Gallbladder Cancer: Causes, Symptoms, Stages, And Treatment
GallBladder is one among the 20 most common cancers in the world. Approximately 178,100 new gallbladder cases were reported globally in the year 2012.
The gallbladder is a small organ present below the liver which stores bile. The diagnosis of the gallbladder cancer is difficult as it does not cause any specific signs. If the gallbladder cancer is diagnosed at an early stage, then the probability of recovery is more. However, most of the gallbladder cancers are diagnosed at the last stages.
What are the Signs and Symptoms of Gallbladder Cancer?
In most of the Gallbladder Cancers, symptoms are not seen until the last stages of cancer. In rare cases, few signs and symptoms are seen in the early stages. The various signs and symptoms that may indicate gallbladder cancer are as follows:
- Abdominal Pain
- Weight loss
- Dark urine
- Greasy or pale stools
What are the Causes of Gallbladder Cancer?
Gallbladder cancer is caused due to a genetic mutation (change in the DNA) in the gallbladder cells. Due to the genetic mutation, the gallbladder cells divide abnormally, and the cells accumulate resulting in the formation of a tumor.
What are the Risk Factors for Gallbladder Cancer?
Risk factorsincrease the risk of developing a condition. It does not guarantee the incidence of the disease in the individual. Risk factors can further be categorised as modifiable risk factors (smoking, sedentary lifestyle) and non- modifiable risk factors(family history, gender). The various risk factors for gallbladder cancer are:
- Age: The risk of developing gallbladder increases with age. The average age at which gallbladder cancer is diagnosed is 72 years.
- Sex: Females are at a higher risk of developing gallbladder cancer when compared to males.
- Obesity: Most patients diagnosed with gallbladder cancer are obese. Obesity also increases the risk of gallstones which is also a risk factor for gallbladder cancer.
- Gallbladder Diseases: Presence of gallbladder diseases such as gallstones, gallbladder polyps, gallbladder infections etc. increases the risk of gallbladder cancer.
- Geography: The incidence of gallbladder cancer is more in Pakistan, India, and South American and Central European countries when compared to the United States.
- Typhoid: People who have typhoid or are the carriers of this disease are at high risk of developing gallbladder cancers, probably this infection increases the risk of gallstones.
- Family History: The family history of gallbladder cancer makes one more susceptible to develop gallbladder cancer.
What are the Diagnostic Tests for the Gallbladder Cancer?
Diagnosis of gallbladder cancer is a little difficult in the early stages as no specific signs and symptoms are observed. In few cases, the gall bladder cancers are diagnosed when the gallbladder is removed for treating gallstones. The various diagnostic tests for the gallbladder cancer are:
- Physical Examination: In physical examination, the physician will look for various signs and symptoms of the gallbladder cancer such as any lumps or tenderness in the abdomen, yellow color in the eyes and skin which may indicate jaundice etc.
- Blood Tests: Blood tests are done to determine the levels of bilirubin, albumin, alkaline phosphate, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and Gamma-glutamyltransferase (GGT). Bilirubin levels are increased in jaundice and alkaline phosphate, albumin; GGT, AST and ALT are elevated in liver or gallbladder disorders.The blood is also tested for tumor makers such as CEA and CA 19-9, the levels of which is high of gallbladder cancer. Tumor makers are specific proteins which are present in the blood when a particular type of cancer is present.
- Imaging Tests: Imaging tests include X-rays, ultrasound, computerized tomography (CT) scan and magnetic resonance imaging (MRI) scan.
- Biopsy: In the biopsy, the tissue of the gallbladder is extracted and studied under a microscope to confirm the diagnosis of gallbladder cancer. Biopsy also gives detail about the extent of spread of the gallbladder cancer.
- Laparoscopy: Laparoscopy is a minor surgery, which is done by using the laparoscope (a narrow tube with a high-intensity light and the camera on one end) which is inserted into the body through the abdominal incision to examine the gallbladder. It helps in determining the stage of cancer.
What are the Stages of Gallbladder Cancer?
The stages of gallbladder cancer are differentiated based on the extent to which it is spread. The various stages of the gallbladder cancer include:
- Stage I: Gallbladder cancer affects only the inner layers of the gallbladder in the first stage.
- Stage II: In stage II, the gallbladder cancer is spread up to the outer layers of the gallbladder.
- Stage III: Gallbladder cancer affects the surrounding organs such as the liver, stomach or the small intestines in the third stage.
- Stage IV: In the last stage of the gallbladder cancer, large tumors are seen in the gallbladder, surrounding areas or even in the faraway organs of the body.
How is Gallbladder Cancer Treated?
The objective of gallbladder cancer treatment is the removal of the gallbladder. If removal of the gallbladder is not possible then the spread of disease is at least stopped. Treatment for gallbladder cancer is based on the stage of cancer.
- Treatment for gallbladder cancer in the earlier stages:
- Surgery: In the early stages of gallbladder cancer when the cancer is confined only to the gallbladder or has spread to the liver then surgery is done to remove the gallbladder and the affected part of the liver.
- Treatment for gallbladder cancer in the later stages:
In the later stages, when cancer has spread to the other parts of the body,then surgery cannot be done. In the later stages, treatment is done to treat the signs and symptoms of the gallbladder cancer. The treatment options included the following:
- Chemotherapy:In chemotherapy, cancerous cells are killed by using medications.
- Radiation therapy:In radiation therapy,high energy X-rays and protons are used to kill cancer cells.