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Gallbladder Cancer

What is Gallbladder Cancer?

Statistics on Gall Bladder Cancer

  • Is the most common cancer of the biliary tract (80 -90%) worldwide according to autopsy studies
  • Has high rates of incidence in South America (Chile and Bolivia) and Asia (South Korea) and the lowest in Africa
  • Is seen up to 65% in less developed countries

What are the Types of Gallbladder Cancer?

  • Adenocarcinomas – These cancers start in the gland-like cells of the gallbladder and account for 9 out of the 10 gallbladder cancersAvoid cooking with solid vegetable shortening, margarine and animal fat. Among adenocarcinomas, papillary adenocarcinoma or papillary cancer accounts for 6% of gall bladder cancersIt has cancerous cells arranged as finger-like projections Papillary adenocarcinoma usually does not spread to the liver or lymph nodes and has a good survival rate
  • Other rarer types are adenosquamous carcinoma, squamous cell carcinoma, small cell carcinoma and sarcoma

What are the Stages of Gallbladder Cancer?

The stages of gallbladder cancer are grouped according to 3 main criteria:

  • The size and spread of the tumor inside the layers of the gallbladder
  • The spread of the tumor to the lymph nodes
  • The spread of the tumor to a different part or organ of the body
Gallbladder cancer may be

What are the Causes and Risk factors of Gallbladder Cancer?

  • Gender: Gallbladder cancer is twice more common in women than men
  • Age Gallbladder cancer is usually noted in older individuals
  • Obesity: Obesity increases the risk of getting the cancer
  • Ethnic groups: Ethnic groups like Native American Indians and Hispanics are at a high risk
  • Chronic bacterial infections of the bile ducts
  • Primary sclerosing cholangitis – Primary sclerosing cholangitis is the inflammation and fibrosis of the bile ducts inside and outside the liver
  • Gallbladder polyps or growths in the walls of the organ
  • Cysts of the common bile duct

What are the Symptoms and Signs of Gallbladder Cancer?

  • Jaundice, where yellowing of the skin and whites of the eyes occurs
  • Pain in the upper right part of the abdomen
  • Fever
  • Nausea and vomiting
  • Lumps in the abdomen due to an enlarged gallbladder and/or spread of the cancer to other areas like the liver
  • Rarer symptoms are loss of appetite accompanied by weight loss, bloating, itchy skin, dark urine and grey colored stools

How is Gallbladder Cancer Diagnosed?

The cancer may be an incidental finding when the gallbladder is removed for other reasons or if an ultrasound done for some other reason shows a mass in the gallbladder

  • Liver function tests are performed to know if the liver has been affected by the gallbladder cancer
  • Levels of Carcinoembryonic Antigen (CEA) are checked for CEA is a protein produced by both cancer cells and normal cells Higher levels of CEA may indicate gallbladder cancer or other conditions
  • Another similar test is CA 19-9 assay CEA and CA 19-9 are referred to as ‘tumor markers’
Imaging studies can include:

What is the Treatment and Management of Gallbladder Cancer?

  • Simple cholecystectomy (done laparoscopically or as an open operation) to remove the gallbladder alone
  • Extended cholecystectomy that involves removing the gallbladder and parts of organs and / or lymph nodes that the cancer may have spread to
In cases where operative removal is not possible, alternatives are called in:

  • Surgical biliary bypass: A new pathway for drainage of bile is created
  • Endoscopic stent placement: A stent (thin, flexible tube) is used to drain the bile into the small intestine
  • Percutaneous transhepatic biliary drainage: This is also a procedure for draining bile
These procedures relieve the patient of jaundice

What is the Prognosis for Gallbladder Cancer?