Gallbladder Cancer : Symptom, Risk Factor, Diagnosis, Stage, Treatment, And Drug

Gallbladder Cancer is cancer cells found in the tissues of gallbladder.It is uncommon cancer.The gallbladder is a pear-shaped organ that lies under the liver in the upper abdomen.The wall of gallbladder has three main layers of tissue, such as mucosal (inner) layer, muscularis (middle, muscle) layer, and serosal (outer) layer.Gallbladder cancer is difficult to detect and diagnose because the symptoms of gallbladder cancer are like the symptoms of other diseases, Its symptoms or its signs cannot be found in the early stages, and it is hidden behind the liver.

The Signs and Symptoms of Gallbladder Cancer 

• Yellowing of skin and whitish of the eyes (jaundice)
• Weakness
• Nausea
• Vomiting
• Fever
• Loss of appetite
• Lumps in the abdomen
• Bloating
• Pain above the stomach or abdominal pain
• Weight loss
• Dark urine
• Itchy skin
• Swelling in the belly

Risk Factors of Gallbladder Cancer

• Gender, it is common in women than men.
• Family history of gallbladder cancer
• Obesity
• Chronic thypoid infection of gallbladder
• Chronic Cholecystitis and Cholelithiasis
• Various single Nucleotide Polymorphisms (SNPs)
• Older age
• Ethnicity and Geography
• Industrial and Environmental Chemicals

Diagnosis

Some tests and procedures are used to diagnose gallbladder cancer.

• Medical History is to get information about Patient"s health habit, past illness, and treatment.
• Physical Exam is to examine the body from signs or symptoms of gallbladder cancer.
• Liver Function Test  is a test in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver.
• Carcinoembryonic Antingen (CEA) Assay is a test to measure the level of CEA in the blood.
• CA 19-9 Assay is a test to measure the level of CA 19-9 in the blood.
• Blood Chemistry Study is a procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood  the organs and tissues in the body.
• Computed Tomography (CT) scan is a procedure that makes a series of detailed pictures of areas inside the body, such as the chest, abdomen, and pelvis taken from different angles.
• Ultrasound Exam is a procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes.
• Percutaneous Transhepatic Cholangiography (PTC) is a procedure that uses x-ray to the liver, and bile ducts.
• Chest X-Ray is an x-ray of organs and bones inside the chest.
• Endoscopic Retrograde Cholangiopancreatography (ERCP) is  a procedure that uses x-ray to the ducts that carry bile from liver to the gallbladder and from gallbladder to the small intestine.

The Stage of Gallbladder Cancer

• Stage 0 (Carcinoma In Situ) : Abnormal cells are found in the inner (mucosal) layer of the gallbladder.
• 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/to one nearby organ, including the stomach, the small intestine, the colon, the pancreas or the bile ducts outside the liver.
• Stage IIIB : Cancer has spread nearby lymph nodes beyond the inner (mucosal) layer 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/to one nearby organ, including the stomach, the small intestine, the colon, the pancreas or the bile ducts outside the liver.
• Stage IVA : Cancer has spread to a main blood vessel of the liver or to two or more nearby organs or areas other than 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 way from the gallbladder.

The Treatment of Gallbladder Cancer

1. Surgery

• Cholecystectomy is  to remove the gallbladder and some of tissues around it.
• Surgical Biliary bypass is done if the tumor is blocking the small intestine and bile is building up in the gallbladder.
• Endoscopic Stent Placement is done if the tumor is blocking bile ducts and puts in a stent to drain bile that has built up in the area.
• Percutaneous Transhepatic Biliary Drainage is done to drain bile when there is a blockage and endoscopic stent placement is impossible.

2. Radiation Therapy is a treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.There are two types of radiation therapy.External radiation therapy uses a machine outside the body to send radiation toward the cancer.Internal radiation therapy uses a radiactive substance sealed in needles, seeds, wires or catheters that are placed directly into or near the cancer.

3. Chemotherapy is a treatment that uses drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing.

4. RadioSensitizers are drugs to make tumor cells more sensitive to radiation therapy.

5. Hyperthermia Therapy is a treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation therapy and certain anticancer drugs.

Drugs for Gallbladder Cancer

• Fluorouracil (5-FU)
• Capecitabine (Xeloda)
• Gemcitabine (Gemzar)
• Cisplatin (Platinol)
• Oxaliplatin (Eloxatin)

The side effects of these drugs

• Hair loss
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Diarrhea
• Sore mouth
• Easy bruising