Gallbladder cancer and bile duct cancer (medical also: gallbladder carcinoma, bile duct carcinoma, cholangiocarcinoma) are with a frequency of one percent of malignant tumors to the rarer cancers. Most affected are patients over the age of 60, more women than men.

What is gallbladder cancer?

In the beginning, there are no symptoms of gall bladder cancer and bile duct cancer. Therefore, the disease is often discovered only very late.
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Gallbladder cancer develops from the gallbladder's mucosa, while bile duct cancer occurs within the bile ducts in the liver due to cell changes. A special form of bile duct carcinoma is the Klatskin tumor, which spreads at the exit site of the intrahepatic bile ducts.

causes

The causes of gallbladder cancer and bile duct cancer are largely unknown. However, a connection with various pre-existing diseases of the liver and the intestine is observed.

The risk groups include patients suffering from gallstones, larger gallbladder polyps or chronic inflammation of the gallbladder, which leads to calcification within the gallbladder (porcelain gallbladder).

Hepatic parasitis, salmonella, which causes chronic acid reflux, and chronic colitis ulcerative colitis may increase the risk of gallbladder cancer or bile duct cancer.

Symptoms, complaints & signs

In the beginning, there are no symptoms of gall bladder cancer and bile duct cancer. Therefore, the disease is often discovered only very late. In many cases, the doctor becomes aware of the tumor only by the so-called Courvoisierzeichen. The Courvoisierzeichen includes the two symptoms jaundice and palpable enlargement of the gallbladder.

Jaundice is caused by a bile. The bile enters the blood. The elevated bilirubin levels cause painless jaundice with yellowing of the eyes and skin. The patient also suffers from a tormenting and persistent itching. In addition, dark staining of the urine and discoloration of the stool occur.

The stool appears whitish to gray. The enlarged gallbladder also causes no pain, the magnification can be diagnosed in addition to the palpation by ultrasound. Other symptoms include increasing pain in the right upper abdomen, nausea and vomiting. The patient also suffers from loss of appetite and heavy weight loss.

If the disease is diagnosed only after the onset of the first symptoms, their chances of recovery are usually very poor, because then metastases have already formed. However, the so-called Klatskin's tumor has better chances of recovery. This form of bile duct tumors produces a bile already early. Therefore, jaundice occurs here already in a stage in which the tumor can still be completely removed.

Diagnosis & History

The diagnosis of bile duct cancer and gall bladder cancer is made by a physical examination and a detailed medical history. If the tumor is already very advanced, a pressure-insensitive resistance can be felt in the upper abdomen, which is medically called "Courvoisier sign".

Increased bilirubin levels and other elevated liver values ​​are detectable in the blood. Final diagnostic procedures include ultrasound, CT, MRI or endoscopic examinations. Often, the diagnosis is incidental in the context of upper abdominal surgery or gall bladder resection.

The 5-year survival rate is less than 20 percent due to increased late detection. Only in the case of very small carcinomas and the slowly growing Klatskin tumor are the chances of recovery considered more favorable.

complications

Gallbladder cancer and bile duct cancer cause common complaints and complications of cancer. Not in every case, a tumor can be completely removed. The later the diagnosis and the treatment, the higher the risk for the spread of the tumor to other regions. In this case, a positive course of the disease can not be guaranteed and it may possibly lead to a reduction in life expectancy.

Gallbladder cancer and bile duct cancer cause general tiredness and fatigue of the patient. Those affected are usually no longer actively involved in life and also suffer from severe weight loss. It also causes jaundice and itching, which can develop in all regions of the skin. Not infrequently, patients also suffer from abdominal pain, vomiting and nausea. The quality of life of the patient is significantly reduced and limited by these tumors.

In the treatment itself, there are usually no complications. Gallbladder cancer and bile duct cancer can be removed by surgery or radiotherapy. However, complete removal is not always possible. If the tumor has already spread to other areas of the body, then usually no complete cure is possible.

When should you go to the doctor?

A doctor should be consulted as soon as a feeling of pressure develops in the right area of ​​the upper body. If it comes to pain or colic, a doctor's visit should be as soon as possible. In case of nausea, vomiting, a general weakness or fever, a doctor is needed. Also to be clarified are symptoms such as diarrhea, constipation or a decrease in overall performance. If the person suffering from a diffuse sense of malady, an inner restlessness, insomnia or irritability, the signs should be discussed with a doctor.

Before taking an analgesic drug, it is advisable to consult with a physician. If sudden pain attacks occur, there is cause for concern. If these are particularly strong, an emergency medical service should be informed. If there are any difficulties in coping with everyday tasks or usual leisure activities, it is advisable to consult a doctor. A social retreat, increased need for sleep, exhaustion or apathy are also considered unusual.

