The Indian Council of Medical Research (ICMR) has issued the consensus document for management of gallbladder cancer which summarizes the modalities of treatment including the site-specific anti-cancer therapies, supportive and palliative care and molecular markers and research questions. It also interweaves clinical, biochemical and epidemiological studies.
The consensus document integrates diagnostic and prognostic criteria with supportive and palliative care that serve the three-part mission of clinical service, education and research. Widespread use of the consensus documents will further help us to improve the document in future and thus overall optimizing the outcome of patients.
“We hope that this document would provide guidance to practicing doctors and researchers for the management of gallbladder cancer patients and also focusing their research efforts in Indian context. It is understood that this document represents the current thinking of national experts on this topic based on available evidence and will have to be revised as we move. Mention of drugs and clinical tests for therapy do not imply endorsement or recommendation for their use, these are examples to guide clinicians in complex decision making. We are confident that this first edition of these guidelines will serve the desired purpose”, said Dr VM Katoch, secretary, Department of Health Research & Director General, ICMR.
Gallbladder cancer (GBC) is a rare though notoriously lethal malignancy with marked ethnic and geographical variations. It is a common disease in countries such as Chile, Japan, India, Central Europe – Poland, Israel and southern Pakistan.
In India, GBC is most prevalent in the northern and northeastern states of Uttar Pradesh, Bihar, Orissa, West Bengal and Assam. It is twice more common in women than in men and is the commonest digestive cancer in women in northern India. The highest frequency of disease is in women over the age of 65. Apart from gallstones, female gender, ethnicity, genetic susceptibility and lifestyle factors are associated risk factors in the development of GBC either as initiators, such as unknown endo- and exobiotic mutagens, or as promoters, including chronic inflammation and infection.