Gallbladder Cancer Treatment in Delhi

Overview

Gallbladder cancer is a rare type of cancer that occurs in the gallbladder, a small organ located just below the liver that stores bile, a fluid produced by the liver that helps digest fats. This cancer develops when the cells in the gallbladder begin to grow abnormally and uncontrollably, forming a tumour. These tumours can either be benign, such as a polyp, or malignant (cancerous), and they can progress over time.

Symptoms of gallbladder cancer can include abdominal pain, jaundice, and weight loss. This cancer is often not detected until it is at an advanced stage. Early diagnosis is crucial for effective treatment and outcomes.

Gallbladder cancer treatment in Delhi depends on the stage and location of the tumour, as well as the patient’s overall health. 

Causes and risk factors

The exact cause of gallbladder cancer is not well understood, but certain risk factors have been identified that may increase a person’s likelihood of developing the disease. These include:

• Being female: Women are more likely to develop gallbladder cancer than men.
• Age: The risk of gallbladder cancer increases with age, with most cases occurring in people over the age of 60.
• Cholelithiasis: The presence of gallstones in the gallbladder is a known risk factor for gallbladder cancer.
• Chronic inflammation of the gallbladder: Inflammation of the gallbladder over a long period of time (chronic cholecystitis) is a known risk factor for gallbladder cancer.
• Obesity: Obesity increases the risk of developing gallbladder cancer.
• Family history: Having a family history of gallbladder cancer may increase a person’s risk of developing the disease.
• Certain genetic conditions: Certain genetic conditions, such as Peutz-Jeghers syndrome and familial adenomatous polyposis, may increase the risk of developing gallbladder cancer.
• Geographic location: North India especially area of Ganges belt is the highest incidence area of gallbladder cancer in the world. 

Symptoms 

Symptoms of gallbladder cancer may not appear until the cancer is advanced. The symptoms can include:

• Abdominal pain: pain in the upper right side of the abdomen that may radiate to the back or shoulder.
• Jaundice: yellowing of the skin and whites of the eyes due to an accumulation of bilirubin in the bloodstream.
• Nausea and vomiting.
• Loss of appetite and weight loss.
• Fatigue
• Fever
• Swelling of the abdomen

Stages of gallbladder cancer

Staging is a way for doctors to determine the extent of cancer and plan the best treatment for the patient. The earlier the cancer is detected, the better the chances of recovery, and the more options for treatment are available.

Gallbladder cancer is typically classified into four stages, depending on the size and location of the tumour and whether it has spread to other parts of the body. The stages are:

• Stage I: The cancer is confined to the inner layers of gallbladder and has not spread to nearby lymph nodes or other parts of the body. A gallbladder tumour at this stage can only be cured if it is detected early.
• Stage II: The cancer has grown to the deeper layers of gallbladder but confined to it. Surgery is the most effective treatment for stage II gallbladder cancer.
• Stage III: Cancer has spread to nearby organs, such as the liver or stomach, but it has not spread to distant parts of the body. Stage III gallbladder cancer can be managed with radical surgery or an extended cholecystectomy.
• Stage IV: Cancer has spread to distant parts of the body, such as the lungs or bones or to the lymph nodes or to the major blood vessels of liver. Unfortunately chances of cure decreases as the stage progresses and is least in stage IV. However, your doctor may advise surgery to alleviate symptoms caused by cancer that has obstructed your biliary system (the system of the body that produces, stores, and excretes bile).

Treatment of gallbladder cancer

Many types of gallbladder cancer treatment in Delhi are available, such as laparoscopy, open surgery, chemotherapy, and radiation therapy.

Surgery

Surgery may be used to treat gallbladder cancer in some cases. The type of surgery you undergo is mostly determined by the size of the tumour and the stage of the disease. Your doctor also assesses other factors when considering surgery including your overall health, your age, and whether the tumour can be removed surgically (is resectable). Surgery may be done to:

• Totally remove the cancer
• Relieve pain and symptoms, or obstructions, in metastatic gallbladder carcinoma (known as palliative surgery). 

The disease is usually diagnosed at an advanced stage; therefore, only a small proportion of gallbladder cancers may be removed completely. It may have progressed to any of the following areas:

• The peritoneum (lining of the abdomen)
• Both sides of the liver
• Major blood vessels 
• Organs located far from the gallbladder

The following surgical procedures are used to treat gallbladder cancer. Other treatments may be given before or after surgery.

Simple cholecystectomy

Surgery to remove the gallbladder is called a cholecystectomy. A simple cholecystectomy, which only removes the gallbladder, is not a treatment for cancer.

