Gallbladder Cancer

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About Gallbladder Cancer

Gallbladder cancer is a rare type of cancer that affects the digestive system of the men. The gallbladder is a small pouch that stores bile. Bile is a fluid that helps us digest food. It helps break down fats in food.

People with early gallbladder cancer often experience no symptoms. It is generally found when someone undergoes surgery to eliminate gallstones. There is no known cause of gallbladder cancer, but there are factors that can increase your risk of developing it. These include:

  • Age
  • Gallstones and inflammation
  • Polyps (non-cancerous tumours of the gallbladder)

Most gallbladder cancers are only found at an advanced stage. They can cause a variety of symptoms, including:

  • Sickness
  • High temperatures (fevers)
  • Weight loss
  • Pain in the tummy (abdomen)

If cancer blocks the bile duct, it may stop the flow of bile from the gallbladder into the small bowel. This causes bile to flow back into the blood and body tissues. This can lead to:

  • The skin and whites of the eyes become yellow (jaundice)
  • The urine becoming a dark yellow colour
  • Pale stools (bowel motions)
  • Itchy skin.

There are four stages of gallbladder cancer:

  • Stage 1: cancer affects only the wall of the gallbladder. Approximately 1 in 4 cancers (25%) are at this stage when they are diagnosed.
  • Stage 2: cancer has spread through the full thickness of the wall of the gallbladder, but it has not spread to nearby lymph nodes or surrounding organs.
  • Stage 3: cancer has spread to lymph nodes close to the gallbladder or has spread to the liver, stomach, colon or small bowel.
  • Stage 4: cancer has spread very deeply into two or more organs close to the gallbladder, or it has spread to distant lymph nodes or organs, such the lungs. This is known as metastatic or secondary cancer.

When it comes to detecting the presence of gallbladder cancer, several diagnostic procedures are available such as:

Ultrasound scan: - This uses sound waves to an image of the
gall bladder and surrounding organs. Once you are lying comfortably on your back, a gel is spread onto your tummy (abdomen). A small device that produces sound waves is then passed over the area. The sound waves are made into a picture on a computer. The test is painless and only takes a few minutes. You may be asked not to eat or drink before the scan. Your doctor or nurse can tell you more about what you need to do before the ultrasound scan.

CT scan: - A CT (
computerised tomography) scan uses x-rays to build a three-dimensional (3D) picture of the inside of the body. You may be given either a drink or injection of dye. This is to make certain areas of the body show up more clearly. This scan takes about 30 minutes and is painless. We have more detailed information about having a CT scan.

MRI (magnetic resonance imaging) scan: - This scan uses magnetism to build up a detailed picture of areas of your body. You may be given an injection of dye, into a vein, to improve the images from the scan. We have more detailed information about having an MRI scan.

An MRCP (Magnetic Resonance Cholangio-Pancreatography) is a special type of MRI scan that may be used. It is not widely available. If you are having this scan, your doctors will tell you more about it.

ERCP (endoscopic retrograde
cholangio-pancreatography): - This test may be used to take an x-ray picture of the pancreatic duct and bile duct. It can also be used to unblock the bile duct if necessary.

You'll be asked not to eat or drink anything for about six hours before the test, so the stomach and the first part of the small bowel (the duodenum) are both empty. The doctor will give you a tablet or injection to make you relax (a sedative). They will use a local
anaesthetic spray to numb your throat. The doctor will then pass a thin, flexible tube called an endoscope through your mouth, into your stomach
and into the small bowel just beyond it.

The doctor will look down the endoscope to find the openings where the bile duct and the duct of the pancreas drain into the duodenum. They can inject a dye that can be seen on x-rays into these ducts. This means they can see whether there are any abnormalities or blockages.

EUS (endoscopic ultrasound): - This scan is similar to an ERCP, but an ultrasound probe is attached to the endoscope. This takes an ultrasound scan of
thegall bladder and surrounding structures.

Angiogram: - This is a test to look at your blood vessels. The bile duct is very close to the large blood vessels that carry blood to and from your liver. An angiogram may be used to check whether any of these blood vessels are affected by cancer.

Angiograms are done in the x-ray department. A thin tube is put into a blood vessel (artery) in your groin. A dye is then injected into the tube. The dye travels around the arteries so they show up on an x-ray.

Laparoscopy: - This is a small operation that allows the doctors to look at your
 gallbladder, liver and other internal organs in the area around the gall bladder. It’s done under a general anesthetic and you will have a short stay in a hospital.

While you are under
anaesthetic, the doctor will make a small cut (incision) in your tummy (abdomen) and insert a thin, flexible tube that has a light and camera (laparoscope). They will look at your gall bladder. They may take a small sample of tissue (biopsy) to look at under a microscope.

Sometimes they remove the
gall bladder during a laparoscopy, to treat gallstones or chronic inflammation of the gallbladder. This operation is called a laparoscopic cholecystectomy.

If the surgeon finds or suspects gallbladder cancer during this operation, they will change the operation to an open cholecystectomy. This is when they remove
thegall bladder and surrounding tissues through a larger cut in the tummy. This makes it easier to remove all of cancer.

After a laparoscopy, you will have one or two stitches in your abdomen. You may have uncomfortable wind and/or shoulder pains for several days after the operation. You can often ease the pain by walking or taking sips of peppermint water. Your doctor may also give you painkillers.

Laparotomy: - If none of these tests has been able to diagnose the cause of your symptoms, you may have an operation called a laparotomy. This is done under a general anaesthetic.

The surgeon makes a cut (incision) in your tummy, so they can look at the
gall bladder and the tissue around it. If they find cancer that has not spread to surrounding tissues, they may be able to remove it. Or they may be able to clear any blockages that cancer might be causing.

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