Gallbladder cancer is a rare type of cancer that develops when malignant (cancer) cells originate in the gallbladder’s tissues. The gallbladder is a pear-shaped organ in the upper belly that sits just under the liver. It holds bile, a digestive fluid produced by the liver. Bile is secreted from the gallbladder by the common bile duct, which connects the gallbladder and liver to the first part of the small intestine when food is broken down in the stomach and intestines.
Based on the origin, gallbladder cancers are categorised into two types:
About 90% of gallbladder cancers are found to be adenocarcinomas. The cancerous growth in this type begins in the gland-like cells present in the inner lining of the gallbladder. Adenocarcinomas are further classified into subtypes – non papillary adenocarcinoma, papillary adenocarcinoma and mucinous adenocarcinoma.
Other types of gallbladder cancers are adenosquamous carcinoma, squamous cell carcinoma, carcinosarcoma, etc. These are both rare and aggressive than adenocarcinomas.
The symptoms of gallbladder cancer can be confusing. If the following symptoms are observed for more than two weeks, it is important to see a physician:
Early signs and symptoms of gallbladder cancer are similar to gallbladder inflammation caused by gallstones. Symptoms of biliary and gastric blockage may develop later.
The exact causes of gallbladder cancer are still not known. Nevertheless, the researchers have identified a few factors that increase one’s risk of developing gallbladder cancer:
There are multiple tests recommended by doctors for the detection and diagnosis of gallbladder cancer. The results from these tests are further used to create personalised treatment plans for patients.
First and foremost, the doctor may conduct a physical examination, during which he/she may look for signs of gallbladder cancer. The doctor may particularly look for lumps, tenderness and fluid build-up in the abdomen region. He/she may also look for signs of jaundice. The lymph nodes nearby are also checked for swelling. If gallbladder cancer is suspected, the following tests may be recommended:
a. Blood Tests: To determine the amount of bilirubin in the blood, blood tests may be performed. Bilirubin levels in the blood can be raised by problems with the gallbladder, bile ducts, or liver. Albumin, liver enzymes (alkaline phosphatase, AST, ALT, and GGT) tests, as well as other blood tests, may be performed. These tests are frequently referred to as liver function tests. They aid in the diagnosis of disorders of the liver, bile ducts and gallbladder.
b. Tumour Markers: Gallbladder cancer patients may have elevated levels of the markers CEA and CA 19-9 in their blood. These indicators are usually seen in significant concentrations in the blood only when cancer has progressed to an advanced stage. While these biomarkers aren’t specific to gallbladder cancer, they can be helpful after an individual has been diagnosed with the disease. These indicators can be tracked over time to study how the patient’s body is responding to the treatment.
c. Imaging Tests: Various imaging tests, such as ultrasound scan, CT scan, MRI scan, etc., are recommended to study the internal structure of the organ and check for the presence of abnormal masses. Apart from supporting accurate diagnosis, these tests also help in disease staging, treatment planning, therapy monitoring and restaging. In the case of gallbladder cancer, a special imaging test is recommended to thoroughly examine the gallbladder region.
d. Biopsy: During a biopsy, cells or tissues from the suspected area are removed so that a pathologist can examine them under a microscope for signs of gallbladder cancer. Even after the tumour has been removed, a biopsy may be performed. If the tumour cannot be removed surgically, the biopsy sample may be collected using a thin needle for further examination.
There are multiple treatment options available for the treatment and management of gallbladder cancer. Following are the commonly recommended treatment methods:
a. Surgery: A cholecystectomy or surgery to remove the gallbladder and some of the surrounding tissues. Nearby lymph nodes may be removed as well. Gallbladder surgery is occasionally guided via a laparoscope. A video camera is attached to the laparoscope, which is introduced through an incision in the abdomen. Surgical instruments are introduced through the pores made. Because there’s a chance gallbladder cancer cells will spread to these openings, the tissue around them may be removed as well.
The following types of palliative surgery may help reduce symptoms if cancer has spread and cannot be removed:
b. Radiation therapy: Radiation therapy is a cancer treatment that destroys cancer cells using high-energy x-rays or other types of radiation. Radiation therapy can either be delivered externally or internally. External radiation therapy delivers radiation to the tumour from a radiation source outside the body. Internal radiation therapy involves injecting a radioactive substance into or near the tumour through seeds, wires, needles or catheters. Radiation therapy may also be recommended to ease pain in advanced stages of the disease.
c. Chemotherapy: Chemotherapy is a cancer treatment that employs potent drugs to inhibit cancer cells from growing by either killing them or keeping them from dividing. Chemotherapy enters the bloodstream and can reach cancer cells all over the body when taken by mouth or injected into a vein. It is usually given to gallbladder cancer patients after surgery (adjuvant therapy). Chemotherapy may be administered alone to help reduce signs and symptoms caused by cancer, and to increase survival to some extent in patients with advanced-stage gallbladder cancer.
If detected in the early stages, gallbladder cancers can be treated with positive clinical outcomes and higher survival rates. Thanks to the advancements in the field of cancer care, today, our specialists can treat advanced-stage gallbladder cancers as well.
However, early diagnosis makes the treatment simpler, and patients can recover at a relatively faster rate. Therefore, it is important to be mindful of any abdominal issues and other symptoms that last for more than two weeks.
Yes, gallbladder cancers are relatively difficult to diagnose for the following reasons:
Yes, gallbladder cancer causes persistent abdominal pain that may intensify as the illness progresses, but there are treatments available to help manage the pain.
No, gallbladder stones do not cause gallbladder cancers. However, their presence can increase one’s risk of developing gallbladder cancer.
Although you cannot prevent gallbladder cancer completely, there are a few things that you can do to reduce your risk of developing this disease. Maintaining healthy body weight, having nutritional and balanced meals, staying physically active, quitting tobacco and reducing alcohol intake are a few preventive measures that may help you reduce your gallbladder cancer risk.