But sometimes cancer may come to light after cholecystectomy done for presumed stone disease, This occurrence is known as INCIDENTAL GALL BLADDER CANCER. In this particular scenario if cancer is confined to the inner most layer of gall bladder ie T1a than even simple cholecystectomy is sufficient, in all other stages simple cholecytectomy is not a treatment for gall bladder cancer and it should not be performed. If there is any suspicion of cancer in gall bladder based on pre operative ultrasound or CT scan than one must consult a specialist HPB SURGEON and a simple cholecystectomy ( either laparoscopic and open ) should not be performed without due deliberation 

Laparoscopic cholecystectomy

Laparoscopic surgery involves placing a laparoscope (a flexible, long tube with a camera and light on one side) through tiny incisions into the abdomen. A laparoscopic cholecystectomy is performed to remove the gallbladder for non-cancerous disorders, including gallstones or chronic gallbladder inflammation (cholecystitis).

If cancer is detected during laparoscopy, the surgeon will switch the procedure to an open radical cholecystectomy to minimise the possibility of cancer being left behind or spreading. If cancer is detected only after gallbladder removal by laparoscopic surgery, more surgical procedure may be required to remove any surrounding tissue where it has spread.

Gallbladder cancer is often found accidentally when the gallbladder is removed for a non-cancerous condition. If the cancer is detected after cholecystectomy and hasn’t progressed beyond the gallbladder, more surgical procedure is often not required. If tests indicate that cancer has progressed around the gallbladder, further surgery may be required to remove extra tissue. 

Extended cholecystectomy

An extended cholecystectomy is a surgical procedure that is more complex than a simple cholecystectomy. It is performed when cancer has spread throughout the gallbladder. This type of surgery involves removing:

• A small section of liver tissue near the gallbladder
• The gallbladder
• Every lymph node around the gallbladder (regional lymph nodes)
• The tissue surrounding the area of the previous laparoscopic procedure on the gallbladder. 

Radical cholecystectomy

If cancer has progressed beyond the gallbladder but surgeons believe it may be removed completely, radical surgery may be performed. As compared to an simple cholecystectomy, a radical or extended cholecystectomy removes a larger portion of the surrounding tissue. A radical cholecystectomy removes:

• A portion of liver tissue around the gallbladder
• The gallbladder
• The common bile duct if needed 
• Lymph nodes from adjacent organs such as the blood vessels and pancreas
• Any adjacent organ if directly involved with cancer like colon or stomach 

Recovery

The recovery period after a radical cholecystectomy varies depending on the extent and the magnitude of procedure performed. A standard radical cholecystectomy may require 5-7 days of hospital stay. Your healthcare team will provide instructions for caring for incisions and any necessary post-operative medication for pain, infection, blood clot prevention, constipation, and other conditions. Some of the general instructions are:

• Take pain relievers as directed and avoid driving while under the influence of narcotics.
• Make sure to take a shower according to the directions provided.
• Ask your health professional when it is okay to return to work.
• Avoid heavy lifting until your doctor tells you to.
• Consider putting a pillow over the incision when sneezing or coughing to reduce pain and increase incisional support.

Cost of gallbladder cancer treatment

The cost of gallbladder cancer treatment depends on the stage of the cancer, the patient’s overall health, and the treatment plan chosen by the patient and their healthcare team. Other factors influencing the cost include the location and type of facility providing the treatment, as well as the patient’s insurance coverage. 

Additionally, the cost of any necessary follow-up care, such as physical therapy or hospice care, may also be factored into the overall cost of treatment.

Why choose Dr. Asit Arora?

Dr. Asit Arora is a highly skilled and experienced surgeon who specialises in the treatment of oncological conditions. He has a deep understanding of the latest medical advancements and technologies related to cancer treatment and is dedicated to providing the highest standard of care to his patients.

Dr. Asit Arora received the award for “Oncosurgeon of the Year” (North India) at the ET Healthcare Awards on November 17, 2022, in Gurgaon. He is a skilled clinician and surgeon known for treating patients with compassion, with over 15 years of surgical experience. His areas of expertise include gastrointestinal oncosurgery, advanced laparoscopic surgery, and HPB cancer surgery, with a special interest in the management of pancreatic cancer, gallbladder cancer, neuroendocrine tumours, VATS esophageal surgery, and minimally invasive GI oncosurgery.

Overall, Dr. Asit Arora is an excellent choice for anyone seeking treatment for gallbladder conditions. His combination of technical expertise, compassionate care, and dedication to the latest medical advancements make him one of the best surgeons in his field.