Gallbladder cancer

　　In recent years, gallbladder cancer has become one of the major diseases that threaten social and human health, bringing great pain and distress to humans. In order to reduce the incidence of gallbladder cancer, we humans should master the causes of gallbladder cancer:

　　1. The relationship between cholelithiasis and gallbladder cancer

　　Gallbladder cancer patients often have gallstones, with a co-occurrence rate of 70% to 80% in Europe and America, 58.8% in Japan, and 80% in China. Gallbladder cancer tends to occur in the neck of the gallbladder, which is easily struck by stones, and is more common in patients with gallstones for more than 10 years, so it is believed that gallstones are closely related to gallbladder cancer. The risk of gallbladder cancer is 10 times higher in patients with stones larger than 3cm than in those with stones smaller than 1cm. Some people believe that gallstones contain carcinogens, but there is a lack of conclusive evidence, and the incidence of gallbladder cancer in patients with gallstones is only 1% to 2%. Therefore, whether there is a clear causal relationship between gallstones and gallbladder cancer is still unclear at present.

　　40% to 50% of gallbladder cancer patients have chronic cholecystitis. Some studies have found that the ratio of atypical cell proliferation and malignant transformation in the severe chronic cholecystitis group is higher than that in the non-severe group, with a high incidence of intestinal metaplasia in non-cancerous sites, and similar intestinal epithelial tumor structures in the cancer focus, thus considering intestinal metaplasia to be an important pathological change in the occurrence of canceration. The occurrence of gallbladder cancer may be: normal gallbladder mucosa → chronic cholecystitis (including stones) → intestinal metaplasia → the development and progression of differentiated gallbladder cancer (intestinal type cancer).

　　2. The relationship between gallbladder benign polyps, adenomas, and gallbladder cancer

　　Sawyer reported 29 cases of benign gallbladder tumors, 4 of which were malignant. He reviewed literature data from the past 20 years and believed that gallbladder adenoma is a precancerous lesion. Gallbladder adenomas are mostly solitary, pedunculated, and have an incidence of canceration of about 10%. If gallstones are present, the risk of canceration increases. Studies have found that those with a diameter less than 12mm are mostly benign adenomas; those with a diameter greater than 12mm are mostly malignant lesions. All in-situ carcinomas and 19% of invasive carcinomas have adenoma components, thus considering adenomas to have the potential for canceration.

　　3. The relationship between abnormal bile-pancreatic confluence and the incidence of gallbladder cancer

　　Research has found that when the common channel of the bile and pancreatic ducts exceeds 15mm, there is bile-pancreatic reflux, which is called abnormal bile-pancreatic confluence. Many authors point out that abnormal confluence of the bile and pancreatic ducts increases the incidence of gallbladder cancer. When the confluence of the bile and pancreatic ducts is deformed, the long-term reflux of pancreatic juice continuously destroys the gallbladder mucosa, repeatedly regenerates, and may undergo malignant transformation during this process. There are reports that in ERCP examinations of gallbladder cancer patients, 16% have malformation of the bile-pancreatic duct confluence. Kimura et al. reported that 96 cases of gallbladder cancer were confirmed by angiography, 65 of which had abnormal bile-pancreatic confluence. Among the 65 patients with abnormal bile-pancreatic confluence, 16.7% had gallbladder cancer. In the control group of 641 patients with normal bile-pancreatic duct confluence, the incidence of gallbladder cancer was 8%. Another group reported that the incidence of gallbladder cancer in patients with abnormal bile-pancreatic confluence was 25%, and the incidence of gallbladder cancer in the normal confluence group of 635 patients was 1.9%.

　　4. Other factors

　　In addition, Ritchie et al. reported that chronic ulcerative colitis often occurs with gallbladder cancer. The incidence of gallbladder cancer in patients with Mirizzi syndrome increases, which may also be one of the causes. There are reports that the onset of gallbladder cancer is related to abnormal gallbladder ducts or congenital bile duct dilatation.

　　Expert tip:If you experience symptoms of illness in your physical health, do not delay diagnosis and go to a regular hospital for medical treatment in a timely manner to avoid delaying the condition and causing serious consequences.

　　When gallbladder cancer patients receive clinical treatment, they may also experience symptoms in other parts of the body. Many patients are very painful due to severe complications. Therefore, it is reminded that patients should not ignore the prevention of complications during the treatment process. The following are some common complications of gallbladder cancer.

　　Complications of gallbladder cancer include gallbladder infection, abscess, perforation, and liver abscess, subphrenic abscess, pancreatitis, portal vein thrombosis, intestinal obstruction, gastrointestinal and intra-abdominal hemorrhage, and may also form fistulas with nearby gastrointestinal tract.

