#WeCanICan

gallbladder CANCER Home / Gallbladder Cancer

Awareness

The gallbladder is a small, pear-shaped organ located under right side of the liver. The gallbladder concentrates and stores bile, a fluid produced in the liver. Bile helps digest fats in food as they pass through the small intestine. Although the gallbladder is helpful, most people live normal lives after having their gallbladder removed.

GALL BLADDER CANCER

  • It’s the 5th most common digestive tract cancer
  • Most common cancer within the biliary tract ( liver, gall bladder and the bile ducts )
  • Has an incidence of 3/100000
  • 2-5 times more commonly seen in women
  • The most common type of cancer in the gall bladder is an adenocarcinoma – starts in the lining of the cells of the gall bladder
  • Most common in the age groups of 50-60 and 70-80 years
  • 0.2-3% of all gall bladders removed at surgery (for gall stones) are likely to have a gall bladder cancer, which may not have been suspected before surgery. Hence very close and accurate examination of the gall bladder specimen is mandatory
  • About 1/3rd of gall bladder cancers are detected pre operatively on imaging.

COMMON FACTS ABOUT THE GALL BLADDER STONES

  • Gall stones are the commonest pathology detected within the gall bladder, seen in the population and on Ultrasound / imaging studies. ( present in 10-20% of western population )
  • By themselves gall stones are not a precursor for gall bladder cancer, but they may be present in a patient with cancer
  • Gall stones, when symptomatic or present with complications , need removal of the gall bladder, which can be safely done using the key hole technique ( laparoscopic cholecystectomy)

RISK FACTORS

  • Gall Bladder Polyps ( small growths from the gall bladder epithelium- cellular lining ) – increase in size > 1 cm , increases the risk of developing gall bladder cancer
  • Cystic / congenital anomalies of the biliary tract
  • Gall stones
  • Primary sclerosing cholangitis
  • Obesity
  • Diabetes
  • Symptoms
  • Treatment

Symptoms

  • Abdomen pain
  • Nausea or vomiting
  • Jaundice (yellow skin)
  • Larger gallbladder
  • Loss of appetite
  • Weight loss
  • Swollen abdomen area
  • Severe itching
  • Black tarry stool

How is the diagnosis of gall bladder cancer made?
The diagnosis of gall bladder is generally best made on imaging – CT scan / MRI scans and on pathology examination of the surgically removed gall bladder specimen Imaging studies help identify the precise stage of the disease and the extent and volume of the disease/ cancer, which decides in planning the treatment What does stage mean?

Once a diagnosis of cancer has been made, the cancer will be given a stage, such as:

  • Where the cancer is located
  • If or where it has spread - whether locally close to the organs in close vicinity of the gall bladder- liver, lymph nodes, stomach , colon or if it has spread out wide to other organs such as lungs, bones, distant lymph nodes, peritoneum ( lining of the abdominal cavity )
  • If it is affecting other organs in the body (like the liver) and blood vessels close to the gall bladder (portal vein, hepatic artery)

There are 5 stages for gallbladder cancer:


  • Stage 0: There is no sign of cancer in the gallbladder.
  • Stage 1: Cancer has formed and the tumour has spread to a layer of tissue with blood vessels or to the muscle layer, but not outside of the gallbladder.
  • Stage 2: The tumour has spread beyond the muscle layer to the connective tissue around the Muscle.
  • Stage 3: The tumour has spread through the thin layer of cells that cover the gallbladder and Possibly to the liver, another nearby organ, and/or nearby lymph nodes.
  • Stage 4: The tumour has spread to a main blood vessel of the liver, 2 or more nearby organs or organs further away. The tumour may also have spread to distant lymph nodes / omentum, peritoneum and lungs, etc

Treatment

Gallbladder cancer treatment depends on many things including the tumour type, its location, stage and grade. The following are a few treatment options for gallbladder cancer that can also be used separately or together with one another:

Surgery: Surgery involves making a cut in the abdomen and removing the gallbladder. This surgery is called a cholecystectomy. Depending on the cancer’s stage, an extended cholecystectomy may be done, where the gallbladder, nearby lymph nodes and some parts of surrounding organs may be removed. Surgery is generally helpful in the earlier stages of the cancer.

Chemotherapy: Chemotherapy is the use of drugs to kill or control cancer cells and is the most common standard therapy in advanced stages of the cancer. It is most often used when surgery cannot be offered because the cancer has spread outside of the gallbladder. It is also considered in some earlier stage cases after surgery.

Radiation therapy: Radiation therapy is the use of high energy x-rays or other particles to kill cancer cells. It can be used for treatment or to control the symptoms and pain of advanced cancer. Sometimes doctors give radiation to shrink a tumour so it is easier to remove during surgery.

Supportive and Palliative therapy: Palliative therapy is treatment given to help control or reduce symptoms caused by advanced cancer. The focus of care is on quality of life and comfort and can be offered by a team at the hospital or at home. Other supportive care considered include procedures to relieve blockage in the gallbladder, bile duct or bowel to ease pain and prevent jaundice or bowel blockage. This can be done by either placing a tube or, sometimes, a biliary or bowel bypass operation. Other supports can include removing fluid from the abdomen with a needle (paracentesis) or pain medicines to relieve discomfort.

Surgery is the corner stone of treatment of gall bladder cancer and the only defined definitive treatment with a potential for cure.

Adequate radical surgery for gall bladder cancer, involves, either simple removal of the gall bladder (for very early stages of the tumour – in select early cases) or an adequate radical cancer operation involving

  • Removal of the gall bladder, along with the liver bed, regional lymph nodes with or without the bile duct
  • Extended resections / operations involving removal of greater amounts of liver and other visceral organs including vascular resections can be done in select cases
I want to be screened for cancer
I am at risk
Alternatives for Treatment