What is Gallbladder Cancer?

The gallbladder is a pear-shaped hollow organ located beneath the liver on the right side of the belly. It's a component of the biliary system in humans. In mature humans, it is a muscular sac with a volume of about 50 mL. Gallstones, gallbladder attacks, and gallbladder illnesses are just a few of the ailments that can affect the gallbladder. Gallbladder cancer, as the name implies, starts in the gallbladder, which is an organ that contains bile. There are around 200 forms of cancers based on the tissue or organ where the cancer develops, and these are referred to as primary cancers. The term "metastasis" refers to the process of cancer spreading from one tissue to another.

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Gallbladder cancer is produced by mutations in the DNA of the gallbladder’s cells. These mutations cause the cells to divide and develop abnormally. Tumors arise as a result of the excess cells, which spread to other organs. The actual etiology of cancer differs from individual to person. Gallbladder cancer can be caused by a variety of conditions, although the actual causes of the disease are yet unknown.

Other Risk Factors

• Age: One of the most prominent risk factors for gallbladder cancer is the patient’s age. It is most common in adults over the age of 70, and quite infrequently in people under the age of 50.
• Sex: Gallbladder disease affects more women than males. Seven out of ten cases of gallbladder cancer are women.
• Family History: Gallbladder cancer is more common in people whose ancestors had gallstones. A genetic mutation known as BRCA2 raises the risk of gallbladder cancer.
• Porcelain Gallbladder: This happens when calcium deposits on the gallbladder’s inner wall as a result of cholecystitis, and it can progress to gallbladder cancer in a few cases.
• Cholecystitis: Gallstones or gallbladder inflammation, often known as cholecystitis, are a key risk factor for gallbladder cancer. Gallstones are seen in nearly 80% of patients with gallbladder cancer. Gallstones are created when cholesterol and bile minerals collect in the gallbladder.
• Diabetes: Gallbladder cancer is more common in people with high blood sugar levels.
• Obesity: Obesity or being overweight causes hormonal changes in the body, resulting in cholecystitis, which increases the chance of gallbladder cancer. Foods heavy in carbs and poor in fiber increase the risk of gallbladder cancer.
• Gallbladder Polyps: These are non-cancerous growths in the gallbladder that can turn cancerous over time.
• Smoking: People who smoke have a higher risk of gallbladder cancer. Furthermore, exposure to substances such as nitrosamines induces DNA alterations. These compounds are commonly found in the rubber and metal industries.
• Pancreatic and Bile Duct Abnormalities: Gallbladder cancer is more likely in patients who have an abnormal connection between the bile duct and the pancreas, as well as bile duct outgrowths. These pancreas and bile duct malformations are generated during birth, but they do not show up until later in life.
• Salmonella Infection: Gallstone patients are more likely to develop gallbladder cancer as a result of typhoid-causing salmonella infection.

The number system is divided into four stages, numbered I through IV. Stage 0 is also referred to by certain doctors.

Stage 0: CIS, or stage 0 gallbladder cancer, is a very early stage of gallbladder cancer. Only the layer of tissue lining your gallbladder has cancer cells. Because the cancer cells are just in the lining, some doctors may not consider this to be a genuine cancer. As a result, the cancer has a very low chance of spreading. The early detection of gallbladder cancer is exceptional, as there are few or no symptoms at this stage. When a person’s gallbladder is removed for gallstones, it is sometimes discovered thus early.

Stage I: Invasive cancer is diagnosed at this stage. It signifies that the cancer has only spread to the inner layers of the gallbladder’s tissues. It hasn’t spread to the surrounding tissues, lymph nodes, or organs.

Stage II: This indicates that cancer has spread through the gallbladder wall’s muscle layer and into the connective tissue beneath. Outside of the gallbladder, it hasn’t spread.

Stage III: This stage is broken into three parts: IIIA & IIIB.

• Stage IIIA: The cancer has developed through the gallbladder wall but has not migrated to the lymph nodes in stage IIIA.
• Stage IIIB: Stage IIIB indicates that the cancer has progressed to neighboring lymph nodes or has broken through the outer layer of the gallbladder.

Stage IV: This indicates that the malignancy has progressed. It is separated into two stages: IVA and IVB.

• Stage IVA: Stage IVA indicates that the cancer has spread to one of the liver’s main blood arteries or to two or more organs outside of the liver. It’s also possible that it’s spread to adjacent lymph nodes.
• Stage IVB: Stage 4B indicates that the cancer has progressed to lymph nodes outside of the gallbladder and is of any size. In some situations, it hasn’t even moved to distant organs in the body.

Gallbladder cancer can sometimes be diagnosed as a result of gallstones or gallbladder inflammation, or during surgical treatments for the same, but most cases are not discovered until the patient presents with the symptoms, and the following tests may be performed to diagnose gallbladder cancer.

Physical Examination: A physical examination may include looking for lumps, discomfort, or fluid buildup in the abdomen. If there are any signs of jaundice, the eyes and skin should be examined.

Medical History: If the doctor feels the patient has gallbladder cancer, the doctor will take a thorough medical history to look for risk factors and symptoms that could indicate the malignancy.

Liver Function Test: Lab tests to determine the levels of bilirubin, albumin, liver enzymes such as alkaline phosphatase, AST, ALT, and GGT, as well as certain other substances in the blood, are known as liver function tests, and they can aid in the diagnosis of gallbladder cancer and related conditions, as well as liver or bile duct disease.

Imaging Tests: The doctor will advise you to get tests such as ultrasonography, MRI, CT scan, etc., to determine the nature of your tumor.

Tumor Marker Tests: The tumor marker test involves taking a blood sample and testing it for biomarkers that can be raised in the presence of a certain form of cancer.

Biopsy: Biopsy is not the preferred technique of diagnosis for gallbladder cancer because it entails removing cells from questionable areas and viewing them under a microscope. This is because, in the case of gallbladder cancer, it can spread the malignancy, and even if surgery is required, surgical biopsy is the preferred choice, as it involves examining cells retrieved during or after surgery.

Angiography: An angiogram is a type of X-ray that is used to examine a patient’s blood arteries. To delineate the blood vessels, a thin plastic tube is introduced into the artery and a small amount of contrast dye is injected. If the cancer has migrated beyond the gallbladder into the surrounding blood arteries, this can reveal tumors or obstructions in the blood vessels.

Laparoscopy: A laparoscope is a tiny tube with a light and a video camera that is introduced into the patient’s belly by a small incision to examine the gallbladder, liver, and adjacent organs, as well as perform a biopsy if cancer is suspected. Gallbladder cancer can also be diagnosed via laparoscopy to identify the stage and extent of the disease.

Cholangiography: This is an imaging test that determines whether the bile ducts are clogged, constricted, or dilated and is used to plan for gallbladder cancer surgery. Cholangiograms used to identify gallbladder cancer include magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), and percutaneous transhepatic cholangiography (PTC).

Surgery: There are two types of surgical treatments for treating gallbladder cancer: potentially curative surgery and palliative surgery. Palliative surgeries are used for metastasized tumors for which surgical measures alone cannot eliminate the cancer from the body. Potentially curative surgeries are used for resectable cancers, that is, cancers that can be entirely removed by surgical procedures.

Chemotherapy: Chemotherapeutic medicines are chemicals that go through the circulation and kill cancerous cells in the body. Because gallbladder cancer chemotherapy is ineffective on its own, it is frequently coupled with other treatments to achieve substantial outcomes. Chemotherapy is administered alone to reduce the chance of recurrence of cancer.

Radiation Therapy: The use of radiation treatment to treat gallbladder cancer has the advantage of reducing the chance of damaging healthy cells. It’s frequently used to treat gallbladder cancer that has spread to other organs.