Rare Cancer in Adulthood - Gallbladder Cancer

Gallbladder is a small organ under the liver with a function of aiding the digestive system in fat metabolism with storing of the bile produced by the liver.

Gallbladder cancer is defined as a cancer arises from the cells of tissue of the gallbladder. It is common cancer in central and South America, central and eastern Europe, Japan and northern India, but rare in North America.

Symptoms
1. Steady pain in the upper right abdomen
Due to enlarged of the tumor
2. Weakness
Due to not enough bile in production of energy in fat metabolism.
3. Loss of appetite
A common symptom of cancer
4. Weight loss
Another common symptom of cancer.
5. Jaundice
Due to abnormal liver function affected by gallbladder cancer.
6. Vomiting
Due to obstruction of bile flow.
7. Gallbladder inflammation
Due to obstruction of bile flow cause of inflammation
8. Etc.

Causes and risk factor
1. Genetic factors
In a study of Alterations of p53 gene in gallbladder cancer patients of North India, researchers concluded that our results show that 1//3rd of the north Indian patients with GBC have antibodies to p53 protein. The commonest identifiable alteration in the p53 gene was a frameshift mutation at codon 271.

2. Gallstones
Risk of gallbladder cancer increases with the presence of gallstones.

3. Inflammation of the gallbladder
Risk of gallbladder cancer increase for people with chronic gallbladder inflammation.

4. Obesity
In a study of Obesity and the risk of gallbladder cancer: a meta-analysis, researchers suggested in summary that this meta-analysis indicates that excess body weight is a risk factor for gallbladder cancer, suggesting that it may in part be prevented by maintaining a healthy body weight.

5. Alcohol drinking
Alcohol increases the risk if the development of gallstones in the bladder

6. Chemical substances
Exposure to certain chemical substance such as aromatic hydrocarbons may increase risk of the disease.

7. Age
elders over 70 of age is at risk of of gallbladder cancer.

8. Family history
Increased risk of the disease with people with family history of gallbladder cancer.

9. Smoking
In a study of Acute effect of smoking on gallbladder emptying and refilling in chronic smokers and nonsmokers, researchers found that there is a link between smoking and gallbladder.

10. Etc

Diagnosis and tests
After recording the family history and physical exam to check for any sign of cancer such as swelling, lump, etc. Your doctor may suggest the diagnosis and tests below.
1. Blood test for tumor markers (CEA and CA19-9)
Any indication of high levels of carcinoembryonic antigen (CEA) and CA19-9 in the blood may be result of gallbladder cancer.

2. Ultrasound
Ultrasound allows your doctor to visualize and assess the size and to check for any abnormality and surrounding area with image taken from the test.

3. CT scan
A CT scan generates a large series of two-dimensional X-ray images taken around a single axis of rotation, to create a three-dimensional picture of the inside of the body in details. The pictures are viewed by your doctor to see the extent of the tumors abnormalities, such as spreading of cancer to the nearby structure and lymph nodes. Unfortunately, CT scan can only review the existence of cancer, but can not tell it is a primary or secondary cancer.

4. Chest x-ray
If your doctor suspected that cancer has invaded the lung tissue.

5. MRI (magnetic resonance imaging)
MRI (magnetic resonance imaging) is one of many advanced technology used to visualize internal structures cross sectional imaging of your body used effectively in providing the better details of the metastasis of cancer in the vulva and surrounding areas.

6. Biopsy
In gallbladder cancer biopsy, a very small tissue sample is extracted and examined under a microscope for the presence of cancer cells by using a thin, tube like medical instrument to look for the grade of abnormal cells growth.

7. Percutaneous transhepatic cholangiography (PTC)
Percutaneous transhepatic cholangiography is a procedure of x-ray the liver and bile ducts after injection of dye in toto the liver and bile duct with a thin tube-like needle inserted through the skin and into the liver to check for any blockage of the organ. In case a blockage is found, bile will be drained through a thin, flexible tube put in the liver to the small intestine.

9. Etc.

Grades
The grade of gallbladder cancer are depending to the tendency of spreading. Low grade cancers usually grow more slowly and are less likely to spread while high grade cancer indicates otherwise.