　　1, In some cases, patients show gradual weight loss, weight loss, fatigue, and present with a poor condition.

　　2, In some cases, metastatic lymph nodes can be palpated above the clavicle, and there may also be metastatic tumors in the breasts and other areas.

　　3, In advanced cases, there may be gastrointestinal bleeding, ascites, and liver dysfunction due to compression of the portal vein.

　　4, Swelling, biliary obstruction can cause multiple liver abscesses, and it is common to form abscesses in the gallbladder cavity where the tumor occurs or around it.

　　Summary: The above is a detailed introduction of some complications of gallbladder cancer. Patients usually experience the above conditions during treatment. Remind patients that if they have the above conditions, they should not handle them independently and should contact the doctor in a timely manner to make professional handling under the correct guidance of the doctor.

　　In recent years, gallbladder cancer has become one of the major diseases that threaten human physical health, causing great suffering. Gallbladder cancer can not only lead to the death of patients but can also lead to complications. What are the typical symptoms of gallbladder cancer? The experts of the tumor hospital introduce the relevant knowledge of the typical symptoms of gallbladder cancer, hoping it will be helpful to you.

　　1, Abdominal pain:

　　About half of gallbladder cancer patients have right upper quadrant pain, distension, or discomfort, weight loss, loss of appetite, and other symptoms. These gallbladder cancer symptoms are often considered as early warning signs of cholangiocarcinoma. The pain starts with symptoms similar to cholelithiasis or cholecystitis. According to clinical observations, cholangiocarcinoma can appear with abdominal pain and jaundice within 3 months.

　　2, Skin itching:

　　It can appear before or after the onset of jaundice, or accompany other symptoms such as tachycardia, bleeding tendency, mental fatigue, weakness, steatorrhea, abdominal distension, etc. Skin itching is caused by an increase in bilirubin content in the blood, which stimulates the terminal nerves of the skin.

　　3, Jaundice:

　　Patients with cholangiocarcinoma often lack typical symptoms in the early stage, and most patients seek medical attention due to jaundice. Jaundice is the earliest and most important symptom of gallbladder cancer. The characteristics of jaundice are progressive worsening and deepening, and it is mostly painless. A small number of patients may have fluctuating jaundice. The jaundice of upper segment cholangiocarcinoma appears earlier, while the middle and lower segment cholangiocarcinoma may appear later due to the buffering effect of the gallbladder.

　　Expert reminder:If you experience symptoms of illness in your physical health, do not delay diagnosis and go to a regular hospital for medical treatment in a timely manner to avoid delaying the condition and causing serious consequences.

　　What are the preventive methods for gallbladder cancer? Gallbladder cancer is also a malignant tumor that causes great harm to the human body. To avoid this harm, active prevention is very important. So, how should gallbladder cancer be prevented? The following introduces the preventive measures for gallbladder cancer.

　　First, before actively treating cancerous changes, it is necessary to remove potential causes of cancer as soon as possible, such as actively treating cholecystitis. For patients with symptomatic gallstones or larger stones, it is necessary to perform cholecystectomy as soon as possible.

　　Second, psychological care:

　　Emotional factors are closely related to the development of diseases, the effectiveness of treatment, and the prognosis. Medical staff should encourage patients to maintain a positive attitude, build confidence in overcoming the disease, give full play to the body's potential ability, and enable patients to actively cooperate with treatment and improve the effectiveness.

　　Three, dietary regulation:

　　Gallbladder cancer patients have poor digestion and absorption of food due to poor bile excretion, especially difficult to digest fatty foods. Patients often show poor appetite, decreased food intake, bloating, and irregular stools. Choose easily digestible and nutritious foods such as fresh fruits and vegetables, eat less or no high-fat foods, quit smoking and drinking, and drink plenty of water.

　　Four, encourage patients to do things within their ability to distract negative emotions, self-regulate their mindset, such as practicing Qigong, taking a walk, listening to popular science knowledge, and combining activity with rest.

　　Five, when resting, maintain a comfortable position, generally with the left lateral position and supine position as the best, to prevent pressure on the gallbladder area.

　　Six, according to current research reports, 70% of gallbladder cancer patients are related to gallstones, and the time from gallstones to gallbladder cancer can last for 10 to 15 years. Gallbladder cancer complicated with gallstones is 13.7 times higher than that without gallstones, and the incidence of stones with a diameter of 3 centimeters is 10 times that of 1 centimeter, indicating that the occurrence of gallbladder cancer is the result of the combined effects of long-term physical stimulation of gallstones, chronic inflammation of the mucosa, and carcinogenic substances in the products of bacteria.

