What is Gallbladder Cancer?
Gallbladder cancer is a malignant growth that begins in the gallbladder, a small pear-shaped organ located beneath the liver. The gallbladder stores bile, a digestive fluid that helps break down fats. Most gallbladder cancers are adenocarcinomas, meaning they start in the glandular cells lining the organ. In medical terms, it is classified as a malignant neoplasm of the gallbladder.
Because early stages often have no clear warning signs, gallbladder cancer is typically diagnosed late. This late discovery makes it one of the most challenging cancers to treat.
Causes and Risk Factors
The exact cause of gallbladder cancer isn’t fully known, but research has identified several risk factors:
- Gallstones: Chronic irritation from stones is the most common cause.
- Porcelain gallbladder: Calcification of the gallbladder wall increases cancer risk.
- Gallbladder polyps: While most are benign, larger polyps can turn malignant.
- Chronic infections: Long-term inflammation, such as follicular cholecystitis.
- Age: More common in older adults, but cases in people under 40, even at age 30, are increasingly reported.
- Gender: Women are affected more often.
- Genetics: Though not strictly hereditary, family history raises risk.
- Geography: Higher rates in South America, India, and Eastern Europe.
- Other conditions: Biliary tract abnormalities, obesity, and exposure to certain toxins.
Symptoms of Gallbladder Cancer
In early stages, symptoms may mimic gallstones or liver disease. Common signs and symptoms include:
- Persistent abdominal pain (especially in the upper right side)
- Jaundice (yellowing of skin and eyes)
- Unexplained weight loss
- Nausea, vomiting, or loss of appetite
- Abdominal bloating
- Fever and itching (in advanced disease)
For women, the symptoms may appear subtle fatigue, digestive discomfort, or back pain making early recognition difficult.
In end-stage gallbladder cancer, additional symptoms include severe pain, ascites (fluid buildup in the abdomen), and liver failure.
How is Gallbladder Cancer Diagnosed?
Diagnosis usually begins with imaging and lab tests:
- Ultrasound of the gallbladder – often the first test, showing masses or wall thickening.
- CT scan and MRI – help detect spread to the liver or nearby structures.
- Endoscopic ultrasound – provides detailed images of bile ducts.
- Blood tests – may detect tumor markers like CEA or CA 19-9, though not always reliable.
- Biopsy – confirms the cancer by examining tissue samples.
Many wonder: Can gallbladder cancer be mistaken for gallstones? Yes, since both cause similar symptoms.
Gallbladder Cancer Staging (AJCC 8th Edition TNM)
The AJCC staging system is widely used:
- Stage I – Cancer limited to the gallbladder lining.
- Stage II – Spread to muscle or connective tissue.
- Stage III – Invasion into nearby liver or organs.
- Stage IV – Advanced disease with distant spread (often to the liver, bile ducts, or peritoneum).
A contracted gallbladder with cancer often indicates advanced disease.
Gallbladder Cancer vs Cholangiocarcinoma
Gallbladder cancer and cholangiocarcinoma (bile duct cancer) are both biliary tract cancers, but differ in origin.
- Gallbladder cancer: Starts in the gallbladder.
- Cholangiocarcinoma: Starts in the bile ducts.
On radiology imaging, cholangiocarcinoma usually shows bile duct narrowing, while gallbladder cancer presents as a mass or thickened wall.
Treatments for Gallbladder Cancer
Treatment depends on stage, patient health, and spread:
Surgery
- Cholecystectomy (gallbladder removal): Best for early disease.
- Extended surgery: May involve liver resection and bile duct removal if spread is present.
Chemotherapy
- Standard regimens often use gemcitabine and cisplatin.
- Newer drugs, including Enhertu (trastuzumab deruxtecan), are being studied in advanced cases.
Radiation Therapy
Used when surgery isn’t possible or after surgery to prevent recurrence.
Targeted & Immunotherapy
Emerging approaches include HER2 inhibitors, immune checkpoint inhibitors, and molecularly tailored therapies.
Survival and Prognosis
Gallbladder cancer is often aggressive. Prognosis depends on stage:
- Early stage: Surgery can be curative, with survival rates up to 80%.
- Stage III: Drops significantly, around 20–30%.
- Stage IV (metastatic gallbladder cancer): Life expectancy is typically months, though treatment may extend survival.
On average, the 5-year survival rate is around 19%, but new treatments are improving outcomes.
Gallbladder Removal and Cancer Risk
Many ask: Does gallbladder removal increase cancer risk?
- No, removal itself does not cause cancer.
- In fact, it eliminates risks of gallstones turning into cancer.
- However, long-term changes in bile flow may slightly affect risks of cancers in other digestive organs, such as the pancreas.
Prevention and Management
While not all cases are preventable, steps can lower risk:
- Maintain a healthy weight.
- Manage gallstones early.
- Avoid tobacco and excess alcohol.
- Eat a diet rich in fruits, vegetables, and whole grains.
- Undergo regular checkups if you have risk factors.
Living with Gallbladder Cancer
Management goes beyond treatment it’s about quality of life:
- Palliative care focuses on comfort in advanced disease.
- Support groups help cope with emotional challenges.
- Awareness efforts, such as the gallbladder cancer ribbon and awareness month, aim to spread education and reduce stigma.
Conclusion
Gallbladder cancer may be rare but remains one of the most deadly gastrointestinal cancers because it is often diagnosed late. While the disease carries a high mortality rate, early recognition and treatment dramatically improve survival. New therapies, from targeted drugs to personalized protocols, offer hope for better outcomes in the future.
FAQs
1. What are the main symptoms of gallstones?
The primary symptom of gallstones is a sudden and intense pain in the upper right part of your abdomen, which can last from a few minutes to several hours. This pain, often called a “gallbladder attack,” can be accompanied by fever, nausea, vomiting, dark urine, and light-colored stools.
2. How are gallstones treated?
In most cases, the standard treatment for gallstones is a surgical procedure called a cholecystectomy, which is the removal of the gallbladder. This is most commonly done using laparoscopic surgery, a minimally invasive procedure where the surgeon makes a few small incisions in the abdomen.
3. Is it possible to live without a gallbladder?
Yes, you can live a normal, healthy life without a gallbladder. The gallbladder’s main function is to store bile, but once it’s removed, the liver simply releases bile directly into the small intestine. Your body will continue to digest food effectively without it.
4. What kind of diet should I follow after gallbladder surgery?
After surgery, it’s best to start with a low-fat, bland diet. You should avoid fried, greasy, and high-fat foods. As you recover, you can gradually reintroduce a wider variety of foods, but it’s often recommended to stick to a healthier, lower-fat diet in the long term.
5. How long does recovery from gallbladder surgery take?
Recovery from laparoscopic surgery is typically quick. Most patients are discharged from the hospital within a day or two and can return to their normal activities within a couple of weeks. However, you should avoid heavy lifting and strenuous exercise for a short period as advised by your doctor.