Gallbladder Cancer

The gallbladder is a small, pear-shaped organ found on the right side of the abdomen, just underneath the liver. The gallbladder is responsible for the storage of the digestive fluid known as bile, which is produced by the liver. A gallbladder has three layers – the innermost layer, the middle layer (muscular), and the outermost layer (serosal). Gallbladder cancer is an irregular growth of cells that originates in the gallbladder. Gallbladder cancer is very uncommon, one of the rarest. When diagnosed at an early stage, the chances of curing gallbladder cancer are very good. Unfortunately, most gallbladder cancer cases are discovered in the late stages, when the prognosis is usually very poor. Gallbladder cancer goes unnoticed until it has advanced because it does not have specific signs or symptoms. Likewise, the hidden nature of the gallbladder makes it easier for gallbladder cancer to grow without being noticed. The cost of Gallbladder Cancer Treatment in India depends on the stage of cancer which varies from USD 6000 to USD 8000. Both surgical and nonsurgical treatments are available for Gallbladder Cancer. After complete analysis, doctor recommends the right treatment depending on stage and severity of the disease. Surgery to remove the gallbladder and some of the tissue around it. Part of the liver and nearby lymph nodes may also be removed. Stages of gallbladder cancer To determine the extent of spreading, numbers (0 through IV) are assigned to the diagnosis. The process is called gallbladder staging.  The gallbladder staging are:

• Stage 0 (known also as carcinoma in situ): This stage is limited to the mucosal (the innermost) layer of a gallbladder.
• Stage I: In this stage, cancer has spread to the connective tissue or the muscularis layer.
• Stage II: In this stage, the cancer has moved beyond the visceral peritoneum (the tissue that covers the gallbladder) to the liver, and/or another nearby organs, like the stomach, small intestine, pancreas, bile ducts, connective tissue or adjacent lymph nodes.
• Stage III: In this stage, the cancer has spread to the liver or the organs near it, and perchance to the lymph nodes.
• Stage IV: In this stage, the cancer has reached the adjacent lymph nodes, and/or organs located far from the gallbladder.

Gallbladder diagnosis To diagnose gallbladder cancer, stage and plan its treatment the following analysis may be required:

• Blood tests (Liver function tests to be precise): This shows how well the liver, gallbladder, and bile ducts are functioning. It also gives clues about what could be causing the symptoms.
• Ultrasound testing: Images of the gallbladder and the liver are generated from sound waves for physical assessment.
• CT scan.
• MRI scan.
• Percutaneous Trans-hepatic cholangiography (PTC), an X-ray imaging.
• Endoscopic retrograde cholangiopancreatography (ERCP). 
• Biopsy.

Treatment for gallbladder cancer There are several options of treatment for gallbladder cancer. However, the selection of a treatment type depends on the stage of cancer, the overall health of the patient, and the patient’s preferences. The primary aim of treatment is the complete removal of gallbladder cancer, but if that isn’t possible, other therapies may be adopted to help control the spread of the disease and ensure the patient is as comfortable as possible. Gallbladder cancer surgery, for early-stage gallbladder cancer Gallbladder cancer surgery may be an option if the gallbladder cancer is still in an early stage. This could be of two types:

• Surgery to remove the gallbladder: this is known as cholecystectomy. When gallbladder cancer is still in early stages and it’s confined to the gallbladder, it can be treated with an operation to remove the gallbladder.
• Surgery to remove the gallbladder and a portion of the liver: When gallbladder cancer has extended beyond the gallbladder and also into the liver, the best treatment option will be surgery to remove the gallbladder, along with portions of the liver and bile ducts that surround the gallbladder.

Chemotherapy This involves the use of drugs to destroy rapidly growing cells, including cancerous cells. It can be administered through a vein in the arm, as a pill, or both means. Chemotherapy may be recommended after surgery if there are remains of gallbladder cancer cells. It can also be adopted as a form of control if surgery isn’t an option. Radiation therapy Radiation therapy, as the name suggests, uses very high-powered beams of energy, like X-rays and protons, to destroy cancer cells. Targeted drug therapy Targeted drug treatments is specifically focused on certain weaknesses present within the cancer cells. Blocking these weaknesses helps targeted drug treatments kill cancer cells. This might be an option for those with advanced gallbladder cancer.

Symptoms

• Pain
• Nausea or vomiting
• Fever or chills
• Chronic diarrhea
• Jaundice.
• Unusual stools or urine.

Causes

The exact cause of gallbladder cancer is yet unknown. However, like other cancers, what we do know is an error (known as a mutation) in a person’s DNA leads to an uncontrolled rapid growth of cells.

As the number of cells proliferates (that is, multiplies), a mass or tumour forms. If left untreated, these cells in the long run spread into nearby tissues, and to distant parts of the body.

It is found 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.

FAQ

How common is gallbladder cancer?

Gallbladder cancer is very uncommon. One of the rarest cancers that occur.

What are gallbladder cancer risk factors? 

Certain factors are likely to increase gallbladder cancer risk. These include:

• Sex, more common in women.
• Age, gallbladder cancer risk increases with age.
• A history of gallstones. 
• Other gallbladder diseases and conditions, such as polyps, chronic inflammation, and infection.
• Inflammation of the bile ducts.
• Race and ethnic group, Latin Americans, Native Americans, and Mexicans possess the highest gallbladder cancer risk.
• Bile duct problems.
• Typhoid.
• Family history of gallbladder cancer.

Are there any factors that affect the chances of recovery?

The treatment options and recovery from gallbladder cancer depend on certain factors;

• The cancer stage; whether or not cancer has spread out from the gallbladder to other places in the body.
• If the gallbladder cancer can be completely removed through surgery.
• The type of gallbladder cancer it is. That is, the appearance of cancer under the microscope.
• Whether the cancer is newly diagnosed or a reoccurrence.
• The age and overall health of the patient. 
• Is cancer asymptomatic or not.

Self-care and prevention of gallbladder cancer.

Prevention, they say, is better than cure. Here are some tips to prevent gallbladder cancer.

• Keep a healthy weight.

• Eat a healthfully and balanced diet. 

• Quit alcohol consumption and smoking.
• Exercise regularly.

What is the outlook of gallbladder cancer?

A gallbladder cancer’s outlook depends on the stage. Those in the early stages have a much better outlook than advanced-stage cancer.

What is the Gallbladder cancer survival rate?

There’s a five-year survival rate for gallbladder cancer stage-wise;

• Stage 0, 80%. 
• Stage 2, 50%.
• Stage 3, 8%. 
• Stage 4, less than 4%.