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Understanding Gallbladder Cancer: Types, symptoms, risk factors and Treatment

Dr. Rashmi ByakodiNov 4, 2022

As per the American Cancer Society, Gallbladder Cancer is tough to diagnose until it becomes advanced and exhibits symptoms. It is an uncommon disease. The prognosis of Gallbladder Cancer is usually poor and depends on the cancer stage. Thus, it’s crucial to have proper knowledge of this disease to initiate timely action. This article will help you learn all about Gallbladder Cancer, its types, symptoms, causes, and treatment.

Gallbladder Cancer

Contents

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What is Gallbladder Cancer?

Gallbladder Cancer begins when cancerous or malignant cells tend to multiply abnormally and uncontrollably in the gallbladder.

The gallbladder is a small pear-shaped sac-like organ located on the right side of your body, just underneath the liver. Its function is to store bile, a kind of digestive fluid made by the liver. The gallbladder releases bile into the small intestine to help break down food. Its wall has four major layers of cells, namely the mucosal or inner layer, muscle layer, connective tissue layer, and serosal or outer layer.

Gallbladder Cancer primarily begins in the mucosal layer and slowly metastasizes to other organs of the body. It is a rare malignant cancer representing nearly 50% of all biliary tract cancer. Almost all biliary cancers are highly malignant and fatal, with a 17.6% survival rate of 5 years. 

Gallbladder Cancer has a poor outcome because it often isn't detected until it is advanced; cancer tends to proliferate and spread to other parts of the body

Risk factors of Gallbladder Cancer?

The American Cancer Society lists several factors that can increase a person's risk of developing Gallbladder Cancer. Here’s a list.

Chronic gallbladder inflammation

If you have gallstones, your risk of developing Gallbladder Cancer increases. That's because when someone has gallstones, the gallbladder releases bile slowly, and the cells of the gallbladder get exposed to chemicals in bile for longer than usual. This may cause inflammation in the gallbladder and eventually lead to cancer.

Porcelain gallbladder

A porcelain gallbladder is a condition in which the walls of the gallbladder become covered with calcium deposits. It may occur due to long-term inflammation of the gallbladder, called cholecystitis. People with this condition have a higher chance of developing Gallbladder Cancer.

Female gender

As per the study, women are 3 to 4 times more susceptible to Gallbladder Cancer than men. Gallbladder Cancer is more common in women, possibly because they also have more gallstones and inflammation of the gallbladder.

Old Age

Gallbladder Cancer primarily attacks elderly people. This does not mean that younger people are immune to the disease, but most cases of Gallbladder Cancer occur in people aged 65 and older when it is diagnosed.

Ethnicity

People of Mexican and Latin American ancestry are more likely to develop Gallbladder Cancer than people of other ethnic backgrounds. They also tend to have more gallstones than people from other ethnic groups. African Americans have the lowest risk of developing Gallbladder Cancer or gallstones. This type of cancer is much more common in India, Pakistan, Central European, and South American countries than in the United States.

Choledochal cysts

Choledochal cysts are small sacs filled with bile, which is a fluid produced by the liver. They usually form along the common bile duct that carries bile to the small intestine. These cysts gradually grow and may develop into Gallbladder Cancer.

Bile duct anomalies

Some people have a defect in their pancreatic duct that lets the pancreatic juice flow backward into the bile ducts instead of the small intestine. This backward flow of pancreatic juice keeps bile from flowing out as rapidly as it should. People who have these abnormalities are more likely to develop Gallbladder Cancer.

Gallbladder polyps

It is a growth that protrudes from the inner layer of the gallbladder wall. Polyps greater than 1cm are more likely to be cancerous.

Primary sclerosing cholangitis (PSC)

A condition in which scar tissues are formed due to inflammation in the bile ducts (cholangitis). This may also lead to Gallbladder Cancer.

Typhoid

People who get frequently infected by salmonella are the carriers of typhoid. Chronic typhoid infection can lead to Gallbladder Cancer. Other possible risk factors may include family history, smoking, exposure to the chemicals that are used in textile and rubber industries, and nitrosamine.

Types of Gallbladder Cancer

The type of Gallbladder Cancer totally depends on the category of cells that has infected the tissue. The most common type of Gallbladder Cancer is gallbladder adenocarcinoma. It is a type of cancer that starts in glandular cells of the inner surface of the gallbladder.

There are three types of adenocarcinoma.

  1. Papillary adenocarcinoma: It is a rare type of cancer where papillary overgrowth tends to develop within the lumen and forms a tumour. This cancer is slow growing and commonly associated with infection and necrosis.

  2. Non-papillary adenocarcinoma: One of the most common adenocarcinomas of the gallbladder.

  3. Mucinous adenocarcinoma: This cancer occurs in the cells that produce a type of mucus called mucin. This cancer is even rarer.

Other very rare types of Gallbladder Cancer are adenosquamous carcinoma, squamous cell carcinoma, and carcinosarcoma.

