Types of Gallbladder Cancer
The gallbladder is a small hollow pear-shaped organ located below the liver that stores the bile secreted by the liver before it is released into the small intestine. The gallbladder contracts during and after a fatty meal, delivering bile through the bile ducts into the intestines to aid digestion.
Gallbladder cancer is characterized by abnormal cell growth that begins in the gallbladder.Gallbladder cancer is rare. When gallbladder cancer is discovered in its early stages, there is a good chance of a cure. However, the majority of gallbladder cancers are discovered at a late stage, when the prognosis is frequently very poor.
Gallbladder cancer may not be detected until it has progressed because it frequently exhibits no specific signs or symptoms. Furthermore, because the gallbladder is relatively hidden, gallbladder cancer can spread undetected.
Types Of Gallbladder Cancer
Since the gallbladder contains many different types of cells, there are several types of gallbladder cancer. The exact type of cancer is determined by the type of cell from which cancer originated within the gallbladder. Adenocarcinoma accounts for more than 85 percent of gallbladder cancers, with other rare types accounting for the remainder. 15% of the total.
- Adenocarcinoma: Cancer began in the gallbladder lining gland cells. Mucus is normally processed by gland cells. Adenocarcinoma is the most common subtype accounting for 90–95% of cases of gallbladder cancer. Gallbladder adenocarcinomas are classified into three types:
- Non-papillary adenocarcinomas (75% diagnosed with it)
- Papillary adenocarcinomas (6% diagnosed with it)
- Mucinous adenocarcinomas (1 to 2% are diagnosed with it)
- Squamous cell cancer of the gallbladder: It develops from skin-like cells that, along with gland cells, form the lining of the gallbladder. Squamous cell carcinoma (SCC) is found in 1–12% of cases. But, the incidence of pure SCC drops down to 0 -- 3.3% when the adenosquamous carcinoma is excluded.
- Small cell cancer of the gallbladder: Small cell carcinoma of the gallbladder is a distinct histologic and clinical entity that shares many clinical characteristics with adenocarcinoma of the gallbladder, such as a similar natural history and proclivity for locoregional spread.
- Adenosquamous cancer of the gallbladder: Adenosquamous cell carcinomas are a rare subtype of gallbladder cancer, traditionally considered more aggressive and with a poorer prognosis than adenocarcinoma.
- Neuroendocrine tumors of the gallbladder: It is also known as carcinoid neuroendocrine tumors are abnormal growths that begin in neuroendocrine cells, which are specialized. Neuroendocrine cells share characteristics with nerve cells and hormone-producing cells.
- Sarcoma of the gallbladder: Sarcoma is a type of cancer that affects the body's supportive or protective tissues, also known as connective tissues. Connective tissues include muscles, blood vessels, and nerves. Cancer that starts in the muscle layer of the gallbladder is called a sarcoma.
- Lymphoma and melanoma of the gallbladder: These are extremely rare types of gallbladder cancer that are not always treated in the same way as other types of gallbladder cancer.
Symptoms of Gallbladder Cancer
Gallbladder cancer symptoms and signs may include:
- Abdominal pain
- Nausea and vomiting
- Loss of appetite
- Weight Loss
Risk Factors of Gallbladder Cancer
Gallbladder cancer develops when healthy gallbladder cells change (mutations) in their DNA. The DNA of a cell contains the instructions that tell the cell what to do. The changes instruct the cells to proliferate uncontrollably and to live when other cells would normally die. The accumulating cells form a tumor, which can spread beyond the gallbladder to other parts of the body. The majority of gallbladder cancers begin in the glandular cells that line the inside of the gallbladder. Adenocarcinoma is a type of gallbladder cancer that begins in this type of cell. This term refers to the appearance of cancer cells under a microscope.
The following factors can increase the risk of gallbladder cancer:
- Your gender: Women are more likely than men to develop gallbladder cancer.
- Your age: As you get older, your risk of gallbladder cancer rises.
- Gallstones: Gallbladder cancer is more common in people who have or have had gallstones in the past. Larger gallstones may pose a greater risk. Even so, gallstones are very common, and gallbladder cancer is extremely rare in people with this condition.
- Other gallbladder diseases and conditions: Polyps, chronic inflammation, and infection are examples of gallbladder conditions that can increase the risk of gallbladder cancer.
- Inflammation of the bile ducts: Gallbladder cancer is increased by primary sclerosing cholangitis, which causes inflammation of the ducts that drain bile from the gallbladder and liver.
Diagnosis of Gallbladder Cancer
Doctors recommend a variety of tests for the detection and diagnosis of gallbladder cancer. The results of these tests are then used to develop individualized treatment plans for patients.
First and foremost, the doctor may perform a physical examination to look for signs of gallbladder cancer. The doctor will look for lumps, tenderness, and fluid build-up in the abdomen. He or she may also search for signs of jaundice. The lymph nodes in the area are also examined for swelling. The following tests may be recommended if gallbladder cancer is suspected:
- Blood tests: Blood tests may be performed to determine the amount of bilirubin in the blood. Problems with the gallbladder, bile ducts, or liver can cause an increase in bilirubin levels in the blood. Tests for albumin, liver enzymes (alkaline phosphatase, AST, ALT, and GGT), and other blood tests may be performed. These tests are commonly known as liver function tests. They aid in the diagnosis of liver, bile duct, and gallbladder disorders.
