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.

What is liver cancer?

Liver cancer is a life-threatening condition that starts in the liver when the hepatocytes or cholangiocytes (liver cells) begin to grow out of control. The treatment and prognosis of these tumours vary based on their different causes.

What are the types of liver cancer?

There are two types of liver cancer:

  1. Primary liver cancer: Liver cancer is commonly known as hepatocellular cancer. Primary liver cancer develops in the liver’s cells, blood vessels, bile ducts, or connective tissue.
  2. Secondary liver cancer – If it originates in another part of the body and spreads to the liver, it is also known as metastatic liver cancer.

Liver cancer specialists perform tests to diagnose the disease and begin treatment. If a person falls under the high-risk category for developing liver cancer, they are advised to undergo regular screening tests to detect cancer at its inception.

Causes and risk factors for liver cancer

A person feels liver cancer pain when liver cells develop changes in their DNA. A cell’s DNA is the material that offers instructions for every chemical process in your body, and these DNA mutations cause changes in these instructions, and as a result, they start growing uncontrollably and form a tumour. Several causes contribute to liver cancer:

  • Cirrhosis
  • Hepatitis B infection
  • Diabetes 
  • Obesity
  • Family history
  • Alcohol abuse and smoking
  • Prolonged use of anabolic steroids
  • Non-alcoholic fatty liver disease
  • Some inherited liver diseases, like Wilson’s disease
  • Herbicides
  • Chemicals such as arsenic and vinyl chloride

Secondary liver cancer is most common in those who have cancers of the large intestine (colon), stomach, pancreas, breast, or lung. It is critical to understand where cancer began since this will define the type of cells that are producing the disease and which treatment option is most suitable for you. 

What are the symptoms?

When liver cancer is in its early stages, a person might have no symptoms, which typically leads to a delay in diagnosis. When patients develop symptoms, they are often so mild that they are neglected. However, patients may experience some symptoms when the swelling in the liver develops. Some symptoms of liver cancer include:

  • Enlarged liver
  • Upper abdominal pain 
  • Loss of appetite
  • Unexplained weight loss
  • Fatigue
  • Fever
  • Swelling or fluid buildup in the abdominal area
  • Jaundice
  • Nausea
  • Chalky stools
  • Weakness and fatigue
  • Vomiting
  • Lump in the abdomen

You should make an appointment with the best liver cancer surgeon in Delhi, NCR, if you experience any of the above-listed signs and symptoms that worry you.

Different stages of liver cancer

After a person’s liver cancer is diagnosed, doctors will try to figure out to what extent it has spread. This process is called staging. The stages of liver cancer describe how much cancer is in the body and help determine how severe the condition is and what the best treatment is for it.

Liver cancer stages range from stage 1 to stage 4, and the lower the number, the less cancer has spread.

  • Stage 1: The first stage of liver cancer is when a tumour develops within the liver and its effects are localised and have not spread.
  • Stage 2: In the second stage of liver cancer, the tumour grows in dimension, reaching a size of 5 cm across, and there is a chance of developing small tumours. However, the spread is still localised.
  • Stage 3: This stage is divided into A, B, and C and is classified by the outgrowth of the tumour.
  • Stage 4: It is the last stage of liver cancer, and the size and number of tumours in the liver grow dramatically. The stage also marks the spread of the tumour into lymph nodes, blood vessels, and many surrounding organs. The fourth stage is also divided into A and B.

Liver cancer treatment

Treatment options for liver cancer depend on the stage of the disease, liver function, and the patient’s overall health. Patients should communicate with their doctor to determine the most appropriate treatment options for their particular needs.

If your cancer is in its early stages and the remaining part of your liver is healthy, a surgical procedure (partial hepatectomy) may heal you. If your cancer is in its early stages but the remaining part of your liver is not functioning properly, you may need to be treated with a liver transplant. 

In cases where the liver tumour is in a difficult-to-remove area (for example, very close to a main blood vessel), a transplant may potentially be a solution. Inoperable cancers are those that have not yet progressed to distant areas of the body or lymph nodes but cannot be safely removed with a partial hepatectomy. Treatment options include embolisation, ablation, chemotherapy, immunotherapy, or radiation therapy. For these cancers, treatment may reduce the size of the tumour(s) enough to enable surgery.

The advanced stage of liver cancer has progressed to the lymph nodes and/or other organs. Since these tumours are so widespread, surgery cannot be used to remove them.

Liver cancer surgery

There are two main types of liver cancer surgery:

  • Partial hepatectomy: This includes removing only a portion of the liver along with the tumour and some healthy tissue surrounding the tumour. MRI, CT, and other imaging tests are initially conducted to determine whether or not the tumour can be entirely removed.
  • Liver transplant: During this surgery, the liver is totally removed and replaced with a new, healthy one. This helps in the restoration of liver function and minimises the probability of cancer recurrence. Patients with liver cirrhosis and tumours, as well as large liver tumours, are candidates for liver transplantation. Transplants can be received from a close family member (a portion of the liver is taken) or from deceased donors for surgery.

Other treatment options 

The following approaches are commonly used in the treatment of liver cancer in Delhi:

  • Surgery for small lesions
  • Ablation, which includes the destruction of tumours without their removal.
  • Embolization, which involves cutting off blood flow to the tumour cells in the liver.
  • Targeted therapy, which involves the introduction of medicines into the bloodstream. 
  • Immunotherapy, which includes delivering medication intravenously to help the body identify and destroy cancer cells.

If your liver cancer is advanced, treatment may take some time. However, doctors will treat and limit cancer and its symptoms, helping you to live longer with fewer complications.

Liver cancer treatment cost and survival rates

Liver cancer treatment cost depends on many factors, for example, consultation costs, medication cost, hospital choice, hospitalisation period, diagnosis procedure, room and stay charges, fees of the medical team, the experience of the doctor, additional medical tests (if required), and post-surgery follow-up care costs.

Survival rates are commonly used to determine how many patients with a specific stage of liver cancer are alive five years after treatments. Liver cancer survival rates are good if it is diagnosed and treated at an early stage. 

Thus, it is vital to contact your doctor as soon as you observe any of the symptoms of liver cancer, or else you are at increased risk of developing cancer. An early liver cancer diagnosis helps you get treatment early and stops the cancer from spreading.

Followup care 

The physician providing liver cancer treatment in Delhi will perform routine medical check-ups to determine whether the disease has resurfaced. The concerned doctor may perform a series of medical tests, physical examinations, or combined approaches as follow-up care. 

The physician will also look for any side effects of the procedure. Let your doctor know about any changes you see in your body after treatment so that an appropriate follow-up care plan may be created. 

Why choose India for liver cancer surgery?

Liver cancer treatment cost in India is quite affordable, and many Indian hospitals have adopted advanced methodologies for radiation therapy. Surgical departments are well equipped to provide minimally invasive procedures, which reduce recovery time and pain and have many other benefits for patients. 

Why choose Dr. Asit Arora for liver cancer surgery?

Dr. Asit Arora is one of the best doctors for liver cancer surgery in Delhi and is currently working as a Director and head of the Division of GI & HPB Oncology at Max Super Speciality Hospital Saket, Gurugram, and Max Smart. He is among the top doctors in India, and his area of expertise includes HPB cancer surgery, Advanced laparoscopic surgery, and Gastrointestinal Oncosurgery. In the 2022 ET Healthcare Awards, he was awarded Oncosurgeon of the Year for his attempts to provide the best treatment to patients in this field of cancer care.