This group of cancers include the cancers of the liver, gall bladder, bile duct and the pancreas. They usually present as an abdominal mass, jaundice in varying degrees, weight loss, vomiting or as the bloating of the abdomen. Treatment which has shown the best results is surgery only, although chemotherapy may play some role.
Liver cancers are most commonly a result of spread from another cancer (metastatic) but primary cancer of the liver is increasingly common. Most commonly seen in cirrhotic patients with history of alcohol abuse or hepatitis B or C, these cancers need treatment mainly by surgical excision of the cancerous liver segment or in some cases a liver transplant. Chemotherapy and radiation have a minimal role in these cases.
Gall bladder cancers are very aggressive cancers with a poor prognosis. However, if detected early, outcomes are shown to be favourable with a radical resection of the tumour. Chemotherapy and radiation treatment have shown to have a minimal impact in these tumours. Surgery usually includes removal of the gall bladder with a segment of adjoining liver and nodal tissue in the region.
Bile duct cancers also have a poor outcome, which depends on the location of the cancer, the closer the location to the pancreas, the better the outcome. The main modality of treatment is surgery which includes removal of the bile duct, gall bladder and surrounding nodal tissue. Sometimes a segment of the liver or part of the pancreas may also need excision. Post surgical usage of chemotherapy has shown some benefit.
Pancreatic cancers are also treated mainly with surgery. This includes resection of the segment of the pancreas where the cancer is located. The resections of head of pancreatic tumours are known as Whipples surgery which includes the removal of the duodenum, bile duct and gall bladder along with the pancreatic segment. Tumours in the distal part of the pancreas involve the removal of the spleen along with the pancreatic tail. Central tumours can be treated with a central pancreatectomy with preservation of the duodenum and spleen.
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