　　Seven, gallbladder cancer is one of the malignant tumors with the worst treatment effect, so the prevention of gallbladder cancer is the most crucial. Therefore, the only effective method of prevention for gallbladder cancer is gallbladder resection.

　　Eight, gallbladder resection surgery under non-acute inflammation is a relatively easy operation, and most of them can be completed by laparoscopic surgery, which is less painful and quick to recover. Pain pumps can also be used after surgery to alleviate the pain caused by the operation. Therefore, there is no need to worry about the pain caused by the operation.

　　The above are the preventive methods for gallbladder cancer. Active prevention is better than treatment. In order to ensure life safety and health, we should actively prevent diseases in our daily lives, and diseases will stay away from us. For cancer, early detection and early treatment are essential.

　　Patients should have a correct understanding of the diagnosis of gallbladder cancer. Then, what are the diagnostic criteria for gallbladder cancer? What are the laboratory tests for early diagnosis of gallbladder cancer? The following introduces the laboratory tests for gallbladder cancer.

　　1. Ultrasound examination:

　　Ultrasound examination is simple, non-invasive, and can be used repeatedly. Its diagnostic accuracy reaches over 90%, making it the first choice for diagnosing gallbladder diseases. With the continuous replacement of instruments, it is not only possible to clearly observe the size of gallbladder lesions, but also to help determine whether there is cancer by observing the blood flow of the lesion tissue. It can also be observed whether there is obvious lymph node metastasis and whether the liver is involved. Experienced examiners can even determine which layer of the gallbladder the lesion involves.

　　2. CT scanning:

　　CT scanning is not as effective as ultrasound for the diagnosis of early gallbladder cancer. However, for patients who have been found to have highly suspicious gallbladder cancer by ultrasound, enhanced CT examination is necessary. The CT imaging changes of gallbladder cancer can be divided into three types:

　　①Thick-walled type: The gallbladder wall is locally or diffusely irregularly thickened.

　　②Nodular type: Papillary nodules protrude into the lumen from the gallbladder wall.

　　③ Solid type: due to the extensive infiltration and thickening of the gallbladder wall by the tumor, and the filling of the intracavitary tumor mass, a solid mass is formed. During enhanced scanning, it is generally observed that the lesion tissue has abundant blood supply. If the tumor invades the liver or there are related lymph node metastases, they can often be displayed on CT images.

　　3、 Magnetic Resonance Imaging (MRI):

　　MRI is generally not the first or necessary examination item for gallbladder cancer, but it can be considered when it is necessary to determine whether the lesion involves the liver or when the patient has obstructive jaundice. Its accuracy is similar to that of CT, but it has the advantage of no radiation damage and can be repeated multiple times.

　　4、 PET-CT:

　　As a relatively qualitative examination item, under the premise of excluding acute cholecystitis, this examination can help in the qualitative diagnosis of gallbladder space-occupying lesions and can help determine whether there are lesions outside the gallbladder. However, it is relatively expensive, and it is prone to false-positive results when combined with acute cholecystitis, so it is generally not considered as a routine examination.

　　5、 Laboratory examination:

　　When gallbladder lesions appear to be malignant, it is generally accompanied by an increase in tumor marker levels. Checking for elevated serum tumor markers (CEA, Ca125, Ca19-9, Ca724, Ca153, etc.) can help in the qualitative diagnosis of gallbladder cancer, but early cancer changes may not show an increase, or when combined with other gastrointestinal diseases and certain tumors, the test may show false-positive results. Liver function tests generally show normal results, but there may be related abnormal findings when there is biliary obstruction.

　　The above is the examination and inspection of gallbladder cancer, which plays a key role in the diagnosis of the disease and is very important for understanding the patient's condition and inspection methods. It should be paid attention to the inspection.

　　In the late stage of gallbladder cancer, it may manifest as persistent dull pain in the upper and right upper abdomen, poor digestion, belching, decreased appetite, jaundice, accompanied by signs of cachexia. When the gallbladder duct is blocked or the tumor metastasizes to the liver or adjacent organs, sometimes a hard mass can be palpated in the upper abdomen. What dietary requirements do gallbladder cancer patients have? The following introduces the dietary taboos for gallbladder cancer patients.

　　1、 Foods that gallbladder cancer patients should eat:

　　(1) Eat more foods with anti-biliary and biliary duct cancer effects: shark fin, chicken gizzard, buckwheat, Job's tears, okara, and monkey head fungus.

