Signs And Symptoms Of Gallbladder Cancer
Noticeable symptoms of gallbladder cancer typically dont appear until the disease is very advanced. Thats why, usually, its already spread to nearby organs and lymph nodes or traveled to other parts of your body when its found.
When they do occur, signs and symptoms may include:
- abdominal pain, usually in the upper right portion of your abdomen
- jaundice, which is yellowing of your skin and the whites of your eyes due to high levels of bilirubin from obstruction of your bile ducts
- lumpy abdomen, which occurs when your gallbladder enlarges due to blocked bile ducts or the cancer spreads to your liver and lumps are created in your upper right abdomen
Occasionally, gallbladder cancer is found by coincidence in a gallbladder that was removed for cholecystitis or another reason. But usually, your doctor will run diagnostic tests because you had symptoms appear.
Tests that might be used to diagnose, stage, and plan treatment for gallbladder cancer include:
Cancer staging tells you if and where the cancer has spread outside of your gallbladder. Its used by doctors to decide on the best treatment strategy and determine the outcome.
Gallbladder cancer is staged using the American Joint Committee on Cancer TNM staging system. The scale goes from 0 to 4 based on how far the cancer has grown into the gallbladder wall and how far its spread.
More information about cancer spread is given by TNM:
What About Other Treatments That I Hear About
When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, diets, and other things. You may wonder about these treatments.
Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.
Questions to ask the doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too?
- What will these treatments be like?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
Our Approach To Pancreatic Cancer
Johns Hopkins pancreatic surgeons perform a variety of innovative techniques to treat pancreatic cancer, including operations using both traditional open methods and minimally invasive methods. During one appointment at our multidisciplinary clinic, patients will meet with experienced specialists who will care for them at every stage of the journey.
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Survival By Stage Of Gallbladder Cancer
There are no UK wide statistics available for gallbladder cancer survival by stage.
The statistics below come from America. They come from the National Cancer Institute’s SEER programme. They are for people diagnosed with gallbladder cancer between 2009 and 2015.
Please be aware that these figures might not be a true picture of survival in the UK. This is due to differences in the American health care systems, population, and data collection.
The American statistics are split into 3 stage groups localised, regional and distant cancers. In the UK, your doctor might not use these terms. Instead, they might describe your cancer as a number stage . The following descriptions are a guide to help you understand whether your cancer is localised, regional or distant. This isnt straight forward and will depend on your individual situation. Talk to your specialist if you are unsure which group you are in.
- Localised – usually includes stage 1 and stage 2 cancers which havent spread outside the gallbladder
- Regional – usually includes stage 3 cancers that have spread outside the gallbladder into surrounding tissues or lymph nodes
- Distant includes stage 4 cancers that have spread to other parts of the body, away from the gallbladder
LocalisedAround 65 out of 100 people survive their cancer for 5 years or more after diagnosis.
Regional More than 25 out of 100 people survive their cancer for 5 years or more after diagnosis.
Blood Chemistry And Complete Blood Count Testing
A complete blood count of a dog with liver or gallbladder cancer may reveal a decreased red blood cell count and changes to the platelets. The blood chemistry may reveal changes secondary to liver and gallbladder cell damage, bile stasis and liver insufficiency. Commonly, veterinarians see an elevation of liver- and gallbladder-specific blood values. Severity of blood changes doesnt necessarily correlate with severity of disease, in all cases.
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How Quickly Can Gallbladder Cancer Spread
Gallbladder cancer is a rare and aggressive disease that is often found incidentally.
There are no screening tests for gallbladder cancer like there are for some other cancers, which makes it harder to find the disease at an early stage.
The majority of people with early disease have no symptoms or will present with nonspecific symptoms like abdominal pain, nausea, vomiting or loss of appetite that resemble gallstone disease or cholecystitis, says Sylvia Alarcon, MD, a medical oncologist specializing in gastrointestinal cancers at Roswell Park Comprehensive Cancer Center. Patients are often diagnosed incidentally with gallbladder cancer during or after surgery to remove the gallbladder due to gallstones.
Liver Metastases: Symptoms Diagnosis And Outlook
Liver metastases are cancerous tumors that have spread to the liver from another part of the body where the cancer originated. Some healthcare professionals may call liver metastases secondary liver cancer.
The cancer cells that develop in liver metastases are not cells from the liver. They are cells from the part of the body where the cancer first developed.
Since the cancerous tumors have spread to the liver from another part of the body, a doctor may refer to liver metastases as stage 4, or advanced cancer.
