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Gallbladder cancer: symptoms, causes, stages and treatment

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The gallbladder is a small pouch-like, a pear-shaped organ found just under the liver and on the right side of your abdomen. This small organ is responsible for storing bile juice produced by the liver. Bile juice is useful for the process of digestion. The gallbladder, however, is highly susceptible to being affected by cancer cells. Gallbladder cancer is one of the most common cancers in India with nearly 10% of the global burden. 

In this article, with insights from Dr Vinay Samuel Gaikwad, a leading surgical oncologist in Gurgaon, we will explore everything you may need to know about gallbladder cancer. 

What is gallbladder cancer?

Gallbladder cancer occurs when the cells in the gallbladder mutate and spread at an abnormal rate. The cancer cells may remain in the organ or even spread outside the gallbladder. 

The outer wall of the gallbladder is made up of four layers of tissue: 

  • Mucosal (inner) layer
  • Muscle layer
  • Connective tissue layer
  • Serosal (outer) layer

Cancer begins to grow in the inner layer, that is, the mucosal layer and spreads through the outer layers. This cancer can further spread through your tissues, lymph nodes or blood. 

What are gallbladder cancer symptoms? 

This cancer is not usually detected in its stages due to its asymptomatic character. However, common symptoms include:

  • Pain in the abdomen, especially in the upper right side
  • Bloating in the abdomen 
  • Unexpected weight loss (without putting any effort)
  • Jaundice – yellowing or paleness of the skin and whites of the eyes 
  • Fever 
  • Nausea and vomiting 
  • Lumps in the abdomen 
  • Itchy skin
  • Dark coloured urine
  • Paler colour of stool 
  • Loss of appetite 

Some of the above-given symptoms may overlap with symptoms of other digestive conditions. Hence it is important to consult a healthcare provider at the earliest for a thorough and accurate diagnosis. 

What are the stages of gallbladder cancer?

Gallbladder cancer progresses through five stages:

Stage 0: When the cancer is confined to the inner layer of the gallbladder

Stage 1: When cancer has spread to the muscle layer

Stage 2: When the cancer cells have spread to the connective tissue

Stage 3: When cancer has metasised to the nearby organs and lymph nodes 

Stage 4: When the cancer has advanced to the lymph nodes and organs located far from the gallbladder 

What are the types of gallbladder cancer?

The most common type is adenocarcinoma. Adenocarcinoma is a type of cancer that starts in the glandular cells of your body. 

Other types of gallbladder cancers include papillary adenocarcinoma, adenosquamous carcinomas, squamous cell carcinomas, and carcinosarcomas. These types, however, are extremely rare. 

What are gallbladder cancer causes?

The exact reason why gallbladder cancer occurs is yet unknown to medical science. Researchers and doctors believe that healthy cells inside the gallbladder mutate in their DNA and begin to multiply abnormally leading to the growth of cancer. 

Though the precise reason for gallbladder cancer is undefined, we do know that some people are more vulnerable to developing this cancer than others. 

Gallbladder cancer is more prevalent in women as compared to men. Other risk factors for why gallbladder cancer occurs include:

  • Old age – Gallbladder cancer symptoms are more common in people older than 75 years of age
  • History of gallstones – Larger gallbladder stones increase your risk of cancer 
  • Other gallbladder disorders and conditions –  Abnormal growths, porcelain gallbladder, abnormal bile ducts, swelling of the gallbladder or bile ducts and diabetes are some conditions that raise your chances of developing gallbladder cancer 
  • Inflammation of bile ducts – A condition called primary sclerosing cholangitis can cause inflammation and drainage of bile from the gallbladder and liver, thereby, increasing your chances of cancer
  • Smoking – Smoking cigarettes largely increases your chances of developing gallbladder cancer. 
  • Obesity – Obesity is a prominent risk factor in the development of gallbladder cancer. 

Why gallbladder cancer occurs more commonly in India? 

Gallbladder cancer, popularly termed as ‘an Indian disease’, is highly prevalent in the northern parts of India. The incidence of gallbladder cancer in India is reported at 9/100000 in women

The probable cause for this alarming incidence is the prevalance of gallstones. Gallstones and cancer have found to be interrelated. It has been noted that nearly 95% gallbladder cancer patients have suffered from gallstones. Researches believe that the chronic irritation caused by the stones leads to the eventual development of cancer. 

