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 common. 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.
Gallbladder cancer signs and symptoms may include:
- Abdominal pain, particularly in the upper right portion of the abdomen
- Abdominal bloating
- Loss of appetite
- Losing weight without trying
- Yellowing of the skin and whites of the eyes (jaundice)
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.
Factors that can increase the risk of gallbladder cancer include:
- Your sex. Gallbladder cancer is more common in women than it is in men.
- Your age. Your risk of gallbladder cancer increases as you age.
- 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 porcelain gallbladder, choledochal cyst and chronic gallbladder infection.
TESTS AND 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).
STAGES OF GALLBLADDER CANCER
The stages of gallbladder cancer are:
- Stage I. At this stage, gallbladder cancer is confined to the inner layers of the gallbladder.
- Stage II. This stage of gallbladder cancer has grown to invade the outer layer of the gallbladder and may extend beyond the gallbladder.
- Stage III. At this stage, gallbladder cancer has grown to invade one or more nearby organs, such as the liver, small intestine or stomach. The gallbladder cancer may have spread to nearby lymph nodes.
- Stage IV. The latest stage of gallbladder cancer includes large tumors that involve multiple nearby organs and tumors of any size that have spread to distant areas of the body.
TREATMENTS AND DRUGS
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 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 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).