Gallbladder cancer

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Gallbladder cancer is a relatively uncommon cancer. If it is diagnosed early enough, it can be cured by removing the gallbladder. Most often it is found after symptoms such as abdominal pain and jaundice occur, and it has spread to other organs such as the liver.

It is a rare cancer that is still being studied and thought to be related to gallstones building up, which also can lead to calcification of the gallbladder, a condition known as Porcelain gallbladder. Porcelain gallbladder is also rare. Some studies indicate that people with porcelain gallbladder have a high risk of developing gallbladder cancer, but other studies question this. The outlook is poor for recovery if the cancer is found after symptoms have started to occur.

Risk factors

* Gender: Approx. twice more common in women than men, mostly between the ages of 50 and 60.
* Obesity increases the risk for gallbladder cancer. It is common in North India indigenous peoples of the Americas.
* Primary carcinoma is linked to chronic cholecystitis and cholelithiasis.
* Alcohol: "…alcohol drinking is a risk factor of gallbladder cancer…" [cite journal
last = Ji
first = J
coauthors = Hemminki K
title = Variation in the risk for liver and gallbladder cancers in socioeconomic and occupational groups in Sweden with etiological implications
journal = Int Arch Occup Environ Health
volume =78
issue =8
pages = 641–9
publisher =
date = 2005 Sep
url = http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Display&DB=pubmed
doi =
pmid = 16001211
accessdate = 2007-05-28
] [Ji J, Couto E, Hemminki K. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15800949&dopt=Abstract Incidence differences for gallbladder cancer between occupational groups suggest an etiological role for alcohol] "Int J Cancer" 2005 Sep 1;116(3):492-3.]

igns and Symptoms

*Steady pain in the upper right abdomen for around 2 months.
*Diarrhea
*Burping
*Weakness
*Loss of appetite
*Weight loss
*Vomiting
*Infection, leading to peritonitis, gangrene, perforation, and or liver abscess
*Jaundice, due to obstruction

Early symptoms mimic gallbladder inflammation and gallstones, which must be excluded as the cause. Later, the symptoms may be that of biliary obstruction.

Disease Course

Most tumors are adenocarcinomas, with a small percent being squamous cell carcinomas. The cancer commonly spreads to the liver, pancreas, stomach,and duodenum.

Diagnosis

Early diagnosis is not generally possible. People at high risk, such as women or Native Americans with frequent gallstones, are evaluated closely. Endoscopic ultrasound, transabdominal ultrasound, CT scan, MRI, and MR cholangiopancreatography can be used to diagnose.

Treatment

The most common and most effective treatment is surgical removal of the gallbladder (cholecystectomy) with lymph node dissection. However, with gallbladder cancer's extremely poor prognosis, most will die by one year following the surgery. If surgery is not possible, endoscopic stenting of the biliary tree can reduce jaundice. Chemotherapy and radiation may also be used with surgery.Mutant Adenovirus based treatment is under investigation by several researcher [5] [6] and a company has even got license to use a mutant of Adenovirus (Onyx-15) to cure cancer.


=Additional

References

*3. Lewis, S.M., Heitkemper, M.M., & Dirksen, S.R. Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 6th ed. St. Louis: Mosby, 2004.
*4. McCance,K., & Huether, S. Pathophysiology: The Biologic Basis for Disease in Adults & Children, 4th ed. St. Louis: Mosby, 2002.
* 5.Toshihiro Tanaka, Hideo Shimura, Takamitsu Sasaki, Kou Narumi, Makoto Maemondo, Toshihiro Nukiwa, Kunio Matsumoto, Toshikazu Nakamura and Seiyo Ikeda1, Gallbladder cancer treatment using adenovirus expressing the HGF/NK4 gene in a peritoneal implantation model, Cancer Gene Therapy (2004) 11, 431–440.

* 6. Kuniaki Fukuda, Masato Abei2, Hideyo Ugai, Emiko Seo, Mariko Wakayama, Takehide Murata, Takeshi Todoroki, Naomi Tanaka, Hirofumi Hamada and Kazunari K. Yokoyama, E1A, E1B Double-restricted Adenovirus for Oncolytic Gene Therapy of Gallbladder Cancer, Cancer Research 63, 4434-4440, August 1, 2003.

External links

* [http://pathology2.jhu.edu/gbbd/ The Johns Hopkins Esophageal Cancer Web page]


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