Therapy for gallbladder cancer
Synonyms in a broader sense
Gallbladder tumor, gallbladder carcinoma, squamous cell carcinoma, adenocarcinoma, porcelain gallbladder
Note
All information given here is only of a general nature, tumor therapy always belongs in the hands of an experienced oncologist (tumor specialist)!
therapy
The treatment of gallbladder carcinoma is very difficult because most gallbladder carcinomas are diagnosed in a non-curative (non-curative) stage. However, healing is only possible through an operation in which the entire tumor could be removed, including the affected lymph nodes. However, in the advanced stage, an operation is also useful, as it restores the drainage conditions and thus improves the quality of life. If the tumor has progressed too far and surgery is no longer possible, palliative therapy is indicated. This means that a curative approach is no longer possible and that the therapy aims to alleviate the symptoms caused by the tumor.
Read more on the subject at: Palliative medicine
Operational approach
In addition to the Gallbladder (Cholecystectomy) often a part of the liver (Partial liver resection) must be removed as the tumor has often already grown into it. Restoring the smooth drainage of bile is important during the operation.
In rarer cases, a cholecystectomy is required for other reasons such as Gallstone disease, removed, an early-stage carcinoma was discovered by the pathologist. Sometimes a re-operation is then necessary, for example to additionally Lymph nodes (Lymphadenectomy) after resection. However, these revelations remain an exception.
Pathological diagnostics
The gallbladder tumor is assessed histologically by the pathologist after it has been removed. For this purpose, the tumor specimen is cut at certain points and at the resection margins. From these samples, wafer-thin sections are made, stained and assessed under the microscope. The type of tumor is determined, its spread in the gallbladder wall assessed and the removed lymph nodes examined for tumor involvement. It is also important that there is sufficient distance between the tumor margins and healthy tissue so that there are no tumor cells on the incision margin that could later cause the tumor to grow again (relapse). Only after the pathological findings can the tumor be clearly classified according to the TNM classification, which describes the primary tumor (T), the lymph nodes (N) and the distant metastases (M).
chemotherapy
Unfortunately, gallbladder tumors are often not very sensitive to cytostatics. However, some ongoing clinical studies are investigating which combinations of cytostatic agents will produce the best results.
Before an operation, an attempt can be made to reduce the size of the tumor (neoadjuvant) by means of chemotherapy, which is usually carried out in combination with radiotherapy (radiochemotherapy), so that the cancer can be operated out more effectively.
Radiation therapy (radiotherapy)
Radiation therapy is generally effective for this form of cancer. However, due to the sensitivity of the neighboring organs (such as the small intestine, liver and kidney), the radiation dose cannot be selected high enough to induce the tumor to go into complete remission. However, a growth stop or a partial reduction in size of the tumor is achieved. This is particularly advantageous in the case of inoperable patients who are receiving therapy that is no longer aimed at healing, but instead aims to alleviate the tumor complaints, such as tumor pain (palliative therapy). Radiotherapy can also be used preoperatively to reduce the size of the tumor (neoadjuvant therapy) in order to improve the results of the operation.
Illustration of the gallbladder
- Gallbladder Body -
Corpus vesicae biliaris - Right liver bile duct -
Ductus hepaticus dexter - Left liver bile duct -
Left hepatic duct - Gallbladder duct -
Cystic duct - Gallbladder Neck -
Collum vesicae biliaris - Mucous membrane -Tunica musoca
- Common
Liver bile duct -
Common hepatic duct - Main bile duct -
Common bile duct - Pancreatic duct -
Pancreatic duct - Extension of the united
Execution corridor -
Ampula hepatopancreatica - Large duodenal papilla -
Major duodenal papilla - Duodenum Descending Part -
Duodenum, descending part - Liver, diaphragmatic side -
Hepar, Facies diaphragmatica - Pancreas -
Pancreas
You can find an overview of all Dr-Gumpert images at: medical illustrations
forecast
Overall, the patient's chances of recovery are rather poor. Only the tumors that were discovered during the removal of the gallbladder (cholecystectomy) carried out for other reasons have a somewhat more favorable prognosis because they are operated on at an early stage by chance, which does not cause any symptoms. The five-year survival rate for this form of cancer is only 5%, which means that 5% of those affected are still alive after 5 years after diagnosis.