　　(2) Eat more foods with anti-infection and anti-cancer effects: buckwheat, mung beans, rapeseed, toon, taro, scallion whites, bitter melon, lily, malan tou, earth ear, crucian carp, water snake, shrimp, loach, jellyfish, yellowfish, needlefish.

　　(3) Consume foods with a bile-promoting and laxative effect: sheep's hoof vegetable, burdock root, figs, walnuts, sesame, chrysanthemum flower, and sea cucumber.

　　(4) Poor appetite: Eat bayberry, yam, Job's tears, radish, mud eel, and kong cai.

　　(5) Abdominal pain and jaundice should refer to the relevant content of liver cancer.

　　2、 Foods that gallbladder cancer patients should avoid eating:

　　(1) Avoid animal fats and greasy foods.

　　(2) Avoid overeating and overindulgence in food.

　　(3) Avoid smoking, alcohol, and spicy刺激性 foods.

　　(4) Avoid moldy, fried, smoked, and salted foods.

　　(5) Avoid hard, sticky, and difficult-to-digest foods.

　　The above are the foods that gallbladder cancer patients should eat and the foods they should avoid. It is hoped that gallbladder cancer patients will strictly follow the dietary requirements, which will be very helpful for the recovery of the disease.

　　The treatment of gallbladder cancer in traditional Chinese medicine is divided into several methods such as dialectical treatment, treatment with single herbs or proven formulas, and acupuncture treatment. At present, most of the treatment of gallbladder cancer with traditional Chinese medicine is after surgical treatment, or in combination with chemotherapy. However, there are also reports that some patients can only be treated with traditional Chinese medicine due to their physical condition that cannot withstand surgery, or because they do not want to accept surgery.

　　In clinical practice, patients are divided into different patterns according to their specific symptoms and signs. For blood stasis, damp-heat, and fire-toxin patterns, the main formula is Da Chai Hu Decoction, with modifications according to the symptoms. For patients with deficiency of vital energy, the main treatment is based on Ba Zhen Decoction combined with Xiao Yao San with modifications.

　　1. Stagnation Type:

　　Treatment Method: Soothing the Liver and Regulating Qi, Reducing Rebellious Pain

　　Prescription: Chai Hu 10 grams, Huang Qin 10 grams, Zhi Qiao 12 grams, Bai Shao 15 grams, Ban Xia 12 grams, Chen Pi 6 grams, San Leng 10 grams, Yao Zhu 10 grams, Bai Hua She Tong Cao 18 grams, Mai Ya 15 grams, Da Huang 6 grams, Bai Zhu 10 grams.

　　2. Heat Type:

　　Treatment Method: Clearing Heat and Dampness, Soothing the Liver and Regulating Qi

　　Prescription: Chai Hu 12 grams, Huang Qin 10 grams, Yin Chen 15 grams, Da Huang 9 grams, Ban Xia 12 grams, Yu Jin 10 grams, Jin Qian Cao 15 grams, Bai Hua She Tong Cao 15 grams, Zhi Qiao 12 grams, Mai Ya 12 grams, Zhi Zi 10 grams, Chen Pi 6 grams, Cang Zhu 12 grams.

　　3. Toxic Type:

　　Treatment Method: Expelling Fire and Toxin, Clearing Heat in the Liver

　　Prescription: Chai Hu 10 grams, Huang Qin 10 grams, Da Huang 9 grams (added later), Zhi Shi 10 grams, Shan Zhi 10 grams, Shi Gao 30 grams, Yin Chen 15 grams, Bai Mao Gen 30 grams, Huang Lian 6 grams, Bai Shao 15 grams, Bai Hua She Tong Cao 15 grams, Mai Ya 18 grams.

　　4. Deficiency Type:

　　Treatment Method: Both Qi and Blood are replenished, and the spleen and kidney are invigorated

　　Prescription: Tai Sheng Shen 20 grams, Huang Qi 30 grams, Bai Zhu 10 grams, Fu Ling 12 grams, Chen Pi 6 grams, Huang Jing 12 grams, Ji Xue Gen 30 grams, Bai Shao 15 grams, Yin Yang Huo 10 grams, Shu Di 12 grams, Mai Ya 15 grams, Bai Hua She Tong Cao 15 grams.

　　This is an introduction to the treatment of gallbladder cancer with traditional Chinese medicine, hoping to provide some help for the early prevention and treatment of the disease. It is hoped that all patients can find and treat the disease early, and aim to extend life time and improve the quality of life.