- Tumour markers: Patients with gallbladder cancer may have elevated levels of the markers CEA and CA 19-9 in their blood. These markers are typically detected in significant concentrations in the blood only when cancer has advanced to an advanced stage. While these biomarkers aren't specific to gallbladder cancer, they can be useful once the disease has been diagnosed. These indicators can be monitored over time to see how the patient's body reacts to the treatment.
- Imaging tests: To study the internal structure of the organ and check for the presence of abnormal masses, various imaging tests, such as ultrasound scans, CT scans, and MRI scans, are recommended. These tests not only aid in accurate diagnosis, but also in disease staging, treatment planning, therapy monitoring, and restaging. A special imaging test is recommended in the case of gallbladder cancer to thoroughly examine the gallbladder region.
- Cholangiography: This test allows the clinician to examine the bile ducts thoroughly. It is possible to perform it using an MRI machine (Magnetic Resonance Cholangiopancreatography), an endoscope (Endoscopic Retrograde Cholangiopancreatography), or a needle inserted through the abdominal skin (Percutaneous Trans hepatic Cholangiography).
- Biopsy: A biopsy involves the removal of cells or tissues from the suspected area so that a pathologist can examine them under a microscope for signs of gallbladder cancer. A biopsy may be performed even after the tumour has been removed. If the tumour cannot be surgically removed, a biopsy sample can be collected with a thin needle for further examination.
Gallbladder Cancer Treatment
- Surgery:A cholecystectomy is a surgical procedure that removes the gallbladder and some surrounding tissues. Lymph nodes in the vicinity may also be removed. A laparoscope is sometimes used to guide gallbladder surgery. The laparoscope, which is inserted through an incision in the abdomen, is equipped with a video camera. Surgical instruments are inserted through the created pores. Because gallbladder cancer cells may spread to these openings, the tissue surrounding them may be removed as well.
If cancer has spread and cannot be removed, the following types of palliative surgery may help reduce symptoms:
- Surgical biliary bypass: If the tumour is blocking the small intestine and bile is accumulating in the gallbladder, a biliary bypass may be performed. During this procedure, the gallbladder or bile duct will be cut and stitched to the small intestine to create a new conduit around the obstructed location.
- Endoscopic stent placement: If the tumour is blocking the bile duct, surgery to place a stent (a thin, flexible tube) to drain accumulated bile may be required. The stent can be inserted around the blocked area to drain the bile internally into the small intestine or through a catheter that drains to the outside of the body.
- Percutaneous Transhepatic Biliary Drainage: Surgery to drain bile is performed when endoscopic stent implantation is not possible due to a blockage. An x-ray of the liver and bile ducts is taken to locate the blockage. Ultrasound images may be used to guide the placement of a stent in the liver that drains bile into the small intestine or an external pouch. This surgery may be suggested to treat jaundice before surgery.
- Radiation therapy: Radiation therapy is a cancer treatment that destroys cancer cells using high-energy x-rays or other types of radiation. Radiation therapy can either be delivered externally or internally. External radiation therapy delivers radiation to the tumour from a radiation source outside the body. Internal radiation therapy involves injecting a radioactive substance into or near the tumour through seeds, wires, needles, or catheters. Radiation therapy may also be recommended to ease pain in the advanced stages of the disease.
- Chemotherapy: Chemotherapy is a cancer treatment that uses powerful drugs to stop cancer cells from multiplying by either killing them or preventing them from dividing. When chemotherapy is taken orally or injected into a vein, it enters the bloodstream and can reach cancer cells all over the body. It is typically administered to gallbladder cancer patients following surgery (adjuvant therapy). Chemotherapy may be used alone to help reduce cancer-related signs and symptoms, as well as to increase survival in patients with advanced-stage gallbladder cancer.
Some questions that are frequently asked:
Q1. Can Gallbladder Stones Cause Cancer?
Ans. Gallbladder stones can raise your risk of developing gallbladder cancer, but they are not a cause of cancer.
Q2. How Long Can a Person Live with Gallbladder Cancer?
Ans. Because the cancer is still contained in the gallbladder in the early stages, 60 to 80 percent of patients have a 5-year survival rate.Survival rates are lower once cancer has spread beyond the gallbladder.If detected late, treating blood cancer might be difficult.
Q3. Is Gallbladder Cancer Painful?
Gallbladder cancer causes ongoing abdominal pain, which may worsen as the cancer spreads, but there are pain management treatments available.
Q4. Is Gallbladder Cancer Difficult to Diagnose?
Ans. Yes, gallbladder cancer is difficult to detect for the following reasons:
- There are no signs or symptoms of gallbladder cancer in its early stages.
- As the disease progresses, the symptoms resemble those of a variety of other conditions.
- The gallbladder is hidden behind the liver.
Q5. What Is the Best Treatment for Gallbladder Cancer?
Ans. Surgery is usually the most effective treatment for gallbladder cancer. Although removing the gallbladder can help prevent cancer from spreading, it is often necessary to combine surgery with other treatments, such as radiation therapy, to help prevent cancer from returning.