Posted on 05/13/2022 9:08:09 AM PDT by ConservativeMind
Patients with pancreatic ductal adenocarcinoma (PDAC) were six times more likely to have had gallstone disease within the year prior to diagnosis than non-cancer patients, suggesting gallstones could be a warning sign for this aggressive and deadly cancer, according to research. PDAC is the most common pancreatic cancer, accounting for more than 90% of cases, and it is often fatal because it tends to be diagnosed in late stages.
"Pancreatic cancer can be difficult to diagnose and then chances of survival are slim. Our findings suggest that gallstone disease may be a way to better diagnose this type of cancer—meaning we could save more lives," said Marianna Papageorge, MD.
Using records in the SEER-Medicare database, researchers identified 18,700 PDAC patients. In the year before diagnosis, 4.7 percent of the PDAC patients had a diagnosis of gallstone disease and 1.6 percent had their gallbladders removed. Among the non-cancer patients, only 0.8 percent had gallstones and only 0.3 percent had their gallbladders removal.
"Gallstone disease does not cause pancreatic cancer but understanding its association with PDAC can help combat the high mortality rate with pancreatic cancer by providing the opportunity for earlier diagnosis and treatment," Dr. Papageorge said.
Since many people have gallstones but do not develop pancreatic cancer, future research could look more closely at laboratory findings and imaging to see if there are specific factors related to gallbladder disease that could further distinguish which patients might have or develop pancreatic cancer, Papageorge said.
"It is such a terrible disease, and survival is so low," Dr. Papageorge said. "People present at such advanced stages, so anything we can do to try to diagnose people earlier and make sure that they're getting curative treatment is crucial. This might be a key to better understanding next steps in screening, management and earlier diagnosis."
(Excerpt) Read more at medicalxpress.com ...
Ultrasound, MRI, PET, and CT scans can help identify an issue, and blood tests for the liver, and cancer tests (CA 19-9 and Carcinoembryonic antigen (CEA)) can help inform it.
TUDCA and other bile acid supplements are known to reduce or eliminate gall bladder sludge or even stones. I have a relative who used TUDCA and another bile acid supplement for awhile until the pain went away and the gall bladder was shown as normal on a follow up scan. This remedy would not necessarily be helpful against cancer, though.
Makes sense.
I recall reading that a lot of cancer starts in scar tissue. People with tissue injury to the lungs from smoking, or the esophagus from reflux, or diverticuli of colon. If gall stones cause damage or scaring, perhaps that is more susceptible
I had a gallstone which caused considerable pain. Doctor told me to drink some vinegar in a small glass of apple juice each morning. Within a couple days, the pain was gone.
Bad news, as I just had a gallstone attack. Can’t even see a surgeon til June, can’t get an operation til August.
Yeah, it’s bearable if you pass the stone, which I did. I’ll try your suggestion for ongoing tenderness.
” lot of cancer starts in scar tissue” It’s the inflammation. All those things like chewing tobacco (oral cancer) cause chronic cell turnover....more chances of a genetic mutation which leads to runaway cell growth (cancer)
“Bad news, as I just had a gallstone attack” Nearly half of pt’s with symptoms but uncomplicated gallstone dz can be managed successfully with observation and dietary management (“avoid all foods that aggravate your sx’s”) (Scand J Gastro 2002;37:834-9). Generally, only persons with sx’s related to the presence of gallstones (steady, nonparoxysmal pain lasting 4-6 hours located in the upper abd) or complications (acute cholecystitis or gallstone pancreatitis) warrant surgical intervention.
