Learn more about the medical cases the doctors of SGH have faced
By Meg Marinis, Director of Medical Research
Isn't the new ER shiny and awesome??? We've got new lettering on the walls, a different color scheme, fancy portable workstations, an electronic patient tracking monitor, handheld tablets, and… The most amazing thing of all?
… The LODOX. It's one of those words that must be written in all capital letters. How can it not be? It's a low-dose radiation scanner that can image the entire body in only thirteen seconds! And it has its own special room behind glass walls. You think our doctors are psyched about it? You should have seen the writers watching the online video of how it works. It could save many, many patients.
… Except, sadly, not Madeline Skurski.
Poor Madeline received a diagnosis of late stage gallbladder cancer.
Gallbladder cancer is a cancer that initially forms in the tissues of the gallbladder – the small pear-shaped organ on the right side of the abdomen, just beneath the liver. The gallbladder stores bile, a digestive fluid produced by the liver, and releases it when the body breaks down food. When discovered in its early stages, gallbladder cancer usually can be cured with treatment. However, most cases of gallbladder cancer are diagnosed in later stages due to non-specific symptoms and the relatively hidden nature of the organ in the abdomen. And unfortunately, treatments for late-stage gallbladder cancer mostly consist of palliative measures.
Like in Madeline's case, some of the symptoms may resemble the stomach flu. Symptoms and signs include:
• Abdominal pain, particularly in the upper, right portion of the abdomen.
• Abdominal bloating.
• Loss of appetite.
• Losing weight without trying.
• Yellowing of the skin and whites of the eyes.
And factors that may increase the risk of gallbladder cancer include:
• Risk increases with age.
• The cancer is more commonly found in women.
• The risk may be increased in patients with a history of gallstones, chronic gallbladder infection, porcelain gallbladder, and choledochal cysts.
Standard treatment for gallbladder cancer includes surgery, radiation therapy or chemotherapy.
Initially, a cholecystectomy may be performed – a procedure to remove the gallbladder and its surrounding tissues (such as the nearby lymph nodes). However, if the cancer has spread beyond the gallbladder, the surgical options remain more palliative. A surgical biliary bypass may be done if the tumor has blocked the small intestine. In these instances, bile will build up in the gallbladder, but surgeons can establish a new pathway by cutting the gallbladder or bile duct and sewing it to the small intestine.
If a tumor has blocked the bile duct, surgeons can place an endoscopic stent to help drain the collection of bile – the drain can either lead to the small intestine or into a bag outside of the patient's body. When a stent cannot be placed endoscopically, a patient may receive percutaneous transhepatic biliary drainage. This procedure uses imaging techniques to guide the stent placement – the stent then is left inside the liver to directly drain the bile.
Depending on the type and stage of the patient's cancer, radiation therapy and chemotherapy may also be given.
Patients also have the option to consider enrolling in a clinical trial for gallbladder cancer.
A variety of clinical trials exist at different research institutions, and each trial has its own requirements. However, many trials are currently studying methods to improve the effect of radiation therapy – two experimental methods include hyperthermia therapy and radiosensitizers.
In hyperthermia therapy, the technique uses high temperatures to weaken or ideally, even kill cancer cells within the body tissue. And radiosensitizers consist of drugs that make tumor cells more sensitive to radiation therapy.
For more information on gallbladder cancer, please visit the following: