"It is important to detect early and after curative treatment be on close follow-up in order to detect any recurrence."

Diagnosis

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It may be picked up incidentally on a scan done for other purposes or in a biopsy of the gall bladder after it was removed for some other indication commonly stones. Whenever Ultrasound picks up some suspicious features in gall bladder, a contrast CT scan can give more information. Needle test or biopsy is not always necessary if imaging features are reasonably suggestive and disease is still in the purview of operability.


To ensure that there is no spread to other regions, a PET CT can help give detailed information. Endoscopic ultrasound may be useful in assessing the local area and the adjacent lymph nodes. MRI scan (MRCP) may be needed in presence of jaundice to map the biliary channel and locate the extent of the block.


If considered operable, laparoscopic (key hole) assessment can help rule out spread which is low volume and too small to be picked up on PET CT scan.


Tumour markers are blood tests which can help understand the prognosis of the cancer and for follow-up assessment. Serum CA 19-9 is the most commonly used tumour marker. It needs to interpreted with caution especially in presence of jaundice.

Treatment

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What is the role of surgery in gall bladder cancer?

Surgery forms the cornerstone for treatment in gall bladder cancer, when it is localised or at least confined to the adjacent areas/ lymph nodes. In addition, based on the final pathology report and clinical assessment, usually adjuvant therapy in the form of chemotherapy with or without radiotherapy may be advised.


Surgery usually varies from Radical cholecystectomy to variable extent of hepatectomy along with lymph node removal. In radical cholecystectomy, adjacent part of liver in the bed of gall bladder is removed.

Role of Proton

Radiation along with chemotherapy is used in some locally advanced gall bladder cancers to reduce the size and extent of the tumour and possibly make it suitable for resection. It is also used with palliative intent to relieve local pain.

What is the role of chemotherapy in gall bladder cancer?

Chemotherapy can have a role preoperatively (neoadjuvant therapy) when cancer is locally advanced or postoperatively as adjuvant therapy. In presence of distant spread or recurrent cancer, it may again be used selectively after discussing the pros and cons and understanding the risks versus benefits.

What is the role of radiotherapy in gall bladder cancer?

Radiotherapy has a limited role in gall bladder cancer. It may be combined with chemotherapy either before surgery or after surgery in selected situations. It may be used to palliate pain at distant sites of cancer like bony metastasis.


Proton Therapy - Radiation along with chemotherapy is used in some locally advanced gall bladder cancers to reduce the size and extent of the tumour and possibly make it suitable for resection. It is also used with palliative intent to relieve local pain.

Winning Over Cancer

Dr. Ashwathy Mathew, Consultant - Radiation Oncologist at APCC and our expert in Gastrointestinal oncology explains how Proton therapy is an effective treatment in Gastrointestinal cancers.

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Welcoming Dr Bhawna Sirohi. Dr. Bhawna Sirohi is a leading Medical Oncologist with an exemplary experience of more than 25 years. She is a renowned senior consultant across the globe who specializes in treating Breast Oncology and Gastrointestinal Cancers.

Dr. Bhawna has worked with the top Oncology Centres & Oncologists around the world. She joins as the Lead – Medical Oncologist at Apollo Proton Cancer Centre.

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Dr. Smarajit Patnaik from Bhubaneswar underwent proton therapy at Apollo proton cancer centre under the guidance of Dr. Ashwathy, Radiation Oncologist, APCC. Dr Smarajit Patnaik says "Thank you for making me feel safe & comfortable and taking utmost care during COVID-19". He also appreciated the quick action taken by the doctors & the professional & warm environment in the hospital.

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Dr. Bhawna Sirohi, Lead - Medical Oncologist at APCC, who specializes in GI Cancers talks about Pancreatic Cancer in this video. She outlines the risk factors, symptoms and the way forward for testing & treatment associated with this specific disease.

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Other Gastrointestinal Cancers

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