If the state of health deteriorates because the symptoms increase in intensity or if further symptoms occur, a check-up with a doctor is necessary. In case of loss of appetite, striking weight changes or mood changes, the advice should be examined by a physician closer. In addition, discoloration of the skin or changes in the appearance of the skin indicate illnesses that need to be treated.

Treatment & Therapy

Gallbladder cancer and bile duct cancer are relatively difficult to treat because of advanced development.

An operative removal of the gallbladder, the extrahepatic bile duct and possibly a part of the liver is therefore the most common method. The surgery may also detect any metastases in the liver, duodenum and other organs. Subsequent radiotherapy is rarely performed because of the risk of damaging healthy neighboring organs. There has been little success in chemotherapy so far. It is therefore usually used only for pain relief.

The treatment therefore focuses on palliative therapies, which should enable the patient to continue to live as free as possible. With stents, the bile ducts are widened, so as not to obstruct the bile flow and to prevent backflow into the liver. Medical research still deals with the therapy of so-called "afterloading". This is a special form of radioactive radiation that is carried out within the body directly in the bile ducts.

Radioactive iridium is introduced with a probe to the tumor to arrest the primary tumor growth in gallbladder cancer and bile duct cancer. If both therapies can not be performed due to anatomical conditions, it is possible to disperse the bile fluid with a catheter and catch it outside the body.

Outlook & Forecast

The prognosis of gall bladder cancer and bile duct cancer depends on various influencing factors. It must always be set according to individual specifications and can not be regarded as universal. Decisive for a cure are the progress of the disease, the spread of the tumor cells in the whole organism, the age of the patient as well as the general state of health of the affected person.

The disease is more common in people over the age of 60 years. Often there are already other diseases that weaken the whole organism. Because gallbladder cancer and bile duct cancer are usually difficult to treat due to its location, surgery and subsequent cancer therapy are performed. The removal of the gallbladder is a slight intervention in comparison.

Nevertheless, the difficulty is to remove the entire diseased tissue completely. Cancer therapy prevents the formation of new cancer cells. At the same time, however, healthy cells are destroyed, which are elementary for the healing process. There is also the difficulty that only a few methods of cancer therapy can be used.

A full recovery is possible. It takes a few years, as the cancer therapy must be successfully completed. Since it can come next to other possible existing diseases also to complications due to cancer and mental disorders, in most cases, an unfavorable prognosis takes place.

prevention

Targeted prevention of bile duct cancer or gallbladder cancer is not known. It is therefore important to pay attention to the symptoms that occur in good time and have them examined by a doctor. Patients who have had or have had more frequent gallstones in the past are advised to have regular liver monitoring, possibly in combination with sonographic examinations, to detect in time the occurrence of malignant events in the gallbladder or bile ducts,

aftercare

A treatment is followed by a constant rehabilitation in a clinic. This should improve the quality of life and eliminate acute complaints. The unfavorable long-term prognosis for gallbladder cancer and bile duct cancer leads to regular check-ups. Anamnesis, ultrasonography, elevation of liver function and computed tomography have become established methods.

The last imaging procedure is necessary if a new disease is to be confirmed or excluded. In medical practice, control intervals have become established. For example, patients should present themselves quarterly after the first three years after illness. Subsequently, the intervals extend over half-yearly to annual appointments.

The time of diagnosis determines the intensity of the aftercare. Mostly, gallbladder cancer and bile duct cancer can only be completely surgically removed at an early stage. Then a complete cure is possible. There are no metastases yet. Statistically, most patients live on only five percent after five years.

Especially this aspect brings an extraordinary burden for those affected and their environment with it. Mental problems arise in a "life on call". Therefore, care for the elderly also represents a central instrument of follow-up in which patients can discuss existential questions.

You can do that yourself

Since the causes of gallbladder cancer as well as for bile duct cancer are still largely unclear, according to the current scientific state, there is insufficient information for extensive self-help measures.

Often, people do not become ill until the second half of life, so that in particular people over the age of 50 belong to the risk group. These people are increasingly recommended in everyday life, as a precaution and even with an existing diagnosis to maintain a healthy and conscious lifestyle. This includes a vitamin-rich and balanced diet. Excessive intake of fats, fiber or sugar should be avoided or reduced. The weight should be kept within normal limits in order to avoid any additional health risks.

Furthermore, sports activities and sufficient exercise strengthen the immune system. This leads to a reduction in the general susceptibility to disease. Stress, hecticness and prolonged emotional stress should be reduced. This may require changes in the general way of life.

A positive attitude to life, optimistic thinking and a stable social environment help to maintain good health as well as a necessary recovery process. Sleep conditions should also be checked and optimized if possible. In addition, the consumption of pollutants and toxins should be avoided. In particular, the enjoyment of nicotine and alcohol should be avoided.

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