Cancer - Areawise in India

Cancer, according to WHO is the leading cause of deaths through out the world,  with 14 million (approx.) new cases and 8.2 million cancer related deaths in the year 2012. The deaths by cancer is likely to increase by 70% in the next 20 years.

The most common types of cancer causing deaths  among men are lung, prostate, colorectal, gallbladder, stomach, and liver cancer.

Among women the  most common types of cancer diagnosed were breast, cervix, stomach, gallbladder, colorectal and lungs 

More than 60% of world’s total new cancer cases occur in Africa, Asia and South and Central America. These regions contribute for 70% of the world’s deaths by cancer

Image Courtesy: Cancer Healer

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Stages in Gallbladder Cancer

Cancer staging, is basically the process of ascertaining the spread of cancer in the body and what is its origin. Staging traces the gravity of the cancer in an individual depending upon  epicenter of the origin and how far has it spread.

Staging is mainly based on the following factors

1. Site of origin of the tumor
2. Size of tumor and the extent of tumors
3. Has the cancer reached the lymph nodes
4. Metastasis ( spread to distant organs)

Stages of Cancer

Stage 0 (Carcinoma in situ) – Abnormal cell growth is found in the innermost (mucosal) layer of the gallbladder; these abnormal cells may in future become cancer.

Stage 1 (First) 

Cancer has started and has spread beyond the innermost (mucosal) layer to a layer of tissue with blood vessels or to the muscle layer.

Stage 2 (Second)

Cancer has spread beyond the middle (muscle) layer to the connective tissue around the layer.

Stage 3 (Three)

Stage 3A- Cancer has spread through the thin layers of tissue that cover the gallbladder and/or to the liver and/or to one nearby organ (stomach, pancreas, colon, small intestine or bile ducts outside of the liver)

Stage 3B- Cancer has spread to neighboring lymph nodes and beyond the inner layer of the gallbladder to a layer of tissue with blood vessels. OR

Spread to the muscle layer; or beyond the middle (muscle) layer to the connective tissue around the muscle. OR

Spread through the thin layers of tissue that cover the gallbladder and/or to the liver and/or to one neighboring organ

Stage 4 (Four)

Stage 4A- Cancer has spread to a main blood vessel of the liver or to 2 or more nearby organs or areas other than the liver. Cancer may have spread to nearby lymph nodes.

Stage 4B- Cancer has spread to either lymph nodes along large arteries in the abdomen and/or near the lower part of the backbone or to organs or areas far away from the gallbladder

Management

The stages are also grouped depending upon the treatment. There treatment can be divided into two groups:

Localized (Stage I): cancer is found in the wall of the gallbladder and can be completely removed by surgery.

Un-resectable (Stage II, Stage III, and Stage IV): cancer has spread through the wall of the gallbladder to surrounding tissues or organs or throughout the abdominal cavity. Except in patients whose cancer has spread only to lymph nodes, the cancer is un-resectable ( surgery cannot be performed).

Cancer keeps coming back!

Cancer that has returned after it has been treated is known as "recurrent cancer". The cancer may come back in the gallbladder or other body parts. If there is a recurrence, the cancer may need to be staged again, known as re-staging (as explained above).

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TARGET THERAPY in Gallbladder Cancer treatment

Gallbladder treatment, chemotherapy has been found to show limited or very less results. Researchers are coming up with a new line of treatment , known as TARGET THERAPY. These drugs are used in combinations of chemotherapy  drugs are now being tested for people with gallbladder cancer.

TARGET THERAPIES

These kind of therapies, are usually drugs or substances that targets the specific molecules in cancer cell growth. In contrast to the chemotherapy drugs, who act against cell division to stop their growth.

These drugs are target oriented and target parts of cancerous cells or  around their neighboring environments. Many of these new drugs target cells with specific changes in gene(s).

One such target are the tumor blood vessels. Gallbladder tumor require the new blood vessels to grow beyond a certain size. Such target drugs are said to really effective especially  in the treatment of Gallbladder cancer. For instance  Bevacizumab (Avastin®) and pazopanib (Votrient®) are examples of drugs that target blood vessel growth and are being studied for their use against gallbladder cancer.

Many other drugs have different targets For example, a protein, EGFR found in high amounts on certain types of cancer cell, is said to be helping the cancer cells in their growth. Drugs such as lapatinib (Tykerb®) and cetuximab (Erbitux®), are now being studied for  their usage in patients with gallbladder cancer,  along with chemotherapy and other targeted drugs.

Drugs such as MEK inhibitors, selumetinib and such as trametinib (Mekinist®) and, are also being studied for their use in the treatment of gallbladder cancer.

Courtesy: www.cancer.org