The Gallbladder and Cancer

Gallbladder

What is Gallbladder?

The gallbladder is a pear-shaped organ that lies just below the liver in the right upper abdomen.

The gallbladder stores bile, a yellow, brown or greenish liquid made by the liver that aids in digestion of  fat.

When food is being broken down in the stomach and intestines, bile is released from the gallbladder through a tube called the common bile duct.

This tube( common bile duct) connects the gallbladder and liver to the duodenum, first part of the small intestine.

Gallbladder (Anatomy)

The wall of the gallbladder has 3 main layers of tissue.

1. Innermost Layer (Mucosal) 
2. Middle Layer (Muscularis) 
3. Outer Layer (Serosal )

Gallbladder cancer starts from the innermost layer and then subsequently spreads to the other layers. Gallbladder cancer is difficult to detect initially, primarily because there are no visible  symptoms. And when the symptoms emerge they are symptoms of various other problems and by then its too late.

Risk Factor(s )

• Porcelain gallbladder (Chronic gallbladder inflammation)
• Gall stone (Cholelithiasis)
• Gallbladder polyps
• Chronic salmonella infection
• Cyst in the bile duct
• Age
• Ethnicity
• Gender ( more prevalent among women’s)

Symptom(s)

• Abdominal pain
• Loss of appetite
• Nausea or vomiting
• Fever and bloating
• Jaundice

Treatment

• Mainly depends on the extent to which the cancer has spread.
• If surgery is still an option.
• If cancer has returned.
• General health and age of the patient.
• Gallbladder cancer can be cured only if it is found in early stages ( Stage 1 or Stage 2)  i.e before it has spread to other organs.

After the cancer has spread to other body parts, nothing much can be done. Palliative treatment remains the only option. Palliative care aims at improving the patient’s quality of life by controlling symptoms and complications as a result of disease and treatment.

I love you, Papa!

Chapter 5 - Palliative Care

In words of Buddha…

No matter how hard the past is, we can always start afresh

It has been more then 10months, I am still trying to come terms with my loss. Had it been that easy, then everyone around me would have been happy. Such a perfect place to live, this world would have been. But none of us is happy ( Don't go by what i say, but introspect, you will find the answers). I come across a lot of people everyday but i haven’t found one such person…who is happy enough to not complain.

I understand that starting afresh is my only option. But the time i will  take to start, only time will tell. Moving from past to present, today i want to talk about the most difficult phase of life...when with every passing moment papa was suffering more. I knew time was running out but .... I became a spectator, He could not be saved.

In my last post i talked about the doctor telling me in my first visit of making my father nearing end…”easier” as NOTHING can be done now. What he meant was they will try to lessen his pain by medicines, care and counseling. This process of “trying” to make life comfortable is known as palliative care or support care or comfort care.

Papa, received palliative care from day 1 of his treatment,  and it continued till the day when he took his last breath. We were trying, but  nothing was coming out. I was loosing hope, I was scared as a result, i  spent most of my day in thinking or reading about other forms of treatment and pain relievers. Papa was trying hard. He just wouldn’t let go. Every time the palliative care team visited papa, at least papa spoke. Papa would plan his queries and ask me to write on paper, this gave me immense peace- though momentarily. As a result i started looking forward to visit from the team, That meant so much to me. 

CARE or NO CARE, i knew the result from the very first day. Nothing helped him. Neither medicines nor our prayers. And now, all i know is my father has left me. In his life, after cancer  the only thing that gave him some relief were the pain killers. Starting form 2 tablets a day to  a day arrived, when papa was just  having  the pain killers - absolutely no food, no juice, no water. We would moisten his lips with cotton dipped in water or may be put few drop of water by a spoon. How helpless CANCER made my father.  This continued for 4 months..But he held on. And then...

Even after taking precaution(s) and trying in vain. All the symptoms came along. one by one and i could do nothing.

He went away right in front of eyes….

Love you papa!

A little more about PALLIATIVE CARE

What is palliative care?

Palliative care is usually given to patients with  life threatening or serious illness such as cancer. The aim of this kind of care, is basically to handle or treat  the symptoms or side effects of the disease  as soon as they appear. The aim is to cure as prevention is not possible. Palliative care is also known as support care, symptom management or comfort care

When to start palliative care?

Palliative care, especially in diseases like cancer starts right from the diagnosis and continues throughout the treatment.

Who gives palliative care?

Usually the treating oncologist, but other people like the pain specialist, dietician, counsellor play an important role. The aim of palliative care is to  make life comfortable. 

Chapter 2 -Symptoms

People say time is the biggest healer.. I say time heals wounds but scars are left to remind you, what you have been through....

For me loosing my father was not just about loosing a parent. Besides loosing a valuable relationship, i lost a friend. My father,  actually both my parents have given us, siblings the liberty to speak our mind. And say whatever we wanted to.

And,  we could tell our parents anything and everything.

Papa was always a very disciplined and an organized person. He did everything so neatly and perfectly that sometimes i wonder how did he. At times mom would forget about something, but papa was more perfect then  organized. He just knew everything( I think all children think about their parent the way i think).

With him gone, and doing all things by myself makes me feel how hectic it is to be a parent and that too a parent, which i could look forward too. Though its been 10months since papa left , it feel likes it was just yesterday when papa was here with us and doing what he was best at- taking care of his children. He was always there for us.

When the doctor told me, papa has stage 4 cancer, i could not believe my ears- did i  just hear cancer? Is it happening to me? Has time come for papa? Will papa leave in few months. And I said to myself, loud and clear - NO, NEVER. I will challenge and win!( If only i had known, what papa was going through)

I wanted to be alone, i went to the park and set with my tablet in my hand. I typed " Gall Bladder Cancer Symptoms".

The result was :-

• Loss of appetite.
• Losing weight without trying
• Abdominal bloating.
• Abdominal pain, particularly in the upper right portion of the abdomen.
• Itchiness.
• Fever.
• Nausea.
• Yellowing of the skin and whites of the eyes (jaundice)

Now, i could relate to papa's loss of appetite and weight, constant complaint of pain in the abdomen, he being tired. 

It was  Diwali ( 13Nov2012), and i wanted to buy this dining table, i asked my father to accompany me. Papa always loved shopping. It was difficult to match his enthusiasm. And i have inherited the same quality. This store had its dining furniture on 3rd floor. As papa started walking he began to shake, he could not climb and  refused to come upstairs. He waited downstairs. Something was wrong. Papa was moving away from us. And we had no idea.  Had i known it or had the slightest inclination of it being cancerous. May be papa would have been here with me.