Primary liver cancer is less common than liver metastases. Typically, people with primary liver cancer have risk factors such as cirrhosis or hepatitis.
may not present any noticeable symptoms. However, as the tumor in the liver advances, the liver may swell.
The swelling can cause an obstruction to blood and bile flow. When this occurs, a person may experience symptoms such as:
- jaundice, or yellowing of the skin and eyes
- nausea and vomiting
- pain in the right shoulder
- pain in the upper right side of the abdomen
A person with cancer in another area of the body who notices new symptoms should let a healthcare professional know as soon as possible.
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What You Can Do
Prevention is key because gallbladder cancer can be hard to treat. You canât change your age, gender, or other things that put you at higher risk. But you can take some steps to help lower your odds.
Keep a healthy weight. Extra fat may fuel cancer growth by raising levels of inflammation and certain hormones in your body. Losing extra weight is one of the most important things you can do to help avoid all types of cancer.
Eat healthfully. Lean toward more plant-based foods, including fresh vegetables and fruits. Limit red meat and processed meats like hotdogs and salami. Choose whole grains like brown rice and whole-wheat pasta.
Limit alcohol. Have no more than one drink a day if youâre a woman and two or less if youâre a man.
If youâve been diagnosed with porcelain gallbladder, when the wall of the gallbladder is covered with calcium deposits, talk to your doctor about whether itâs a good idea to take out your gallbladder with surgery. Sometimes the benefits may not be worth the risks.
Catheterizable Continent Diversion Pouch
This is a reservoir of bowel with a stoma that is catheterizable for emptying the bladder. The urine is siphoned out of the urinary reservoir with a small catheter every four to six hours. The catheterizable pouch may require surgical repair at some point after surgery due to the wear and tear of frequent catheterization. This type of reconstruction is not performed on patients with a history of bowel disease.
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How Is The Stage Determined
The staging system most often used for gallbladder cancer is the American Joint Committee on Cancer TNM system, which is based on 3 key pieces of information:
- The extent of the tumor : How far has the cancer grown into the wall of the gallbladder? Has the cancer grown through the gallbladder wall into nearby organs such as the liver? The gallbladder wall has several layers. From the inside out, these are:
- The epithelium, a thin sheet of cells that line the inside wall of the gallbladder
- The lamina propria, a thin layer of loose connective tissue
- The muscularis, a layer of muscular tissue that helps the gallbladder contract, squirting its bile into the bile duct
- The perimuscular fibrous tissue, another layer of connective tissue
- The serosa, the outer covering of the gallbladder that comes from the peritoneum, which is the lining of the abdominal cavity
The depth that a tumor grows from the inside through the other outer layers is a key part of staging.
- The spread to nearby lymph nodes : Has the cancer spread to nearby lymph nodes and if so, how many?
- The spread to distant sites : Has the cancer spread to distant organs such as the liver, the peritoneum , or the lungs?
The system described below is the most recent AJCC system, effective January 2018. This system is used to stage cancers of the gallbladder as well as cancers that start in the cystic duct .
Cancer staging can be complex, so ask your doctor to explain it to you in a way you understand.
Surgery Is The First Step
Surgery is the only potentially curative treatment for gallbladder cancer. If the pathology confirms gallbladder cancer, the next step is to determine the stage of cancer. Staging evaluation will determine the next steps in management. In patients with early-stage disease, it is important to determine if the tumor can be removed by surgery. If the tumor cannot be surgically removed, or is in a later stage, then palliative systemic therapy it is recommended to prolong life, which will mean reducing the tumor burden, Dr. Alarcon says. It is also recommended that patients, if they are eligible, participate in clinical trials. If patients are not able to tolerate systemic treatment, then the best supportive therapy would be indicated. It is also important to send tumor for molecular testing to evaluate for other treatment options including immunotherapy and targeted therapy.
Dr. Alarcon says less than half of the people diagnosed with gallbladder cancer will have localized disease, meaning their cancer hasnt spread to the lymph nodes, while 25% of patients will learn their cancer has spread to their lymph nodes and the remaining percentage will have distant metastasis. At later stages, especially if the gallbladder cancer has spread, prognosis is poor, she says.
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Tests That May Be Done
Blood tests: Blood tests can be used to help find out how much bilirubin is in the blood. Bilirubin is the chemical that gives the bile its yellow color. Problems in the gallbladder, bile ducts, or liver can cause a high bilirubin level. Other blood tests can show how well the liver is working.
Ultrasound: For this test, a small wand is moved around on your skin. It gives off sound waves and picks up the echoes as they bounce off tissues. The echoes are made into a picture on a computer screen. This is often the first test used to look at the gallbladder.
CT or CAT scan: This test uses x-rays to make pictures of your insides. It can show the size, shape, and place of any tumors in the gallbladder or near it.
MRI: To make clear pictures, this test uses radio waves and strong magnets instead of x-rays. MRI scans can help show if tumors in the gallbladder are cancer. They can also be used to look at nearby blood vessels and other organs. And they can help find out if the cancer has spread.
Cholangiogram: This test looks at the bile ducts to see if they are blocked, narrowed, or widened. It can be used to help plan surgery. There are many types of cholangiograms, and each has different pros and cons.
Angiogram: This test looks at blood vessels around the gallbladder. It may be used to help plan surgery. It can be done with x-rays or with a CT or MRI scan.
Questions to ask the doctor
Stereotactic Body Radiation Therapy
Stereotactic Body Radiation Therapy, or SBRT, is a method of delivering external beam radiation to the site of a tumor using high-dose, precisely focused beams of radiation. Once only used for the brain, stereotactic radiation therapy can now be used to treat tumors in other regions of the body, including otherwise inoperable tumors of the liver, thanks to recent advances in imaging, dose delivery and patient positioning techniques. SBRT, also known as fractionated radiosurgery , destroys tumors with high doses of radiation, while sparing healthy surrounding tissue. UMGCCC was the first medical center in the Mid-Atlantic region to offer the Trilogy System, the one of the most advanced forms of technology available for providing stereotactic body radiation therapy.
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Transurethral Resection Of The Bladder Cancer Tumor
This is when the tumor is removed from the urinary tract through the urethra using an electrical force. Transurethral resection is an endoscopic or scope procedure that does not involve making an incision in the body.
Drug therapy after TUR is commonly prescribed for patients with large, multiple or high-grade tumors.
Subtleties And Future Questions
Several factors have to be carefully considered in interpreting the trial results, explained Dr. Apolo.
A major one is that the study did not directly compare survival between people who got avelumab immediately versus when their cancer progressed. Only about half of the participants who initially received supportive care alone went on to receive immunotherapy after their cancer got worse. There could be many reasons for this, including lack of access to these drugs in different countries, Dr. Apolo said.
But it also might be that, for some people, the cancer was progressing too rapidly, she added. When these tumors start growing, they start growing very quickly. So if you wait to start at the time of progression, maybe its too late, added Dr. Apolo.
Not all patients will be caught by the second-line safety net, agreed Dr. Plimack.
So, for now, said Dr. Balar, the takeaway message from the JAVELIN study is after chemotherapy, dont wait to give immunotherapy.
But more and more, studies are looking at whether some patients should receive immunotherapy as first-line treatment, he continued. Immunotherapy is one of the most important advances weve made in the last 30 years, Dr. Balar said.
The JAVELIN results cant provide any insight into which patients benefit from first-line treatment with a platinum-based chemotherapy, he added. This trial wasnt designed to ask: Is chemotherapy necessarily the best choice for every patient? he explained.
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Should I Make Any Lifestyle Changes Including In My Diet Or Physical Activity
Achieving and maintaining a healthy weight by eating a balanced diet with plenty of fruits, vegetables, and whole grains, and staying physically active, can help your overall health. These lifestyle changes can also have a positive effect for men with bone metastases, Tagawa says. Both diet and exercise, he says, are things that are under a mans direct control.
A healthy lifestyle can help you better manage side effects from treatment as well. Try setting small but realistic goals for yourself when it comes to eating a healthy diet and getting plenty of exercise.
While no single food is likely to have a benefit for prostate cancer, smart food choices may help you feel better day to day. Start by cutting out foods high in sugar, saturated fat, and added flavorings and preservatives.
If youre not sure which healthy foods to choose, ask your doctor for a referral to a dietitian. This specialist can help you develop a meal plan that includes foods that offer the best chance of slowing the cancers growth and keeping you as healthy as possible.
As an oncologist, Tagawa says he concentrates on treating the cancer itself, but hes aware that many of the men he sees with advanced prostate cancer are older and more likely than younger men to have health problems that can benefit from diet and exercise.
And if youre on hormone therapy, talk to your doctor about investing in some weights or elastic resistance bands to support your bone strength too.
Liver And Gallbladder Cancer In Dogs Faqs
How long do dogs live with liver cancer?
Depending on the type of cancer, some dogs can live years after diagnosis. However, in more severe cases, the survival rate is much lower.
Is a dog with liver cancer in pain?
Depending on the specific disease, dogs with liver cancer may feel lethargic, appear nauseous and have a tender abdomen.
How fast does liver cancer progress in dogs?
Depending on the type, liver cancer can progress in a matter of weeks or years.
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