Gall bladder cancer

Gall Bladder Cancer - Gallbladder Cancer

Gallbladder cancer occurs when healthy cells in the gallbladder undergo changes and begin to grow uncontrollably, forming a mass (tumor). This tumor can either be cancerous or benign (non-cancerous). The following section discusses primary gallbladder cancer, which starts in the gallbladder.

The Gallbladder Organ

The gallbladder is a pear-shaped organ located beneath the liver. It stores bile, a fluid produced by the liver that helps digest fats in food.

The wall of the gallbladder consists of three layers:

• Mucosa: The innermost layer of the gallbladder wall.

• Muscularis: The middle layer made of muscle tissue.

• Serosa: The outermost layer.

Gallbladder cancer typically begins in the innermost mucosal layer and then spreads outward.

Statistics

In India, around 19,570 new cases of gallbladder cancer are diagnosed each year, placing it in the 20th position among all cancers. Approximately 14,736 people die annually due to gallbladder cancer, ranking 16th in terms of cancer mortality.

Survival Rate

According to data from the United States, the five-year survival rate for gallbladder cancer is 19%. If diagnosed and treated early, before spreading, the survival rate can reach 66%.

Risk Factors

A risk factor is anything that increases a person’s chances of developing cancer. Risk factors do not directly cause cancer but can contribute to its development.

Key risk factors for gallbladder cancer include:

• Gallstones: Gallstones are the most common risk factor for gallbladder cancer. These are substances formed by fat and bile salts. In the United States, 75% to 90% of people diagnosed with gallbladder cancer had gallstones in the past, although only about 1% of people with gallstones develop gallbladder cancer. The reason why only some develop cancer remains unclear.

• Gallbladder Polyps: Small growths in the gallbladder wall caused by trapped gallstones. Polyps larger than 1 cm are more likely to become cancerous, and doctors may recommend their removal.

• Age: Most gallbladder cancer patients are over the age of 70.

• Gender: Women are twice as likely to develop gallbladder cancer compared to men.

• Smoking: Smoking increases the risk of gallbladder cancer.

• Family History: Having close relatives with gallbladder cancer slightly increases the risk.

Symptoms

• Jaundice (yellowing of the skin and eyes)

• Abdominal pain

• Nausea

• Vomiting

• Swollen abdomen

• Abdominal mass

• Fever

• Itching

Diagnosis

• Biopsy: A small sample is taken from the suspicious area and examined under a microscope to confirm whether cancer is present.

• Endoscopic Retrograde Cholangiopancreatography (ERCP): A procedure where a dye is injected into the bile ducts to detect tumors via X-ray.

• Percutaneous Cholangiography: A small needle is inserted through the skin into the gallbladder to inject a dye, which is then visualized through X-ray to check for tumors.

• Laparoscopy

• Blood Tests: Including CA 19.9, LFT (liver function tests)

• X-ray

• CT Scan

• MRI

• Ultrasound

• PET-CT

Treatment

1. Surgery

• Tumor and surrounding healthy tissue (margin) are removed.

• Some surgical procedures for gallbladder cancer include:

• Cholecystectomy: Complete removal of the gallbladder.

• Radical Gallbladder Resection: Removal of the gallbladder, part of the liver, and lymph nodes.

• Palliative Surgery: Surgery to reduce symptoms but not cure cancer.

2. Radiation Therapy

• High-energy radiation is used to destroy cancer cells. It may be used before surgery to shrink the tumor or after surgery to destroy remaining cancer cells.

3. Chemotherapy

• Chemotherapy involves using drugs to kill cancer cells. It is usually given after surgery to prevent cancer from returning. Common drugs used include capecitabine (Xeloda), gemcitabine (Gemzar), and cisplatin.

4. Immunotherapy

• Immunotherapy boosts the body’s immune system to fight cancer cells. In advanced gallbladder cancer, drugs like durvalumab (Imfinzi), pembrolizumab (Keytruda), and nivolumab (Opdivo) may be used.

Follow-up

After completing cancer treatment, follow-up tests at regular intervals are essential. These tests help manage side effects and ensure the cancer has not returned. Regular physical exams, blood tests, and imaging tests are part of this process.

‍

‍