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Gallbladder Cancer
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Gallbladder
cancer is a rare disease that effects the gallbladder, a
major part of the digestive system. Hard pebble-like
substances sometimes form in the gallbladder, and if
large enough, can lead to the blocking of bile ducts.
Bile ducts help the
body break down food to be digested.
When the bile ducts are blocked, obstruction occurs.
Obstruction of the bile ducts can lead to inflammation
of the gallbladder. Inflammation of the gallbladder can
lead to
infection or the build up of cancerous cells.
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Cancerous cells in the gallbladder may lead to a
malignant tumor forming and the first stage of
gallbladder
cancer will begin. It is important to note
that while almost all patients with gallbladder
cancer
also have gallstones, even more people with gallstones
do not have or will never develop gallbladder
cancer.
Most
people do not realize they have gallbladder
cancer until
after the first stage because the symptoms associated
with the first stage of gallbladder
cancer are not
specific to the disease. If a patient is fortunate to
discover gallbladder
cancer early on, they can be
treated and saved, going on to live a normal life.
Gallbladder
cancer that is discovered in a later stage
carries a poor prognosis and most patients pass away
within a few years time. The only way to discover and
treat the earliest stage of gallbladder
cancer is
through diagnostic tests that will be discussed later on
in this overview.
Gallbladder Cancer Causes:
While there is no direct cause of
gallbladder
cancer, there are certain risk factors that
increase an individual's risk for the disease. Women are
twice as likely as men to develop gallbladder
cancer.
Obesity has also been linked to higher incidences of the
disease. Races that are more likely to have gallbladder
cancer include Mexicans and Native Americans. Those with
a family history of gallbladder
cancer or gallstones
have an increased chance of being diagnosed with one of
the two conditions yet the disease is still very rare
overall.
Gallstones:
Gallstones in the gallbladder increase one's chances of
developing gallbladder
cancer. Simply having gallstones
does not mean gallbladder
cancer is going to develop
next. Gallstones are hard, pebble-like substances that
grow in the gallbladder and can disrupt the functions of
the gallbladder by causing an obstruction. When the bile
duct is blocked by gallstones,
infection, or
inflammation in the gallbladder can occur, leading to a
higher risk of gallbladder
cancer. |
Gallbladder Cancer Prevention:
Gallbladder
cancer does not have any
proven prevention methods. The causes of
the disease, such as gallstones, cannot
be prevented from forming in the
gallbladder. Prevention through
treatment is difficult because it is
often not treated until the
cancer
reaches an advanced stage. Patients
usually do not suffer serious symptoms
in the early stage of gallbladder
cancer, leading to a late diagnosis.
Once the
cancer has spread, there is
little hope of preventing the
cancer
from taking a patient's life within a
few years.
Types of Gallbladder Cancer:
There are two main types of gallbladder
cancer tumors, adenocarcinoma and
non-adenocarcinoma. Adenocarcinoma
tumors occur more frequently than
non-adenocarcinomas.
Papillary and Non-Papillary:
Under a microscope, papillary
cancer is
arranged like fingers. Papillary
cancer
tends to have a better prognosis than
other gallbladder cancers because they
are less likely to spread to the liver
or nearby lymph nodes. Papillary
cancer
can either be invasive or non-invasive.
Invasive papillary
cancer is likely to
spread to other organs while
non-invasive papillary
cancer is rarely
malignant and carriers a better
prognosis. |
Mucinous Adenocarcinoma:
Mucinous
adenocarcinoma are
cancer cells that
develop in apool of mucus. The mucus lines the walls
of the gallbladder and becomes very
thick. The gallbladder can get clogged
or backed up due the thickness and
quantity of the mucus. The inflammation
caused by the mucinous adenocarcinoma
could lead to gallbladder
cancer, though
mucinous adenocarcinoma is rare.
Non-Adenocarcinoma:
There are six types of
non-adenocarcinoma gallbladder cancers,
they are squamous cell
cancer,
adenosquamous carcinomas, small cell,
sarcoma, neuroendocrine, lymphoma, and
melanoma. |
Gallbladder Cancer Symptoms:
The symptoms of
gallbladder
cancer are usually not felt
until the stages advance. This causes a
diagnosis of the disease to be made in a
later stage when symptoms are more
prevalent.
Symptoms
of Gallbladder Cancer:
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Weakness
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Loss of appetite
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Weight loss
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Vomiting caused by obstruction in the
gallbladder
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Jaundice
(yellowing of the skin) caused by
obstruction in the gallbladder
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Gallbladder Cancer Diagnosis:
A gallbladder
cancer diagnosis
can be made once a series of tests have been
completed. First, there will be a physical test
where a doctor checks the patient's
body for
obvious signs of
cancer, such as tumors or a
yellowing of the eyes known as jaundice. A
discussion about symptoms should also take
place. Blood tests can be performed to measure
the amount of bilirubin there is in the blood.
Bilirubin is used in the gallbladder and an
excess of it may be a sign of trouble in the
gallbladder. Elevated protein levels known as
tumors markers can also be checked for in the
blood.
Imaging tests serve as the most important aspect
of diagnosis gallbladder
cancer. Imagine tests
that will help determine if a patient has
gallbladder
cancer include x-rays, ultrasounds,
CT scans, cholangiogram, a laparoscopy and a
biopsy.
Gallbladder Cancer Staging:
A staging system to recognize how developed the
cancer has become is used for gallbladder
cancers. The staging model factors in the
severity of tumors, spreading to lymph nodes and
the chances of the
cancer metastasizing.
