World Cancer Day: Watch Out For These Symptoms, Treatment Of Gallbladder Cancer

February 4 is marked as World Cancer Day and today, we are talking about the gallbladder, a tiny pear-shaped organ under.

The liver and behind the right lower ribs, which is usually about 3 to 4 inches long in adults and normally no wider than an inch. For the uninitiated, the American Cancer Society highlights, “The gallbladder concentrates and stores bile, a fluid made in the liver.

Bile helps digest the fats in foods as they pass through the small intestine. Bile is made by the liver and is either sent into ducts that carry it to the small intestine, or stored in the gallbladder and released later.”

The Cancer Organisation states that Gallbladder Cancers are rare and nearly all of them are adenocarcinomas i.e. a cancer that starts in gland-like cells which line many surfaces of the body, including the inside of the digestive system.

In an  Lifestyle, Dr Abhishek Mitra from Department of Surgical Oncology at Paras Cancer Center, Paras Hospitals in Gurugram alerted, “Gallbladder cancer (GBC) is a notorious and an aggressive cancer, associated with a dismal overall survival.”

He added, “Unfortunately, the world-wide incidence for gallbladder cancer is the highest in the Northern part of India, especially along the Gangetic belt especially in the states of Uttar Pradesh and Bihar. Research has been conducted to understand why it is common in this region in India. A combination of factors play a role but the exact causation is still not known.”

Symptoms of Gallbladder Cancer:

The symptoms of Gallbladder Cancer are often neglected. Gallbladder Cancer can be asymptomatic for a variable period before symptoms begin and the presentation of the gallbladder cancer can also be varied and simulate other conditions. Dr Abhishek Mitra listed symptoms to watch out for since it is important to be understood and be aware of them:

1. Abdominal pain: Usually experienced in the right upper or upper central part of abdomen. The intensity and frequency of this pain can be variable. Pain which changes its character and becomes continuous in nature, is typical of a gallbladder cancer.

2. Non-specific: Dyspepsia, nausea, decreased appetite, unintentional weight loss (any of these or in combination).

3. Asymptomatic: Patient can present with an incidentally detected mass/abnormality of gallbladder on imaging (ultrasound/CT scan) done for another reason or as a part of health check-up.

4. Jaundice, extreme weight loss, loss of muscle mass, confinement to bed, ascites (fluid in tummy) are usually seen in advanced cases of gallbladder cancer.

Risk factors for gallbladder cancer:

Dr Abhishek Mitra shared the risk factors that included:

1. Age and sex – the incidence of gallbladder cancer increases with age, peaking at around 6th to 7th decade of life. The females are more prone to this cancer than males (2-3:1)

2. Gallbladder stones – Gallstones are seen to be present in ¾ of the cases of gallbladder cancer. The larger and symptomatic stones are likely to associated with a higher risk

3. Abnormal pancreaticobiliary duct junction (APBDJ) – The abnormal communication of the bile duct and pancreatic duct leads to an increase in incidence of GBC due to abnormal reflux of pancreatic juices into the biliary tree.

4. Gallbladder polyps – Adenomatous polyps of gallbladder have the potential to transform into GBC and thus it is important to recognize this premalignant entity.

5. Porcelain gallbladder – The calcification of gallbladder wall results in this rare premalignant entity.

Solutions:

The delay in detecting and thereby treating GBC stems from lack of awareness and understanding of this cancer. Asserting that it is important for general population and general physicians, who are usually.

The first point of contact, to understand this dreaded cancer, Dr Abhishek Mitra advised, “Awareness, early consultation by patients for their otherwise neglected symptoms and timely referral by the physicians and registered medical practitioners can go a long way in prevention.”

Pointing out that the treatment for gallbladder cancer mainly depends on the clinical stage, general condition of the patient and the symptoms, Dr Abhishek Mitra added, “All cases should be discussed .

In a multi-disciplinary tumor board consisting of surgical, medical and radiation oncologists, radiologists and pathologists to formulate the treatment plan. Patients presenting at an early stage of GBC are treated with surgery.

Patients who are at an advanced stage (not resectable by surgery, spread to other organs) or not fit for surgery are candidates for non-surgical treatment options like chemotherapy and sometimes radiotherapy.

The treatment for those presenting at an intermediate stage (eg: large mass invading liver, adjacent organs/vessels, large nodes) is yet to be defined, although majority of these patients are operated after chemotherapy.”

He explained that the patients with advanced GBC at presentation are mainly treated with palliative treatment options chemotherapy, immunotherapy or chemoradiotherapy. Dr Abhishek Mitra said, “Patients with advanced GBC are associated.

With obstructive jaundice, gastric outlet obstruction or colonic obstruction require palliation. Palliation of these symptoms should be done using interventional radiology or endoscopic interventions and surgery should be reserved for a selected few, when these non-surgical palliative procedures are not feasible.”