GALL BLADDER CANCER

GALL BLADDER CANCER



Q. What are the types of gallbladder cancer?
A. The majority of these cancers are "adenocarcinomas", with subtypes such as papillary, nodular, and tubular, depending on the appearance of the tumor cells under the microscope. Less common subtypes include: squamous cell, signet ring cell, and adenosquamous (adenoacanthoma).

Q. What causes gallbladder cancer? What are the risk factors?
A. The cause of gallbladder cancer is unknown, although it has been associated with gallstones, high estrogen levels, cigarette smoking, alcohol, obesity, and the female gender. Approximately 70-90 percent of people with gallbladder cancer have gallstones. However, the opposite is not true,AS DR. HARI KRISHNA suggests, as most people with gallstones do not develop gallbladder cancers, and it is unclear how big of a risk gallstones pose. It has been suggested that infection with salmonella may also increase the risk of gallbladder cancers. Also, patients with inflammatory bowel disease (ulcerative colitis and Crohn's disease) are 10 times more likely to develop cancer of the extrahepatic biliary tract.

Q. What are the signs and symptoms of gallbladder cancer?


A. Unfortunately, there are no specific, surefire symptoms that suggest a diagnosis of gallbladder cancer. Usually, patients present with problems resulting from blockage of the bile ducts, such as jaundice, loss of appetite and weight loss. There may be a mass and/or pain in the abdomen, especially on the right under the ribcage. However, people often have no symptoms, or their symptoms closely mimic those of gallstones. The most common way gallbladder tumors are diagnosed is incidentally, during surgery performed to remove the gallbladder (cholecystectomy) for some other reason. About 1-2% cholecystectomies reveal a cancer of the gallbladder.

On patient examination, a healthcare provider (HCP) may detect jaundice of skin or the whites of the eyes, a mass in the right upper abdominal quadrant or around the belly button (periumbilical).

Q.How is gallbladder cancer diagnosed?

A. First and foremost, a HCP should always perform a thorough history and physical examination. Laboratory work should include metabolic chemistry and liver function panels to look for abnormal levels of various substances in the blood that are suggestive of general hepatobiliary disease. A urinalysis is usually done to evaluate urinary levels of some of these substances as well.

The role of tumor markers, [carbohydrate antigen 19-9 (CA 19-9), cancer antigen 125 (CA125), and carcinoembryonic antigen (CEA)] has not been established in gallbladder cancer.

Ultrasonography ( US) is the standard study done first in patients presenting with right upper quadrant pain. It allows HCPs to make a diagnosis of gallbladder cancer in about half of patients, and can also detect disease spread into the liver or bile ducts about half of the time. This is an important test, as it can help differentiate people who are having pain from gallstones from those who have gallbladder cancer. Endoscopic ultrasound, where a camera is inserted down through the mouth (while under sedation) allows the ultrasound probe to be placed closer to the gallbladder and appears to be more accurate than the traditional ultrasound which is placed against the abdominal wall. Endoscopic ultrasound may also better detect nodes and whether the tumor has spread beyond the gallbladder.

Computed tomography (CT) scans can also be helpful in patients with upper abdominal pain. They are better than US for detecting tumor invasion out of the gallbladder and disease spread to other sites in the abdomen or pelvis. About 70-80% of cases will have some degree of liver invasion, and so the combination of CT and US provides more accurate information.

Magnetic resonance imaging (MRI) has been useful in examining this region for disease spread into the liver or other tissues. This technology is particularly good for planning surgery, by evaluating surrounding blood vessels [magnetic resonance angiogram (MRA)] and bile duct passages [magnetic resonance cholangiogram (MRC)].

Cholangiography, either through the skin or the stomach, is a technique that allows HCPs to not only establish a diagnosis, but to locate the blockage and place a stent through the blockage to help alleviate the blockage.

Routine blood work may also help your physician determine whether there is a blockage in the bile ducts and how well the liver is functioning. There are tumor markers which can be tested for in the blood, such as CEA and CA 19-9. These markers can be elevated in cancer of the gallbladder, but are not good for diagnosis as they are non-specific and other conditions can cause them to be elevated.

Q. How is gallbladder cancer treated?

A. Cancer Healer is really effective in gall bladder cancer and brings marked improvement even at the last stages. It treats lung cancer promptly without any side effects and can also go in conjunction with chemo therapy as well as radio therapy and even after operations