Gallbladder Cancer
Gallbladder Cancer
What Is Gallbladder Cancer ?
Gallbladder cancer treatment cost in India is quite reasonable. The average cost of Gallbladder surgery in India will be around $5500-8000 which includes all the basic treatments like surgeon fees, medicine, hospital charges, accommodation, and travel.
The cancer that starts in the gallbladder is known as gallbladder cancer. This cancer starts in the innermost layer of tissue that then spreads from the outer layers as it develops. A gall bladder is basically located on the right side of the abdomen, just below the liver. Bile (a digestive fluid) is stored in the gallbladder.
Types Of Gallbladder Cancer
Gallbladder cancer can manifest in various forms due to the presence of different types of cells in the gallbladder. The specific type of cancer is determined by the type of cell in which the cancer initially develops within the gallbladder. Adenocarcinoma is the most common type of gallbladder cancer, constituting over 85 percent of cases, while other rarer types make up the remaining 15 percent.
Adenocarcinoma is the primary type of gallbladder cancer, originating in the gland cells lining the gallbladder. These gland cells are responsible for processing mucus. Adenocarcinoma is the most prevalent subtype, accounting for 90-95% of gallbladder cancer cases. Gallbladder adenocarcinomas are further categorized into three types:
1. Non-papillary adenocarcinomas (diagnosed in 75% of cases)
2. Papillary adenocarcinomas (diagnosed in 6% of cases)
3. Mucinous adenocarcinomas (diagnosed in 1 to 2% of cases)
Squamous cell carcinoma (SCC) of the gallbladder develops from cells that are similar to those found in the skin, as well as from gland cells that compose the gallbladder lining. SCC accounts for 1-12% of gallbladder cancer cases. However, when we exclude adenosquamous carcinoma, the incidence of pure SCC decreases to 0-3.3%. Adenosquamous carcinoma is a subtype that contains both squamous and glandular elements.
Small cell carcinoma of the gallbladder is a unique form of gallbladder cancer with its own distinct histological and clinical features. It shares several clinical traits with gallbladder adenocarcinoma, including a similar natural course and a tendency to spread to nearby regions.
Adenosquamous cell carcinomas are a less common subtype of gallbladder cancer, typically thought to be more aggressive and associated with a worse prognosis compared to adenocarcinoma.
These tumors, also known as carcinoid neuroendocrine tumors, originate from abnormal growths in neuroendocrine cells, which are specialized cells that exhibit characteristics of both nerve cells and hormone-producing cells.
Sarcoma is a form of cancer that impacts the body’s supportive or protective tissues, known as connective tissues, which encompass muscles, blood vessels, and nerves. When cancer originates in the muscle layer of the gallbladder, it is referred to as sarcoma.
These are highly uncommon forms of gallbladder cancer that may require distinct treatment approaches compared to other types of gallbladder cancer.
Symptoms Of Gallbladder Cancer
- Abdominal pain
- Bloating
- Itchiness
- Fever
- Indigestion
- Nausea and vomiting
- Loss of appetite
- Weight Loss
Risk Factors Of Gallbladder Cancer
Gallbladder cancer arises when normal gallbladder cells undergo mutations in their DNA. DNA within a cell holds the directives that govern the cell’s functions. These mutations instruct the cells to multiply without restraint and survive when they would typically undergo programmed cell death. The amassed abnormal cells coalesce to form a tumor that can extend from the gallbladder to distant 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
Physicians advise an array of tests to detect and diagnose gallbladder cancer, with the results serving as the foundation for customized treatment strategies. To commence, the doctor may conduct a physical examination to identify potential indicators of gallbladder cancer. The examination entails searching for anomalies such as lumps, tenderness, and fluid accumulation in the abdominal region. It may also involve assessing for signs of jaundice. Additionally, any swelling in the nearby lymph nodes is thoroughly examined. If gallbladder cancer is suspected, the following tests might be suggested:
Blood tests might be conducted to assess bilirubin levels in the bloodstream. Elevated bilirubin levels can result from issues with the gallbladder, bile ducts, or liver. Other blood tests, including those for albumin, liver enzymes (such as alkaline phosphatase, AST, ALT, and GGT), are also conducted. These tests are collectively referred to as liver function tests and play a crucial role in diagnosing disorders related to the liver, bile ducts, and gallbladder.
