Gallbladder Cancer - Terre Haute Regional Hospital | Terre Haute, IN
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Definition

Gallbladder cancer is a disease in which cancer cells grow in the gallbladder. This is a relatively rare form of cancer. The gallbladder is a small pear-shaped organ that sits beneath the liver. It stores bile until it is needed by the digestive system. Bile is a greenish-yellow digestive fluid produced by the liver that helps in digesting fat.

The Gallbladder
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Causes

Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues. Cancer that has invaded nearby tissues can then spread to other parts of the body.

It is not clear exactly what causes these problems in the cells, but is probably a combination of genetics and environment.

Risk Factors

Gallbladder cancer is more common in women and those of Native American or Hispanic descent. Other factors that may increase your chance of gallbladder cancer include:

  • Gallstones or chronic inflammation of the gallbladder, including calcification of the gallbladder (porcelain gallbladder)
  • Obesity
  • Increasing age—especially 65 years and older
  • Physical abnormalities of the gallbladder and ducts, such as choledochal cysts or polyps of the gallbladder
  • Exposure to some chemicals, such as azotoluene and nitrosamines, found in metal processing and rubber production
  • Typhoid fever or chronic salmonella infection

Symptoms

Gallbladder cancer often shows no symptoms in its early stages. As the disease progresses, symptoms associated with bile obstruction often develop. These include:

  • Abdominal pain
  • Pain in the upper back (called referred pain)
  • Yellowing of the skin and whites of the eyes—jaundice

Other symptoms may include:

  • Nausea and/or vomiting
  • Loss of appetite
  • Weight loss
  • Liver and spleen enlargement
  • Increased abdominal girth

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. Gallbladder cancer is often hard to diagnose because there are no early symptoms. Gallbladder cancer is usually discovered incidentally during abdominal surgery for other reasons.

Tests may include:

  • Blood tests
  • Biopsy—The removal of a sample of tissue for testing. This is usually an open surgery.

Imaging tests evaluate the gallbladder and surrounding structures. These may include:

The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, gallbladder cancer is staged from I-IV. Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.

Treatment

Treatment depends on the stage of the cancer. For advanced cancers, treatment is done only to help relieve symptoms. Treatments include:

Surgery

Surgical removal of the gallbladder is called cholecystectomy. Part of the liver and lymph nodes near the gallbladder may also be removed. In some cases, surgery is done to relieve symptoms by opening obstructed bile ducts. ERCP may also be used for this purpose.

Radiation Therapy

Radiation therapy uses radiation to kill cancer cells and shrink tumors. Radiation is most often administered from a source outside the body.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. Chemotherapy is not considered curative for gallbladder cancer, but may relieve symptoms in some.

Combined Modality Therapy (CMT)

CMT is a term gaining popularity and meaning several treatments at once or in succession. Although it has not been shown that chemo- and radiation therapy at the same time are better than radiation therapy alone in the treatment of gallbladder cancer, CMT is better with many other kinds of cancers.

Prevention

There are no curent guidelines for preventing gallbladder cancer because the cause is usually not known. If you have problems with gallstones, talk to your doctor about removing the gallbladder.

Revision Information

  • American Cancer Society

    http://www.cancer.org

  • National Cancer Institute

    http://www.cancer.gov

  • Canadian Cancer Society

    http://www.cancer.ca

  • Women's Health Matters

    http://www.womenshealthmatters.ca

  • Gallbladder cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003101-pdf.pdf. Accessed November 26, 2014.

  • Gallbladder cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 9, 2014. Accessed November 26, 2014.

  • Gallbladder cancer. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/liver%5Ftumor%5Fcenter/conditions/gallbladder%5Fcancer.html. Accessed November 26, 2014.

  • Tumors of the gallbladder and bile ducts. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/hepatic%5Fand%5Fbiliary%5Fdisorders/gallbladder%5Fand%5Fbile%5Fduct%5Fdisorders/tumors%5Fof%5Fthe%5Fgallbladder%5Fand%5Fbile%5Fducts.html. Updated November 2013. Accessed November 26, 2014.

  • 10/1/2014 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Bhaskaran K, Douglas I, et al. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5.24 million UK adults. Lancet. 2014;384(9945):755-765.