Advanced medical treatment for gallbladder cancer

Advanced treatment options for gallbladder cancer include conventional surgery and chemotherapy, as well as the introduction of the latest technologies and treatments. As gallbladder cancer is difficult to detect in its early stages and is often diagnosed at an advanced stage, personalized treatment is important. Below are the main advanced medical approaches and techniques for gallbladder cancer.

1. Robot-assisted surgery (da Vinci surgery)

Abstract: Robotic-assisted surgery is a surgical procedure that uses the da Vinci Surgical System to remove the gallbladder and surrounding tissue with high precision. In the surgical treatment of gallbladder cancer, the tumor can be precisely removed while reducing the risk of damaging nerves and blood vessels.
Advantages: smaller wounds, less blood loss and post-operative pain, resulting in a faster recovery.The risk of complications is also reduced, as the operation can be performed without affecting surrounding vital tissues and organs.

2. Laparoscopic surgery

Summary: Laparoscopic surgery is a minimally invasive procedure in which a small incision is made in the abdomen and a camera and surgical instruments are used to remove tumors from the gallbladder. It is used for less advanced or early-stage gallbladder cancer.
Advantages: faster post-operative recovery and shorter hospital stays tend to occur.Less post-operative pain and improved quality of life for the patient is expected.

3. Chemoembolization of hepatic arteries (TACE)

Summary: Transarterial chemoembolisation (TACE) is a treatment for gallbladder cancer that has invaded the liver or for advanced cancer that is difficult to treat with surgery.It attacks cancer cells by injecting anti-cancer drugs directly into the arteries that supply the cancer cells with nutrients and then embolising the blood flow.
Advantages: it can exert a strong anticancer effect locally with minimal systemic side effects and is expected to be effective against advanced cancers. It is unique in that it can be applied even when surgery is not possible.

4. Radiofrequency ablation (RFA)

Abstract: Radiofrequency ablation (RFA) is a treatment in which a needle is inserted into the tumour and a radiofrequency current is used to heat and destroy it.It may also be applied when gallbladder cancer has invaded the liver and can be expected to provide local tumour control.
Advantages: non-surgical, less stressful on the patient and efficient in treating localized tumors. Effective for early-stage tumors and when surgery is difficult.

5. Proton therapy (proton therapy)

Abstract: Proton radiotherapy uses protons to destroy cancer cells and is characterised by greater precision and less impact on normal tissue than conventional radiotherapy.It is also used for gallbladder cancer, particularly in cases where surgery is difficult or for recurrent cancer.
Advantages: allows for concentrated irradiation of cancer cells and less damage to the surrounding normal tissue.This results in fewer side effects and is particularly effective against advanced or recurrent cancers.

6. Heavy particle radiotherapy

Description: heavy particle radiotherapy is an advanced form of radiotherapy that uses heavy particles, such as carbon ions, to attack cancer cells. They are more energetic than conventional radiotherapy and therefore have a more powerful effect on cancer cells.
Advantages: because it has less impact on normal tissue, it can be effective in cases of advanced or recurrent gallbladder cancer. It may also be applied in cases where surgery is difficult.

7. Molecularly labelled therapies

Abstract: Molecular targeted therapies target specific molecules or genes involved in the growth and proliferation of cancer cells. Molecularly targeted drugs may be used for gallbladder cancer when certain genetic mutations are present. For example, FGFR mutations and HER2-positive cancer cells may benefit from drugs targeting them.
Advantages: selectively effective against cancer cells with minimal impact on normal cells. It is an effective alternative to chemotherapy for advanced or recurrent cancers.

8. Immunotherapy (immune checkpoint inhibitors)

Abstract: Immunotherapy is a treatment that activates a patient’s immune system to attack cancer cells.In gallbladder cancer, immune checkpoint inhibitors (such as pembrolizumab and nivolumab) are also used to prevent cancer cells from trying to escape the immune system.
Advantages: may be effective against advanced or recurrent cancers that do not respond to chemotherapy or radiotherapy. It is attracting attention as a new treatment option because it has relatively few side effects and is expected to have long-term therapeutic effects.

9. Cancer genomic medicine

Abstract: Cancer genomic medicine involves genetic profiling of cancer cells to select the best treatment for individual patients. In gallbladder cancer, molecularly targeted drugs and immunotherapies may also be chosen based on specific genetic mutations and biomarkers.
Advantages: personalized medicine based on the genetic mutations of each patient is possible, targeting specific molecules and thus providing effective treatment with fewer side effects. Particularly effective against advanced or recurrent cancers that are difficult to treat with standard therapies.

10. Nano knife (irreversible electroporation, IRE)

Abstract: Nano knife is a treatment in which a high-voltage electric current is applied to the tumor to destroy the membranes of the cancer cells. It is used against liver and gallbladder cancer and is often applied when the tumor is adjacent to blood vessels or vital tissue.
Advantages: it can destroy tumors without damaging vital structures such as blood vessels and bile ducts, making it useful when surgery is difficult or as a local treatment. The non-invasive nature of the treatment reduces the burden on the patient.

Summary

Advanced medical treatment for gallbladder cancer offers a wide variety of options, including surgery, radiotherapy, immunotherapy and molecular targeted therapy.This allows individual patients to be treated for advanced or recurrent cancers.

Condition-specific treatment is expected to improve the effectiveness of treatment and reduce side effects.

In addition, personalized therapies such as cancer genomic medicine and immunotherapy are advancing, ushering in an era in which treatment can be optimized for each individual patient. As gallbladder cancer is difficult to detect in its early stages, the choice of effective treatment for advanced cancer is extremely important. It is important to consult with a specialist doctor thoroughly to select the best treatment option.

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