Most Advanced Gallbladder Cancer Treatment in India - Low Cost Gallbladder Cancer Treatment and Surgery in India

Gallbladder Cancer

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Gallbladder cancer is a rare disease in which malignant (cancer) cells are found in the tissues of the gallbladder. The gallbladder is a pear-shaped organ that lies just under the liver in the upper abdomen. The gallbladder stores bile, a fluid made by the liver to digest fat. When food is being broken down in the stomach and intestines, bile is released from the gallbladder through a tube called the common bile duct, which connects the gallbladder and liver to the first part of the small intestine.

The wall of the gallbladder has 3 main layers of tissue.

·         Mucosal (innermost) layer

·         Muscularis (middle, muscle) layer

·         Serosal (outer) layer

Between these layers is supporting connective tissue. Primary gallbladder cancer starts in the innermost layer and spreads through the outer layers as it grows.

Symptoms and Signs Of Gallbladder Cancer

Gallbladder cancer is usually not found at an early stage because the gallbladder is located deep inside the body. Therefore, gallbladder cancer can be difficult to detect during routine physical examinations. Sometimes, gallbladder cancer is found unexpectedly after removal of the gallbladder for another reason, such as gallstones. When symptoms do occur, they include the following:

·         Jaundice (yellowing of the skin and whites of the eyes)

·         Abdominal pain

·         Nausea and vomiting

·         Bloating

·         Lumps in the abdomen

·         Fever

Diagnosis of Gall Bladder Cancer

·         Ultrasound. Ultrasound is a painless procedure in which a technician moves a wand-like device (transducer) over the surface of the abdomen. High-frequency sound waves form images on a screen that can identify a tumor in the gallbladder and bile ducts (Biliary tract).

·         Computerized tomography (CT) scans. CT scans generate cross-sectional images of the body that can show whether cancer has spread to other tissues or organs. All CT scanners at Mayo Clinic use spiral CT technology (an X-ray tube revolves around the patient) and several CT scanners use multi-detector row spiral technology, which creates three-dimensional images.

·         Magnetic resonance imaging (MRI) scans. MRI technology uses magnetic fields and radio waves to create detailed images of the gallbladder, bile ducts, liver and tumor. This highly sensitive technology can identify small abnormalities in the gallbladder.

·         Positron emission tomography (PET). To perform a PET scan, doctors inject sugar (glucose) and a very small amount of radiation into the bloodstream. The scan helps show if a tumor has spread, because tumors typically pick up the sugar and appear on the image as "hot spots."

·         Biopsy. In a biopsy, a pathologist removes a small tissue sample and looks under a microscope for cancer cells. Doctors may use fine-needle aspiration (FNA) to collect the tissue. During an FNA procedure a doctor will give you a local anesthetic and then gently guide a small needle through the skin and abdomen into the gallbladder. Ultrasound or CT scans help the doctor locate the tumor.

Stages of Gallbladder Cancer

The following stages are used for gallbladder cancer :

·         Stage 0 (carcinoma in Situ) : Abnormal cells are found in the inner (mucosal) layer of the gallbladder; these abnormal cells may become cancer and spread into nearby normal tissue

·         Stage I : Cancer has formed and has spread beyond the inner (mucosal) layer to a layer of tissue with blood vessels or to the muscle layer

·         Stage II : Cancer has spread beyond the muscle layer to the connective tissue around the muscle.

·         Stage IIIA : Cancer has spread through the thin layers of tissue that cover the gallbladder and/or to the liver and/or to one nearby organ (eg, stomach, small intestine, colon, pancreas, or bile ducts outside the liver)

·         Stage IIIB : Cancer has spread to nearby lymph nodes and [#Section_218] beyond the inner layer of the gallbladder to a layer of tissue with blood vessels or to the muscle layer; or beyond the muscle layer to the connective tissue around the muscle; or through the thin layers of tissue that cover the gallbladder and/or to the liver and/or to one nearby organ

·         Stage IVA : Cancer has spread to a main blood vessel of the liver or to 2 or more nearby organs or areas other than the liver. Cancer may have spread to nearby lymph nodes.

·         Stage IVB : Cancer has spread to either lymph nodes along large arteries in the abdomen and/or near the lower part of the backbone or to organs or areas far away from the gallbladder.

Treatment for Gall Bladder Cancer in India

Surgery, chemotherapy and radiotherapy are all used to treat gallbladder cancer. Many patients get a combination of treatments. For example, chemotherapy or radiotherapy can be used to shrink the tumour before surgery.

Your treatment will depend on the stage, grade and type of cancer cells you have. The stage looks at the size of your cancer and if it has spread from where it started.

The grade of the cancer can tell if your cancer grows quickly or slowly. You can have a low, moderate or high grade cancer.

Surgery

Surgery offers the best chance of curing early-stage cancer that has not spread beyond the gallbladder. To determine if surgery is possible, surgical oncologist at DHRC may order images of the gallbladder, bile ducts and the liver. Surgeons will use a camera and miniature instruments inserted through tiny incisions in the abdomen (laparoscopic surgery) to see if the tumor has spread (metastasized). Surgery options include:

·         Simple cholecystectomy If the tumor is very small and has not spread to the deeper layers of gallbladder tissue, the surgeon may use this procedure, which removes only the gallbladder. Occasionally this procedure can be done using laparoscopic surgery.

·        Extended cholecystectomy. This is the most commonly performed surgery, involving removal of the gallbladder, the liver tissue next to it, and nearby lymph nodes.

Chemotherapy

·         When the cancer has spread to other organs, medical oncologists may recommend chemotherapy.

·       Chemotherapy currently does not cure advanced gallbladder cancer, but sometimes slows the disease's progression.

Radiotherapy

Radiotherapy treats cancer by using high-energy x-rays that destroy the cancer cells while doing as little harm as possible to normal cells. It is occasionally used for cancer of the gall bladder. It can either be given externally from a radiotherapy machine or internally by placing radioactive material close to the tumour (brachytherapy).

Advanced Treatments of GallBladder Cancer

Advanced cancer means that your cancer has spread from the area where it started. If it spreads to the area around your gallbladder, it is called local spread. If it spreads to other areas of your body, it is called secondary cancer or metastatic cancer. It is usually not possible to cure advanced cancer. Treatment is given to control the cancer and to improve your quality of life. These treatments can involve surgery, chemotherapy and radiotherapy.

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