERAPY: This treatment is given to build up the immune system to destroy cancer cells.
DIET FOR GALLBLADDER PATIENTS:
- mashed vegetables with milk, grated cheese and egg.
- porridge with sugar and cream.
- instant soups with milk instead of water.
- easier to have small meals like yoghurts, dried fruits, fresh fruit, nuts, cheese, chocolate, ice cream, instant coffee and so on.
AWARENESS AND KNOWLEDGE OF GALLBLADDER CANCER:
Gallbladder Cancer is a very uncommon disease, so people are not serious. People should be aware and have knowledge about the symptoms and consult a doctor immediately. Awareness of the follow up after the treatment for gallbladder cancer should be high- lighted so that the cancerous cells do not spread and recur.