Gallbladder Cancer Symptoms, Causes, and Treatment

The gallbladder is an organ that is part of the digestive system and plays a role in producing bile, which is necessary for fat metabolism. The gallbladder, which stores and secretes bile, is located in the upper right part of the abdomen. Due to various reasons, changes can begin to occur in the cells of the gallbladder, and these cellular changes may lead to the development of cancer. Gallbladder cancer, which can present with symptoms such as abdominal pain and bloating, is a serious medical condition that requires intervention.

What is Gallbladder Cancer?

Gallbladder cancer is a type of insidious cancer that develops when malignant cancer cells begin to invade the gallbladder. This rare type of cancer is typically noticed in its advanced stages or when it has metastasized. The cancer cells initially develop in the mucosal layer inside the gallbladder and over time begin to spread to other layers, affecting the entire organ. As the cancer progresses, it may spread to surrounding organs and tissues. Gallbladder cancer is often discovered during the investigation of another disease. In some cases, the appearance of various symptoms can raise suspicion for gallbladder cancer. Individuals who suffer from gallbladder inflammation or gallstones are at a higher risk for developing gallbladder cancer.

What Are the Symptoms of Gallbladder Cancer?

Gallbladder cancer is an insidious disease that does not cause any symptoms in its early stages. As the cancer begins to progress, the symptoms that emerge may be confused with those of other diseases or might not be initially taken seriously. The worsening of symptoms can suggest medical conditions such as gallstones or bile duct blockages. Gallbladder cancer, with symptoms similar to these conditions, can cause the following symptoms:

• Pain in the upper abdomen
• A sensation of a lump in the abdominal area
• Bloating
• Nausea and vomiting
• Jaundice, leading to yellowing of the skin and whites of the eyes
• Unintentional weight loss
• Fever

What Causes Gallbladder Cancer?

Gallbladder cancer occurs when cells in the gallbladder begin to multiply uncontrollably and transform into malignant cells. The main cause of this cellular change is mutations or alterations in genetic material. Genetic factors can contribute to these mutations, but diseases, medications, and lifestyle choices can also play a role.

While the exact process of how cancer cells develop is not fully understood, some risk factors have been identified that may trigger this condition. For example, gallbladder cancer is more common in women than in men. Additionally, this type of cancer is more frequently seen in individuals over the age of 65.

Aside from age and gender, people with a history of gallbladder-related diseases have a higher risk of developing cancer. Individuals with gallstones or a history of gallstones, those with gallbladder polyps, or people suffering from chronic gallbladder inflammation (also known as cholecystitis) are more likely to develop cancerous cells. Chronic inflammation in the bile ducts or cysts in the common bile duct can also increase the risk of cancer. People who have had a Salmonella typhi infection may also experience cancer cell development related to typhoid.

Dietary factors and lifestyle choices can also contribute to the development of cancer cells in the gallbladder. Calcium accumulation in the gallbladder and obesity are among the factors that can lead to cancer.

Stages of Gallbladder Cancer

When a gallbladder cancer diagnosis is made, it is also necessary to determine the stage of the cancer to decide on the appropriate treatment approach. Staging helps to identify the original location of the cancer and whether it has metastasized. There are different stages from 0 to 4, with higher numbers indicating more advanced stages and increased severity. The stages of gallbladder cancer can be described as follows:

Stage 0: Cancerous pre-cells are found in the mucosal layer that makes up the inner structure of the gallbladder. There is no spread at this stage.
Stage 1: Cancer cells are developing in the mucosal structure of the gallbladder. There is a risk of the cells spreading to the muscle wall of the gallbladder.
Stage 2: Malignant cancer cells have spread beyond the muscle layer of the gallbladder to the connective tissue.
Stage 3: The malignant cells affecting the gallbladder have started to spread to nearby organs. There is also a risk of spreading to the lymph nodes.
Stage 4: Cancer cells have spread to nearby lymph nodes and have metastasized to distant organs.

How is Gallbladder Cancer Diagnosed?

Various tests are performed to evaluate suspicions of gallbladder cancer and determine whether cancer is present. These tests can also help identify the type and stage of cancer, whether metastasis has occurred, and what treatment should be pursued. The methods used for gallbladder cancer diagnosis include the following:

Laboratory Tests: Liver function tests, carcinoembryonic antigen (CEA) tests, and CA 19-9 tests can be used. The liver function test measures the levels of substances secreted by the liver, which can help determine if the liver is affected by cancer. CEA can determine the levels of CEA in the blood, which can be related to cancer. High levels can be associated with cancer. CA 19-9 is a tumor marker in the blood, and high results can confirm the suspicion of cancer.
CT Scan: Computerized tomography (CT) can provide detailed images of the abdominal, chest, and pelvic regions, helping to identify any structural changes in the organs and tissues.
Ultrasound: High-energy sound waves are used to create detailed images of body tissues.
Percutaneous Transhepatic Cholangiography: A type of X-ray used to obtain images of the liver and bile ducts. A thin needle is inserted under the ribs to inject a special fluid (dye) into the bile ducts and liver, allowing detection of any blockages.
Endoscopic Retrograde Cholangiopancreatography (ERCP): ERCP scans can be performed to examine bile ducts, which may narrow due to cancer in the gallbladder.
Magnetic Resonance Imaging (MRI): MRI, which uses radio waves, provides comprehensive images of tissues and organs.
Laparoscopy: During this procedure, a small incision is made in the abdominal area, and a device called a laparoscope, which contains lights and a camera, is inserted to examine the gallbladder and other organs to determine the extent of cancer spread.
Biopsy: A tissue sample is taken to determine the stage of cancer. The sample is examined in a lab to assess whether cancer is present. A biopsy is the definitive method for diagnosing gallbladder cancer.

How is Gallbladder Cancer Treated?

As with all cancers, early detection and treatment of gallbladder cancer are vital. In the early stages, the goal is to completely eliminate the cancer, while in advanced stages, the focus of treatment is to alleviate the patient's symptoms.

If the patient is in the early stages, surgery may be performed. During surgery, the gallbladder and nearby tissues can be removed. If the surgery is extensive, affected lymph nodes and part of the liver may also be removed.

In some cases, radiation therapy or chemotherapy may be used either after surgery or before surgery. The aim of radiation therapy is to destroy cancer cells and slow down tumor growth while minimizing damage to healthy cells. It can also be used to relieve symptoms. Chemotherapy uses intravenous medications to kill cancer cells and stop their growth.

Immunotherapy may also be used to support cancer treatment. Medications and supplements are used to strengthen the immune system, helping to destroy cancer cells.

Gallbladder cancer is a serious condition when metastasized. Therefore, if you suspect cancer, it is recommended that you do not ignore the symptoms and consult a healthcare provider. If you have gallstones or a history of related treatments, you should not neglect regular check-ups as advised by your doctor.