• Outcomes were not improved with more-restrictive selection criteria for surgery in biliary colic, but the restrictive strategy reduced the number of surgeries (Lancet 2019 Apr 26;e-pub). Investigators in the Netherlands conducted a multicenter, randomized, noninferiority study that compared outcomes in 1067 participants who were selected for surgery either at the surgeon’s discretion (standard-care group) or according to more-stringent criteria (restrictive-strategy group). Patients in the restrictive-strategy group had to meet five clinical criteria for cholecystectomy: severe pain attacks, pain lasting 15 minutes or longer, epigastric or right upper quadrant pain, pain radiating to the back, and pain that responded to analgesic therapy. The percentage of patients who were pain free 12 months after surgery (the primary endpoint) was similar in the restrictive-strategy and standard-care groups (56% and 60%, respectively); thus, noninferiority was not shown with more-restrictive surgical criteria. However, significantly fewer patients in the restrictive-strategy group than in the standard-care group underwent surgery (68% vs. 75%). The that many patients in both groups failed to become pain free, which suggests that the original working diagnosis in some patients may have been incorrect and that surgery may have been the wrong treatment. Suggesting that perhaps cholecystectomy should be performed in a more limited manner, possibly in patients with clear findings of cholecystitis versus those with occasional biliary colic.
I started taking supplements for gallstone pain about a year ago - changed my life. Beet root, enzymes, HCl, bile salts. Pain improved immediately, gone in 4-6 weeks. I continue to take on an as needed basis.
Thank you!
I don’t feel bad. And that was my only attack—I think over the past few years I’ve had two flareups that I thought were heartburn. But if this is all I have right now, I can go on like this forever.
Do you know what the deal is with the drug udosil (Sp)? They say it can reduce gallstones, but it doesn’t seem to be the first choice.
I DID have an attack that lasted 3 hours when I went to the ER, and it passed within the hour, and thank God for morphene. Ultrasound showed stones, but like I say, they haven’t been a problem in the past except when I eat really specific foods (tuna fish with lots of mayonnaise, for ex).
3 medical options include:
1. Contact dissolution: performed by direct needle puncture of the gallbladder. Methyl tert-butyl ether (MTBE), a potent cholesterol solvent works in 65%, but 70% recur at 4yrs (Dig Dis Sci 1995;40:1775). Passage of the solvent into the duodenum can result in excessive absorption, leading to drowsiness, confusion, and anesthesia.
2. Extracorporeal shock-wave lithotripsy (ESWL): works in 80%, but 70% recur. Only 20% of pt’s qualify as can be used only if <1 radiolucent stone <20mm D with a patent duct, a normal functioning gallbladder, and mild sx’s. Contra if: coagulation and platelet abnormalities, cystic or vascular abnormalities of the liver, acute gallstone-related complications, pregnancy.
3. Oral bile salt therapy: Optimal for small stone size (<1 cm), mild sx’s, normal gallbladder function (normal filling and emptying), buoyant stones on oral cholecystography (suggesting a high cholesterol content) and minimal calcification and low density on CT imaging. Typical use the bile acids, either chenodeoxycholic acid or ursodeoxycholic acid (UDCA). Work by inhibiting biliary secretion of cholesterol, increasing hepatic bile secretion, inhibiting the deposition of cholesterol into stones, and improving gallbladder emptying. All pure cholesterol stones dissolve, however, most gallstones have a mixed composition with calcium salts that limit the efficacy of this form of therapy. If only ideal pt’s are selected dissolution rates may exceed 90%, but <10% of pt’s fall into this category (Medicine 1982;61:86)….thus incomplete dissolution remains a significant problem
I thought people with diabetes were at high risk?
New, fast onset diabetes, yes.
On your #3, I have read that getting remaining tiny stones out of the gall bladder via eating fat can be helpful, but it cones with occasional pain.
This (#3) was what my relative did, and it fully resolved, with no more issues.
Not heard of this. Many with small stones pass them and go on to be symptom free (with or without diet changes). It’s the big ones....like kidney stones that need surgery.
The gall bladder specifically responds by pouring out bile to only sensed fat.
That is why eating fat can get rid of remaining smaller bile stones.
Given I had semi emergency gallbladder removal surgery in 2020, I suppose this does not help me.
I went in for a scan on my gallbladder and they noticed my pancreas was swollen and laying on my liver. They had me cme in for a quick biopsy and then later removed my gallbladder and the swelling went down. Always scary to have conversations with a doctor about your pancreas. They refused to tell me over the phone and I had to come into talk with the doctor.
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