Stages
Gallbladder cancer is classified as 5 stages
1. Stage 0
If the cancerous cell have not penetrated into deeper tissue but on the surface of the inside lining of the gallbladder .

2. Stage I
In stage I, the cancerous cells are no longer in the surface but have invaded into deep the inside gallbladder lining but still completely inside the gallbladder.
a. Stage IA
The cancer is not ≤ 3 mm (1/8 inch) deep and ≤ 7 mm (1/4 inch) wide.
a.1. Stage IA1:
The spreading is not less than 3mm(1/8 inch) deep and & less than 7mm (1/4 inch) wide.
a.2. Stage IA2:The invasion area is ≥ 3 mm but ≤ 5 mm (about 1/5 inch) deep and & less than 7 mm (about 1/4 inch) wide.
b.Stage IB:
The cancer in this stage have invaded the connective tissue, & less than 5mm (1/5 inch).
b.1. Stage IB1:Cancer is 4 cm large (1 3/4 inches).
b.2. Stage IB2:Cancer is ≥ 4 cm (1 3/4 inches) but & less than 5cm (1/5 inch)

3. Stage II
In stage II, the cancerous cells have spread to distant tissues, but is still within the gallbladder.

4. Stage III
In this stage, cancerous cells has spread to the tissues immediately surrounding the gallbladder.

5. Stage IV
In this stage, cancerous cells has spread to the tissue immediately outside of the gallbladder to distant parts of the body.

Prevention
A. How to avoid
1, Quit smoking
Smoking
In a study of Acute effect of smoking on gallbladder emptying and refilling in chronic smokers and nonsmokers: a sonographic study by Degirmenci B, Albayrak R, Haktanir A, Acar M, Yucel A. researchers found that smoking prolongs the maximal GB emptying time both in smokers and in nonsmokers though it is not significant. It delays GB contraction in chronic smokers and causes a significant decrease in GB emptying volume. Smoking causes no significant delay in GB refilling in both smokers and nonsmokers. These effects of smoking observed in acute phase result in bile stasis in GB. Bile stasis is the underlying cause of most GB disorders in chronic process.

2. Reduce intake of Alcohol drinking
Alcohol increases the risk if the development of gallstones in the bladder.

3. Reduce weight
In a study of Obesity and the risk of gallbladder cancer: a meta-analysis, researchers suggested in summary that this meta-analysis indicates that excess body weight is a risk factor for gallbladder cancer, suggesting that it may in part be prevented by maintaining a healthy body weight.

4. Chemical substances
In a study of Gallbladder cancer presenting with Trousseau's sign in a 31-year-old man with
occupational exposure to aromatic hydrocarbons, researchers found that his exposure to aromatic hydrocarbons was aetiologically important and further studies of workers with similar exposures should be taken.

5. Avoid inflammation of gallbladder
Cholecystitis People with inflammation of the gallbladder, Cholecystitis, are at risk of the cancer.

6. Etc.

B. Diet
1. Garlic
An analysis of several case-controlled studies in Europe suggests an inverse association between garlic consumption and risk of common cancers.

2. Soy
In laboratory studies, saponins have shown the ability to inhibit the reproduction of cancer cells and slow the growth of tumors in several different tissues.

3. Carrot
Carrot contains high amount of beta carotene which has shown to induce appotosis of cancer cells. In study of Cell Cycle Regulation and Induction of Apoptosis by β-carotene, researchers found that in vivo study warrants further confirmation that β-carotene acts as apoptosis agent in cancer cells particularly leukemia cells but not normal cells.

4. Tomato
Many studies showed that antioxidant lycopene in tomato inhibits cancer cell growth and exhibit apoptosis, causing cell death.

5. Cruciferous vegetables
Cruciferous vegetables such as cauliflower, broccoli, cabbage, etc. beside contain high amount of antioxidants, but also phytonutrients that have been shown to help prevent the onset and halt the progression of certain cancers.

6. Etc.

C. Nutritional supplements
1. Antioxidants - - free radical scavengers
Vitamin A, C, E are free radical scavengers enhanced the immune system against the forming of free radicals and prevent the alternation of cell DNA cause of abnormal cell growth. For more information of how antioxidants help to treat cancer, click here

2. Beta -carotene
In some laboratory, animal, and human studies, researchers found that vitamin A, certain retinoids may also inhibit cancer development.

