Gall bladder cancer

Overview

Gallbladder cancer is cancer that begins in the gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder stores bile, a digestive fluid produced by your liver.

Gallbladder cancer is uncommon. When gallbladder cancer is discovered at its earliest stages, the chance for a cure is very good. But most gallbladder cancers are discovered at a late stage, when the prognosis is often very poor.

Gallbladder cancer is difficult to diagnose because it often causes no specific signs or symptoms. Also, the relatively hidden nature of the gallbladder makes it easier for gallbladder cancer to grow without being detected.

Symptoms

Gallbladder cancer signs and symptoms may include:

  • Abdominal pain, particularly in the upper right portion of the abdomen
  • Abdominal bloating
  • Itchiness
  • Fever
  • Loss of appetite
  • Losing weight without trying
  • Nausea
  • Yellowing of the skin and whites of the eyes (jaundice)

 

Causes

It's not clear what causes gallbladder cancer. Doctors know that gallbladder cancer forms when healthy gallbladder cells develop changes (mutations) in their DNA. These mutations cause cells to grow out of control and to continue living when other cells would normally die. The accumulating cells form a tumor that can grow beyond the gallbladder and spread to other areas of the body.

Most gallbladder cancer begins in the glandular cells that line the inner surface of the gallbladder. Gallbladder cancer that begins in this type of cell is called adenocarcinoma. This term refers to the way the cancer cells appear when examined under a microscope.

Prevention

There is no known way to prevent most cases of gallbladder cancer. Many of the known risk factors for gallbladder cancer, such as age, gender, ethnicity, and bile duct abnormalities, are beyond our control. But there are some things you can do that may lower your risk.

Maintaining a healthy weight is one important way a person may reduce their chances of developing gallbladder cancer, as well as several other cancers. The American Cancer Society recommends that people try to stay at a healthy weight throughout life by being physically active and eating a healthy diet, with mostly plant foods.

Since gallstones are a major risk factor, removing the gallbladders of all people with gallstones would prevent many of these cancers. But gallstones are very common, and gallbladder cancer is quite rare, even in people with gallstones. Most doctors don't recommend people with gallstones have their gallbladder removed unless they are having symptoms. This is because the possible risks and complications of surgery probably don't outweigh the possible benefit. Still, there are other reasons a doctor may recommend removing the gallbladder.

Diagnosis

Diagnosing gallbladder cancer

Tests and procedures used to diagnose gallbladder cancer include:

  • Blood tests. Blood tests to evaluate your liver function may help your doctor determine what's causing your signs and symptoms.
  • Procedures to create images of the gallbladder. Imaging tests that can create pictures of the gallbladder include ultrasound, computerized tomography (CT) and magnetic resonance imaging (MRI).

 

Prognosis

The prognosis (chance of recovery) options depend on the following:

  • The stage of the cancer (whether the cancer has spread from the gallbladder to other places in the body).
  • Whether the cancer can be completely removed by surgery.
  • The type of gallbladder cancer (how the cancer cell looks under a microscope).
  • Whether the cancer has just been diagnosed or has recurred (come back).

 

Treatment

What gallbladder cancer treatment options are available to you depend on the stage of your cancer, your overall health and your preferences. The initial goal of treatment is to remove the gallbladder cancer, but when that isn't possible, other therapies may help control the spread of the disease and keep you as comfortable as possible.

Surgery for early-stage gallbladder cancers

Surgery may be an option if you have an early-stage gallbladder cancer. Options include:

  • Surgery to remove the gallbladder. Early gallbladder cancer that is confined to the gallbladder is treated with an operation to remove the gallbladder (cholecystectomy).
  • Surgery to remove the gallbladder and a portion of the liver. Gallbladder cancer that extends beyond the gallbladder and into the liver is sometimes treated with surgery to remove the gallbladder, as well as a portion of the liver and bile ducts that surround the gallbladder.

It's not clear whether additional treatments after successful surgery can increase the chances that your gallbladder cancer won't return. Some studies have found this to be the case, so in some instances, your doctor may recommend chemotherapy, radiation therapy or a combination of both after surgery. Discuss the potential benefits and risks of additional treatment to decide what's right for you.

Treatments for late-stage gallbladder cancer

Surgery can't cure gallbladder cancer that has spread to other areas of the body. Instead, doctors use treatments that may relieve signs and symptoms of cancer and make you as comfortable as possible. Options may include:

Chemotherapy. Chemotherapy is a drug treatment that uses chemicals to kill cancer cells.

Radiation therapy. Radiation uses high-powered beams of energy, such as X-rays, to kill cancer cells.

Procedures to relieve blocked bile ducts

Advanced gallbladder cancer can cause blockages in the bile ducts, causing further complications. Procedures to relieve the blockage may help. For instance, surgeons can place a hollow metal tube (stent) in a duct to hold it open or surgically reroute bile ducts around the blockage (biliary bypass).

Resources

Start by making an appointment with your family doctor or a general practitioner if you have sign or symptoms that worry you. If your doctor suspects you may have gallbladder cancer, you may be referred to a doctor who specializes in treating digestive conditions (gastroenterologist), a surgeon who operates on the liver or gallbladder, or a doctor who specializes in treating cancer (oncologist).