Gallbladder Cancer

The gallbladder is a pear-shaped, very small organ on the right side of your abdomen, just underneath your liver. The gallbladder functions to store bile, which is a digestive fluid produced by your liver. Gallbladder cancer is a cancer that grows in the gallbladder and is rather uncommon. When this cancer is diagnosed in the early stages, the chance for a cure is very likely. Unfortunately, most gallbladder cancer cases are not discovered until the late stage, which means that the prognosis at this time is poor. This is a difficult cancer to diagnose because there are no obvious signs or symptoms. With the gallbladder being so small and hidden around other organs, it is a challenge to easily see making it easy for tumors and cells to grow into tumors without being detected.

Many doctors and specialists are not sure of the root cause of gallbladder cancer. It is known that this cancer forms when the healthy cells in the gallbladder have mutations in their DNA. It is these mutations that cause the cells to grow out of control and continue living on even as other healthier cells begin to die. These growing cells eventually grow a tumor which can grow outside of the gallbladder and spread throughout the body. Gallbladder cancer most often begins in the glandular cells that line the inner surface of the gallbladder. This cancer is called an adenocarcinoma, which refers to how the cancer cells present under a microscope.

The Symptoms

Gallbladder cancer signs are often invisible and present as the symptoms of other illnesses or cancers. These are the things you should watch for, and if you suspect you may have gallbladder cancer or another illness, contact your doctor immediately.

  • Abdominal pain that resides particularly in the upper right portion of the abdomen
  • Abdominal bloating
  • Fever
  • Losing weight without trying
  • Nausea
  • Yellowing of the skin and whites of the eyes, which is called jaundice

The Risk Factors

There are things in life that can greatly increase your risk of developing certain types of cancer. The risk factors for gallbladder cancer are as follows:

  • Your gender. Gallbladder cancer is more common in women than in men.
  • Your age. Your risk of gallbladder cancer increases as you get older.
  • A history of gallstones. Gallbladder cancer is most common in people who have had gallstones in the past. Still, gallbladder cancer is very rare in these people.
  • Other gallbladder diseases and conditions. Other gallbladder conditions that can increase the risk of gallbladder cancer include gallbladder polyps and chronic gallbladder inflammation and infection.

Diagnosing Gallbladder Cancer

The tests done by your doctor to confirm your gallbladder cancer diagnosis are quite simple. A blood test is done to evaluate your liver function which can help to determine if this is what is causing your symptoms. Images of the gallbladder can also be taken which create pictures of your gallbladder via ultrasound, CT scan or MRI scan.

After your confirmed diagnosis, your doctor will then work to find the stage of your cancer. The stage of the cancer helps to determine the overall prognosis and best plan for treatment. Procedures and tests used to help stage your cancer might include:

  • Exploratory surgery. Your doctor may recommend surgery to look inside your abdomen for signs that gallbladder cancer has spread.

In a procedure called laparoscopy, the surgeon makes a small incision in your abdomen and inserts a tiny camera. The camera allows the surgeon to examine organs surrounding your gallbladder for signs that the cancer has spread.

  • Tests to examine the bile ducts. Your doctor may recommend procedures to inject dye into the bile ducts. This is followed by an imaging test that records where the dye goes. These tests can show blockages in the bile ducts.

The tests may include endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiography, and percutaneous transhepatic cholangiography.

  • Additional imaging tests. Most people with gallbladder cancer will undergo a series of scans to help determine whether the cancer has spread or remains localized. Which scans should be performed vary depending on your circumstances. Common scans include a CT of the chest and abdomen, ultrasonography, and an MRI of the liver.

Treatment for Gallbladder Cancer

Your overall treatment plan will be based on the outcome of the stage of your cancer, your overall health, and your preferences on how to handle your care. Removal of the cancer is the ultimate goal, but in certain cases, this may not be possible. Therapies and localized treatments may be available for those with tougher cases to treat.

In the early stages of gallbladder cancer surgery may be an option. There are two types of surgery done in this case, and they are:

  • Surgery to remove the gallbladder. Early gallbladder cancer that is confined to the gallbladder is treated with an operation to remove the gallbladder, which is called a 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 portions of the liver and bile ducts that surround the gallbladder.

Other treatments done after surgery may or may not increase the chances that the gallbladder cancer will return. Some studies have found this to be true, while others are still testing. Because of this, your doctor may recommend chemotherapy, radiation therapy, or a combination of both after your surgery to ensure the cancer cells have been eradicated. If you have worry or concern about this treatment, discuss it with your doctor before signing off or giving the go-ahead.

Late-stage gallbladder cancer has usually spread to other areas of the body. Surgery is most often impossible at this stage and doctors will opt for treatments to relieve the signs and symptoms to make you as comfortable as possible. These treatment options may include:

  • Chemotherapy. Chemotherapy is a drug treatment that uses chemicals to kill cancer cells and is available in pill form, injectable form, and intravenous drip methods.
  • Radiation therapy. Radiation uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. In some cases, these treatments can be localized on the specific cancer itself.
  • Clinical trials. Clinical trials are studies testing experimental or new medications to treat gallbladder cancer. Talk to your doctor to see whether you are eligible to participate in a clinical trial, or if there are any in your area you may be able to participate in.

Gallbladder Cancer Issues

There are certain issues that may arise between diagnosis and treatment with gallbladder cancer. Advanced cases can cause blockages in the bile ducts, which will cause further complications. Your doctor may do a procedure to open the blockage by inserting a hollow metal tube, also called a stent, in a duct to help hold it open. They may also need to go to a more extreme route, and surgically re-route bile ducts around the blockage, which is called a biliary bypass.

Questions to Ask your Specialist

Here are the most commonly asked questions about gallbladder cancer.

  • What is my stage of gallbladder cancer?
  • Can you explain the pathology report to me? Can I have a copy of my pathology report?
  • Will I need more tests?
  • What are the treatment options for my gallbladder cancer?
  • What are the benefits and risks of each option?
  • Is there one treatment option you recommend over the others?
  • What would you recommend to a loved one in the same situation?
  • Should I get a second opinion from a specialist? What will that cost, and will my insurance cover it?
  • Are there any brochures or other printed material that I can take with me? What websites do you recommend?

If you suspect you may have gallbladder cancer, do not wait to make an appointment for testing and diagnosis. Early detection and treatment are key, so take any and all concerns to your doctor to plot out your best treatment plan.

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