3. Theanine
an amino acid that produces tranquilizing effects in the brain, theanine found in green tea, has a significant clinical results for naturally calming as it promotes alpha brain waves, putting you in a state of relaxation without causing drowsiness. It also increases the dopamine levels in the brain, leading to a well-being feeling.

4. Indole-3-carbinol
Cabbage, a curciferous vegetables contains high amount of indole-3-carbinol, a chemical which boosts DNA repair in cells and appears to block the growth of cancer cells.

5. Quercetin
In study of effects of quercetin on human laryngeal cancer Hep-2 cells, researchers found that Quercetin could effectively inhibit the proliferation of Hep-2 cells and its mechanism is probably related to the apoptosis

6. Etc.

Treatments
A. In conventional medicine
1. Surgery
Surgery is the primary treatment for patient with in gallbladder cancer. If the cancer has not spread and within the gallbladder, then removing it will have a higher chance to cure. If the cancer has spread to the liver then surgery will include the removal of the gallbladder and parts of the liver.

2. Radiotherapy
a. By using high-energy x-rays or other types of radiation, radiation therapy kills cancer cells and keep them from growing or regrowing. Depending to stage, grade and location of the affected area. Radiation may be used in situations when surgery isn't an option.
b. Side effects
b.1.. Fatigue
b.2. Chest pain
b.3. Heart problem
b.4. Short of breath
b.5. Skin discoloration or pinkness, irritation.
b.6. Etc.

3. Chemotherapy
a. Chemotherapy is most use to treat with advance stage of skin cancer, as it has spread to a distant parts of the body by using drugs taken by mouth or injected into a vein or muscle of the patient to stop the growth of or to kill cancer cells.
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.

4. Etc

B. Herbal medicine
1. Aloe
In some studies, researchers suggest that some chemical compounds of aloe, such as acemannan, aloeride, and di(2-ethylhexyl)phthalate (DEHP) may have immunomodulating and anticancer effects.

2. Leaves of Camellia sinensis
In some clinical studies researchers suggested that the polyphenols in green tea, may play an important role in the prevention of cancer by killing cancerous cells and stopping their progression.

3. Allium sativum,
An analysis of several case-controlled studies in Europe suggests an inverse association between garlic consumption and risk of common cancers.

4. Allium tuberosum
In a study of A Pilot Study on Anticancer Activities of Chinese Leek researchers found that Chinese leek extract inhibited cancer cell growth and induced apoptosis in vitro. Oral administration of leek extract significantly reduced lung metastases in the present animal model.

5. Absinthe
Absinthe is also known as Wormwood, a distilled, highly alcoholic beverage flowers extracted from leaves of the herb Artemisia absinthium. In a study, researcher at the University of Washington found that wormwood can be used as a promising potential treatment for cancer.

C. Traditional Chinese medicine
1. Gan Cao
Gan Cao is also known as Licorice root. In-vitro, researchers found that saponins in Gan Cao stimulate the immune system and inhibit Epstein-Barr virus expression and possess anti-cancer activities.

2. Huang Qi
In study of Astragalus-Based Chinese Herbs and Platinum-Based Chemotherapy for Advanced Non–Small-Cell Lung Cancer: Meta-Analysis of Randomized Trials, researchers found that astragalus may increase effectiveness of platinum-based chemotherapy when combined with chemotherapy. These results require confirmation with rigorously controlled trials.
According to the American Cancer Society, the substances, licochalcone-A, licocoumarone and glabridin, which are present in licorice root, may prevent mutations in the DNA and kill existing cancer.

3. Wu Ling Zhi
Wu Ling Zhi is also known as Trogopterus Dung. A report from China Journal of Chinese Materia Medica 2006-07 showed that Radix ex Rhizoma Ginseng and Trogopterus Dung inhibit the proliferation and induce the apoptosis of tumor cell.

4. Qing Hao
Qing Hao is also known as wormwood. In a study, researcher at the University of Washington researcher found that wormwood can be used as a promising potential treatment for cancer among the ancient arts of Chinese folk medicine.

5. Ban Zhi Lian
In a recent study results suggest that ginger, tea, and a Chinese herb called Scutellaria barbata or Ban Zhi Lian could all help to prevent cancer.
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