Gallbladder Cancer Treatment Information

GALLBLADDER (BILIARY) CANCER TREATMENT INFORMATION

What does the Biliary System Do?

The gallbladder is an organ in the abdomen which collects bile drained by the liver into this sac, which is connected to the liver by the cytic duct. It is then transported as needed, through the common bile duct into the small intestine. It then travels to meet the draining pancreatic duct at the "Ampulla of Vater" . The bile and pancreatic secretions then pass into the first portion of the small intestine ("duodenum") through the sphincter of Odi", a small drainage hole.

Bile is a putrid greenish substance which helps digest fats, by coating them and breaking them down. This process is called emulsification. Digested fats can then be absorbed into the bloodstream and used to make energy for the body. Any inflammation of the bile system is called "cholangitis", while specific inflammation of the gallbladder only is called"cholescystitis" . Inflammation can be caused caused by germs, drugs, radiation, immune diseases, or most commonly a blockage of the bile flow by gallstones or a tumor.

When the bile flow is blocked, for whatever reason, it tends to backflow into the bloodstream and remain unprocessed ("unconjugated") by the liver. The form which bile takes in the bloodstream is called "bilirubin" and there is normally some present (<1.4 mg/dL) in the blood serum. When the bilirubin increases, the whites of the eyes ("sclera") and then skin turn yellow, called "jaundice", while the stool becomes much lighter or even white. Digestion of fats is impaired, leading to loose, smelly stools ("steatorrhea"). The blockage may affect the pancreas, causing pancreatitis, and paralyze the local digestive tract ("gallstone ileus").

The biliary system is surrounded by important organs-- the pancreas, esophagus, liver, bowel, spinal column, and major blood vessels. Infection or cancers can directly invade these areas with relative ease ("local spread") . Furthermore, there is a system of"lymph channels" draining blood serum from the liver and gallbladder, and transporting this serum to nearby"lymph nodes" . The lymph nodes are normally pea-sized "filters", full of white blood blood cells, which purify the blood serum. The lymph nodes are interconnected and eventually return the purified serum to the bloodstream. When lymph nodes are invaded by infection or cancer, they swell ("lymphadenopathy") and when overwhelmed act as a route of spread ("lymphogenous spread") . Moreover, the bile duct area, and digestive system in general, has a rich blood supply from both major arteries and draining veins. These blood vessels can act to carry cancers or infections to distant parts of the body ("hematogenous spread" ). The point is that initially local cancers of the bile system may be spread through the body ("disseminated") with relative ease. Most non-cancerous gallbladder and bile duct problems occur in women with the "Five F's"-- Female, Forty to Fifty years old, Fertile, Fat, and Flatulent (a medical student's mnemonic). More rarely, the "biliary system" (gallbladder and bile ducts) will be afflicted with cancer.

Like all organs, the biliary system is made up of individual "cells" which are arranged to form "tissues" . The cells in the bile duct system grow rapidly in womb life, childhood and through puberty. In adulthood, they divide much more slowly, to replace those that die of injury or old age. Like all cell division in the body, this process is tightly controlled to proceed in an orderly manner. This control is exerted by the genetic material ("genes") in each cell, which are in turn are made up of "DNA" . Biliary cancer starts within a single cell. Something changes the control mechanisms within this cell, the genes become damaged, and it starts dividing in a rapid and disorganized manner. Eventually these abnormal cells for a clump, or"tumor". A tumor is merely a swelling, as isn't necessarily cancerous. A "benign" tumor just grows in it's local area, and although it may become very large it doesn't spread and isn't cancer.

By contrast, a malignant tumor is cancer and has a capacity to spread to any area of the body. The process of spread of called"metastasis" . Thus, any metastatic tumor is by definition cancerous. Only a cancer which starts in the biliary system is called "primary" biliary cancer. A cancer that has spread there from another area (i.e. lung, colon, ovary) is named for it's place of origination.

How Common is Biliary Cancer?

Hepatobiliary cancer (meaning in either the liver or bile ducts) occurs in 20,000 new patients and causes15,000 deaths each year in the United States. About 3000 of the cases are in the liver itself, the remaining 17,000 cases are in the Gall Bladder and bile drainage ducts. Bile duct cancer is equally common in males and females, and the average patient is 60 years old. However, gall bladder cancer is three times more common in women than men, (similar to the higher rate of gallstones in women). Any biliary cancer is rare (<1% of cases) in patients under age 45.

People don't think about their gallbladder unless it is diseased with gallstones, or it develops cancer. In the past gallbladder cancer was almost always fatal, since it tended to be advanced when first be diagnosed and effective treatments were not available.

There has been much research in the past decade on treating gallbladder and other biliary tract cancers. It is crucial to make the right choices in treating this condition. It can make the difference between life and death. Understanding your options for gallbladder cancer will give you the peace-of-mind knowing that you have done everything possible to fight this disease successfully.

CancerAnswers's materials explain, in plain English, the definition, types, frequency, symptoms, evaluation, and historic and latest effective treatments for gallbladder cancer. We describe surgery, radiation, and chemotherapy, and tell you their results. We tell you everything you need to know to help you make the right choices today for a gallbladder or biliary tract cancer problem.

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