Symptoms of Gallbladder Cancer

Gallbladder Cancer is difficult to diagnose at an early stage because it usually does not show any obvious symptoms. When symptoms occur, they look similar to chronic health conditions. However, the following symptoms can be the indicators of Gallbladder Cancer.

  • Pain in the abdominal area

  • Jaundice

  • Nausea and vomiting

  • Swelling in the belly area

  • Loss of appetite

  • Unintended weight loss

  • Dark-coloured urine

  • Greasy or light coloured stool

  • Abdominal bloating

  • Fever

Diagnosing Gallbladder Cancer

Gallbladder Cancer is often found at later stages because it usually does not show signs or symptoms until it is fairly advanced. If the doctor suspects Gallbladder Cancer, they will examine the medical history and order blood or urine tests.

Liver function tests (LFT): These tests indicate the condition of the liver, bile duct, and gallbladder, and give hints about the symptoms.

Ultrasound: High-energy sound waves are put in to form an image of the internal organs and tissues. It can help diagnose Gallbladder Cancer.

CT scan: It is a procedure that helps take detailed images of internal organs from different angles. It also shows the condition of the gallbladder and other nearby organs.

MRI scan: This procedure uses a magnet and radio waves to form detailed images of internal organs inside the body. This procedure shows more minute details than any other test.

Percutaneous trans-hepatic cholangiography (PTC): A procedure in which a dye is injected into the liver, and after that, x-rays are taken to identify any blockages in the bile duct or liver.

Endoscopic retrograde cholangiopancreatography (ERCP): A thin, lighted tube called an endoscope is inserted into the small intestine. A catheter is inserted through the endoscope into the gallbladder. A dye is then injected into the ducts, and X-ray images are taken to see if there are any blocked bile ducts.

Biopsy: Some tissues from the tumour are taken and examined under a microscope to confirm cancer.

Stages of Gallbladder Cancer

The cancer stage is determined by how far the cancer has spread from its original location. Gallbladder Cancer can be staged as mentioned below. 

Stage 0: In this stage, the cancer is restricted to the inner layer of the gallbladder and has not spread to any other place.

Stage 1: In this stage, the cancer cells have spread to the lamina propria (muscle layer).

Stage 2: Cancer has developed into the connective tissues of the muscle layer in this stage.

Stage 3: Cancer has metastasized to the liver and/or to the nearby organs such as the stomach, duodenum, pancreas, colon, or surrounding lymph nodes.

Stage 4: Cancer has invaded more than three lymph nodes and spread to distant organs such as the peritoneum or the lungs and portal vein or hepatic artery.

Treatment of Gallbladder Cancer

It is critical to detect Gallbladder Cancer before it spreads to other parts of the body. Oncologists normally adopt the following treatment approaches to treat Gallbladder Cancer.

Surgery: Gallbladder Cancer can be treated with cholecystectomy, which includes the surgical removal of the gallbladder and surrounding tissues. Some lymph nodes placed near the gallbladder and liver may also be removed by the surgeon.

Radiation Therapy: This therapy uses high-energy x-ray beams to destroy the cancer cells and halts them from growing further without damaging the healthy cells. It uses a machine that sends radiation from outside the body to the affected area only.

Chemotherapy: This procedure uses drugs to destroy cancer cells and stops their growth. Chemotherapy drugs may be injected intravenously or intramuscularly or can be taken orally. These drugs travel through the bloodstream and attack the cancer cells to destroy them.

Targeted therapy: A type of therapy that administers drugs or other elements to detect and attack, especially cancer cells. It generally causes less damage to healthy cells than that of chemotherapy and radiation therapy.

Immunotherapy: This treatment uses a person's immune system to recognize and kill cancer cells.

Frequently Asked Questions (FAQs)

Here’s a list of common queries related to Gallbladder Cancer and their resolution.

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What are the types of Gallbladder Cancer?

Here are the different types of Gallbladder Cancers.

  • Papillary adenocarcinoma

  • Non-papillary adenocarcinoma

  • Mucinous adenocarcinoma

  • Adenosquamous carcinoma

  • Squamous cell carcinoma

  • Carcinosarcoma

What are the symptoms of Gallbladder Cancer?

Symptoms of Gallbladder Cancer include the following. 

  • Abdominal pain

  • Jaundice

  • Nausea and vomiting

  • Swelling in the abdominal area

  • Loss of appetite

  • Unintended weight loss

  • Dark-coloured urine

  • Greasy or light coloured stool

  • Abdominal bloating

  • Fever

What is the survival rate for Gallbladder Cancer?

People with Gallbladder Cancer have an overall 5-year survival rate of 19%, but the survival rate can depend on several factors, including the location and stage of cancer. As per the American Cancer Society, the 5-year survival rate of Gallbladder Cancer at the different stages is listed here.

Seer stage | 5-year survival rate Localised | 66% Regional | 28% Distant | 2% All stages combined | 19%

Sources

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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