Stage 0: Tis,
N0, M0- The
cancer has not spread outside the
gallbladder. Patient's have an 81% five-year
survival rate at this stage.
Stage
1A: T1
(a or b) N0, M0- The tumor spread to the muscle
layer or lamina propria but does not spread
outside the gallbladder. Patient's have a 50%
five-year survival rate at this stage.
Stage
1B: T2,
N0, M0- The tumor spreads into the perimuscular
fibrous but not outside the gallbladder.
Patient's have a 29% five-year survival rate at
this stage.
Stage 2A: T3,
N0, M0- The tumor extends to the serosa layer or
grows into the liver or another nearby organ or
tissue. There has been no spread to lymph nodes
or distant organs. Patient's have a 7% five-year
survival rate at this stage.
Stage
2B: T1-T3,
N1, M0- More growth in the gallbladder
continues. The
cancer has spread to the lymph
nodes but not distant organs or tissues.
Patient's have a 9% five-year survival rate at
this stage.
Stage
3: T4,
any N, M0- Blood vessels have been infected
leading to liver have been infected with blood.
More than one nearby organ other than the liver
has bee infected.
Cancer may have spread to
tissues but has not spread to distant organs.
Patients have a 3% five-year survival rate at
this stage.
Stage
4: Any
T, Any N, M1- The
cancer has spread to distant
organs and tissues from the gallbladder.
Patient's have a 2% five-year survival rate at
this stage. |
Gallbladder Cancer Prognosis:
A
gallbladder prognosis refers to the
estimated chance for survival and
recovery, treatment options, and the
chance for a recurrence of the disease.
Gallbladder
cancer carries a poor
prognosis. This is because most
patient's are not diagnosed with the
disease until the later stages when it
become more difficult to treat. The
staging model along with other factors
such as age and previous medical history
all factor into a prognosis. If a
patient is fortunate to discover the
disease in the earliest stage, the
prognosis improves and patient may go on
to lead a normal full life.
Gallbladder Cancer Treatment:
Gallbladder
cancer treatment relies on
surgeries, drugs, and radiation.
Treatment options depend on stage
progression, past medical history,
prognosis, and the opinion of the
patient. If the patient is feeling very
ill, and does not want to go through the
process of radiation drugs or painful
surgeries, they may elect to not receive
treatment. For some, one surgery may be
enough to lead a long and healthy life.
Others could experience extended
surgery, chemotherapy, and radiation
treatment, but still remain sick and die
within a few years.
Surgery:
Surgery
is performed to remove the gallbladder
and any cancerous cells and tumors
associated with gallbladder
cancer
surgery. Laparoscopic, open surgery and
extended surgery are three different
methods of gallbladder
cancer surgery.
Cholecystectomy:
Cholecystectomy is the term for removing
the gallbladder through surgery.
Laparoscopic Surgery:
Laparoscopic surgery during a
cholecystectomy involves small incisions
made in the abdomen and a small camera
placed on the tiny instrument used by
the doctor. The images are shown on a
monitor next to the patient. This type
of surgery allows for a faster recovery
time but is still efficient for removal
of the gallbladder. |
Radiation Therapy:
Radiation
therapy involves high energy rays
similar to x-rays that are capable of
killing
cancer cells. There are two main
forms of radiation to treat gallbladder
cancer -- external beam radiation
therapy and brachytherapy. Radiation
therapy is used to shrink tumors, kill
cancer cells and help clear any
obstructions in the gallbladder.
Radiation therapy is often combined with
chemotherapy. That process is known as
chemoradiation.
Chemotherapy:
Chemotherapy is a popular method to kill
cancer cells in the
body. A combination
of drugs is inserted in a patient's
mouth or injected in a vein. The drugs
travel in the blood stream, killing
cancer throughout the
body. Chemotherapy
is not known to be as successful in
treating gallbladder
cancer as it is
with other cancers. A a new method
called hepatic chemotherapy is being
tested. It involves injecting the
gallbladder area directly with chemo
drugs and doctors hope it is more
effective than regular chemo treatment.
Gallbladder Cancer Research:
Gallbladder
cancer
research is constantly being conducted
around the world. New chemotherapy drugs
and surgical methods are tested in
clinical trials. Successful research
toward treating gallbladder
cancer often
comes directly out of clinical trial in
which sick volunteers offer their bodies
to science in hope of creating new ways
to treat or cure the disease. For many
patients, approved medical practices
have failed to treat them to their needs
and only new ideas and methods can help.
Clinical trials along with statistical
information on past patients go toward
researching new and better ways to cure
gallbladder
cancer. |
Gallbladder Cancer Statistics:
The American
Cancer Institute estimates
9,720 will be diagnosed with gallbladder
cancer in 2009 and 3,370 will die from
the disease in the same year. Statistics
also show that women are twice as likely
to develop gallbladder
cancer than men.
Mexicans and Native Americans are the
ethnic groups at most risk to develop
the disease.
Gallstones may be a leading cause in
gallbladder
cancer, but out of 500,000
people who needed surgery for gallstones
issues, less than 10,000 of those people
will be diagnosed with gallbladder
cancer.
Survival rates are determined by the
cancer's stage. The size and severity of
the tumor, the spreading of
cancer to
the lymph nodes, and spreading of
malignant
cancer to other organs
determine the stages.
The American
Cancer
Institute measures gallbladder
cancer
patient's based on a five-year survival
rate. |
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Stage |
5-Year Survival Rate |
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0 |
81% |
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IA |
50% |
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IB |
29% |
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IIA |
7% |
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IIB |
9% |
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III |
3% |
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IV |
2% |
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