Gallbladder Cancer - Medical Malpractice Lawyers

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Gallbladder Cancer - Medical Malpractice

Gallbladder cancer is an uncommon condition in which cancer cells grow in the place of normal gallbladder cells. The gallbladder is a small organ located beneath the liver in the abdominal cavity. It normally stores and drains digestive juices called bile from the gallbladder to the duodenum to help with absorption of fatty substances in the diet. There are three layers to the gallbladder. This includes the mucosal layer which is the innermost layer. The middle layer is called the muscular layer and the serosal layer is the outermost layer of the gallbladder. Most gallbladder cancer begins in the mucosal layer of the gallbladder and spreads outward.

Risk factors for getting gallbladder cancer include being Native American and being female. Far more females get gallbladder cancer than men.

The major signs and symptoms of having gallbladder cancer include being jaundiced, having right upper quadrant of the abdomen, fever, bloating, nausea, vomiting and lumps noted in the abdomen. Gallbladder cancer is a hard cancer to detect early enough to do anything substantial to treat it. This is why it has a high death rate. Sometimes Stage I or early gallbladder cancer is found when the gallbladder is taken out for other reasons.

The diagnosis of gallbladder cancer helps doctors identify the stage of the cancer. The main diagnostic tools used to diagnose gallbladder cancer include an ultrasound of the gallbladder, which can show the mass and possibly any metastases in the gallbladder. A CT scan can also show the gallbladder and metastases as can an MRI. A careful history and physical examination might show jaundice or a mass in the abdomen. Liver function studies can be abnormal and often show an elevated direct bilirubin. A carcinoembryonic antigen or CEA test shows the evidence of gallbladder cancer in some cases. Another cancer marker is the CA 19-9 assay that is measured as being elevated in certain cases of gallbladder cancer. A chest x-ray can show evidence of metastases.

In certain cases, doctors can perform an endoscopic retrograde cholangiopancreatography or ERCP. This is a dye study that looks at the tubes and gallbladder via an x-ray that visualizes dye injected into the common bile duct. Laparoscopy and biopsy of the liver is a good test to show the presence of gallbladder cancer. A laparoscopy can also be done with a complete removal of the tumour and gallbladder at the same time. Finally, a percutaneous transhepatic cholangiography is a test that evaluates the liver and bile ducts by inserting a needle and injecting dye into the liver or bile ducts before an x-ray is taken. It can show how the exact biliary system looks like.

The prognosis and treatment of gallbladder cancer depends on the stage of the cancer. There are five stages of gallbladder cancer, of which only the first stage has a significant survival rate. In stage 0, the cancer is small and located in the mucosal layer only of the gallbladder. Stage IA has spread beyond the mucosal layer into the muscular layer. Stage 1B means the cancer has spread outside of the muscular layer and into the serosal layer. Stage IIA means the cancer has spread beyond the visceral peritoneal layer covering the gallbladder or has touched a nearby organ. Stage IIB has spread beyond the innermost gallbladder layer and into the lymph nodes nearby. Stage III cancer has spread to a nearby blood vessel in the liver or to several nearby organs and lymph nodes. Stage IV cancer has spread to distant body areas. Only stage 0 and stage I can be completely removed with surgery. The other stages are considered unresectable by surgery alone. The treatment options include various types of chemotherapy and radiation to the gallbladder and stomach area. There are several clinical trials for gallbladder cancer that may be more effective than standard treatments, which do not really work all that well. The rate of death from cancer beyond stage I cancer is really high.

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here