It is, thus, suggested that in case a person suffers from large gallstones, the treatment protocol should include the removal of the gallbladder in order to avoid the probability of cancer. 

Another reason for this cancer, especially in the Indian population, is the sedantary and unhealthy lifestyle habits that includes nutrient deficient diet and a lack of physical activity. 

How is gallbladder cancer diagnosed? 

Due to it asymptomtic nature, this cancer is not diagnosed early on. In most cases, this cancer is identified on the onset of gallstones or other disorders. 

In order to diagnose your condition, your oncologist will perform the following gallbladder cancer test: 

Lab tests

  • Blood test: Your doctor will perform a blood test to check the presence of certain substances in your blood that may indicate cancer. 
  • Liver function test: A liver function test examines the levels of proteins and enzymes present in your liver. Your doctor will identify specific substances released by your liver in the blood. 

Your oncologist may also administer other lab tests such as Carcinoembryonic antigen (CEA) assay and CA 19-9 assay. 

Imaging tests

  • Ultrasound: Your oncologist will perform an abdominal ultrasound to view the insides of your abdomen. 
  • CT scan: A CT scan allows your doctor to take more detailed and clear images of your organs and identify cancer cells. 
  • Endoscopic retrograde cholangiopancreatography (ERCP): ERCP is a combination of endoscopy and X-ray to take pictures of your bile ducts. 

In addition to the above gallbladder cancer test, your oncologist may order overall physical health checks, endoscopic ultrasound, biopsy and diagnostic laparoscopy to diagnose cancer. 

How is gallbladder cancer treated? 

The treatment protocol will depend on the type of cancer, stage of cancer, if the cancer has spread, your overall health and the severity of your symptoms. You will receive treatment through a multidisciplnary care team which will include surgical oncologist, medical oncologist, gastrenterologist and radition oncologist. 

In most cases, more than one treatment protocols are used in a combination for effective outcomes. Listed below are some common treatment methods for gallbladder cancer:

  • Surgery: Your oncologist will treat the cancer by removing gallbladder and nearby tissues through a procedure called cholecystectomy. If the cancer has spread further to the liver and nearby lymoh nodes, your surgeon may also remove a small portion of the liver along with gallbladder to eliminate cancer. 
  • Radiation therapy: Radiation therapy is the use of high-energy radiation beams that targeted to destroy cancer cells or stop their spread. 
  • Chemotherapy: Chemotherapy is a medicinal treatment in which specific drugs are offered to the patient to kill cancer cells and stop them from multiplying. 
  • Targeted drug therapy: Targeted drug therapy targets certain genes and proteins of the cancer cells and stops them from spreading. 
  • Immunotherapy: Immunotherapy is a drug treatment in which specific drugs are offered to support your immune system in order to fight cancer. 

Can gallbladder cancer be prevented?

It is not highly likely to prevent gallbladder cancer. However, you can take cautious steps to decrease your risk. Some expert-approved tips include:

  • Avoid smoking 
  • Maintain a healthy body weight 
  • Eat a healthy diet 
  • Get regular screening if you have higher risk 

The concluding note 

The disease burden of gallbladder cancer is uncommon. Nonetheless, its incidence in India is preferably high. It is important for patients to understand that timely detection can help in seeking timely and effective treatment in the long run. 

If you have higher risk for gallbladder cancer or if you are experiencing bothersome symptoms, visit the CK Birla Hospital, best hospital for gallbladder cancer in India

FAQs

Ques: How fast does gallbladder cancer grow? 

Ans: If the cancer is not addressed in its early stages, it can grow at an alarming speed. 

Ques: Can stage 4 gallbladder cancer be cured?

Ans: Gallbladder cancer only be cured if it has not spread beyond the primary organ. Stage 4 can, thus, can be effectively treated. 

Ques: How long can a person live with gallbladder cancer? 

Ans: The survival rate depends on the type, stage and spread of cancer as well as patient’s overall health.