Patients diagnosed with gallbladder cancer may exhibit elevated levels of markers such as CEA and CA 19-9 in their bloodstream. These markers are usually present in significant concentrations in the blood during the later stages of cancer. While these biomarkers are not exclusive to gallbladder cancer, they can be valuable in monitoring the disease post-diagnosis. Tracking these indicators over time allows healthcare professionals to assess the patient’s response to treatment.
To examine the internal structure of the organ and detect any abnormal masses, a range of imaging procedures like ultrasound scans, CT scans, and MRI scans are advised. These tests serve multiple purposes, including precise diagnosis, staging the disease, devising treatment strategies, monitoring therapy progress, and restaging if necessary. In cases of gallbladder cancer, a specialized imaging test is often recommended for a comprehensive evaluation of the gallbladder area.
This procedure enables the healthcare provider to conduct a comprehensive examination of the bile ducts. It can be performed using various methods, including an MRI machine (Magnetic Resonance Cholangiopancreatography), an endoscope (Endoscopic Retrograde Cholangiopancreatography), or a needle inserted through the abdominal skin (Percutaneous Transhepatic Cholangiography).
Gallbladder Cancer Treatment
Surgery: A cholecystectomy is a surgical procedure aimed at gallbladder removal along with some adjacent tissues. In some cases, nearby lymph nodes may also be excised. Laparoscopy is occasionally employed to assist with gallbladder surgery. A laparoscope, equipped with a video camera, is introduced through an abdominal incision, and surgical instruments are inserted through the resulting small openings. Since gallbladder cancer cells could potentially extend to these areas, the surrounding tissue may also be eliminated.
If cancer has spread and cannot be completely removed, the following forms of palliative surgery may be considered to alleviate symptoms:
In cases where the tumor is obstructing the small intestine and causing bile buildup in the gallbladder, a biliary bypass may be conducted. In this surgical procedure, either the gallbladder or the bile duct is severed and then surgically connected to the small intestine, forming a new pathway to circumvent the blocked area.
In cases where the tumor is obstructing the bile duct, a surgical procedure may be needed to insert a stent, which is a slender, flexible tube, to facilitate the drainage of accumulated bile. The stent can be placed around the blocked section to allow the internal drainage of bile into the small intestine or via a catheter that leads to the exterior of the body.
Biliary Drainage Surgery: When endoscopic stent placement is not feasible due to blockage, a procedure to drain bile is conducted. An x-ray of the liver and bile ducts is performed to locate the obstruction. Ultrasound images may be used to guide the insertion of a stent into the liver, allowing for the drainage of bile into the small intestine or an external pouch. This surgery may be recommended to address jaundice before further treatment.
Radiation Therapy: Radiation therapy is a cancer treatment method that employs high-energy x-rays or other radiation types to destroy cancer cells. It can be delivered externally or internally. External radiation therapy directs radiation at the tumor from an external radiation source. Internal radiation therapy involves introducing a radioactive substance into or near the tumor through seeds, wires, needles, or catheters. Radiation therapy may also be suggested for pain relief in the advanced stages of the disease.
Chemotherapy: Chemotherapy is a cancer treatment that uses potent medications to halt the multiplication of cancer cells by either killing them or preventing their division. Chemotherapy can be administered orally or intravenously, allowing it to reach cancer cells throughout the body via the bloodstream. It is typically given to gallbladder cancer patients after surgery as adjuvant therapy. Chemotherapy may be used alone to alleviate cancer-related symptoms and enhance survival in advanced-stage gallbladder cancer patients.
FAQs
The presence of gallbladder stones can increase your susceptibility to gallbladder cancer, but it is not a direct cause of cancer.
In the early stages when the cancer is confined to the gallbladder, 60 to 80 percent of patients have a 5-year survival rate. However, survival rates decrease significantly once cancer has spread beyond the gallbladder. Late detection of gallbladder cancer can make treatment more challenging.
Gallbladder cancer can result in persistent abdominal pain that may intensify as the cancer progresses. Fortunately, there are treatments available for managing and alleviating this pain.
Indeed, gallbladder cancer is challenging to identify due to the following factors:
1. In the early stages of gallbladder cancer, there are no evident signs or symptoms.
2. As the disease advances, the symptoms can mimic those of various other conditions.
3. The gallbladder is situated behind the liver, making it less accessible for early detection.
Surgery is typically the most effective treatment for gallbladder cancer. While removing the gallbladder can be crucial in preventing the spread of cancer, it’s often necessary to complement surgery with additional treatments like radiation therapy to reduce the risk of cancer recurrence.
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