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Gallbladder Cancer
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Gallbladder cancer is a cancer that originates in the gallbladder. The gallbladder is a little, pear-shaped sac that sits beneath the liver. It collects and stores bile from the liver. The bile is used for digestion, in particular, for digestion of fats. Gallbladder cancer isn't very common and has a good cure rate when caught early. Unfortunately, it is often caught in the later stages of the cancer and then the prognosis is not good at all.
Gallbladder cancer has few signs and symptoms so it is tough to diagnose. It tends to grow unabated beneath the protective nature of the liver. There are, however, some signs and symptoms you should pay attention to. These include right upper quadrant abdominal pain, bloating of the abdomen, an itchy feeling on the skin, jaundice (yellow skin and eyes), poor appetite, fever, nausea and vomiting, and weight loss.
No one knows the exact cause of gallbladder cancer. It happens when DNA changes occur in the wall of the gallbladder and the cells grow without control. The cancer generally stays within the wall of the gallbladder for a period of time and then it travels to other body areas, such as the liver. Gallbladder cancer is referred to as an adenocarcinoma because it begins in the lining of the gallbladder.
Strong risk factors for gallbladder cancer involves being more common in women, being of an older age, having a history of gallstones and having a condition called a porcelain gallbladder, a choledochal cyst and having chronic cholecystitis.
Doctors can diagnose gallbladder cancer using blood tests that evaluate the liver function abilities. There may be an elevation of liver enzymes in gallbladder cancer. Doctors can also use a CT scan or MRI scan of the abdomen to see the gallbladder and locate areas of tumor. Once a biopsy or removal of the gallbladder is accomplished, microscopy is used in order to identify the type of tumor noted.
Doctors do exploratory surgery whenever there is the question of gallbladder cancer. It can be done using a laparoscope and a camera or in an open procedure. Biopsies of the gallbladder or complete removal of a suspicious gallbladder can be done with a laparoscope as well. Dye can be injected into the bile ducts to see how far they are patent and where they are blocked by stones or tumor. One test is called an endoscopic retrograde cholangiopancreatography. Another is called a percutaneous transhepatic cholangiography. Still another is called a magnetic resonance cholangiography.
There are four stages to gallbladder cancer. In stage I cancer, the cancer is localized just in the inner lining of the gallbladder. It carries a good prognosis. Stage II disease involves cancer that has invaded the outer wall of the gallbladder and it may also involve protrusion into nearby organs. Stage III gallbladder cancer can involve invasion into more than one nearby organ or into the hepatic artery or vein. Stage IV cancer involves gallbladder cancer invading distant areas of the body.
The treatment of gallbladder cancer depends on the stage of the cancer and how involved it is. Ideally the gallbladder and cancer should be removed as soon as possible but, in some cases, this may not be possible. In early stage cancer, removal of the gallbladder may be all that is needed. If the cancer has spread to the outer wall of the gallbladder or to nearby organs, radiation therapy may need to be done to shrink the tumor before removal of remaining tumor is accomplished. Sometimes a portion of the liver needs to be removed along with the gallbladder.
In late stage gallbladder cancer, the doctors resort to chemotherapy drugs and to radiation therapy to the primary tumor or to the metastatic tumors that are large enough to be treated with radiation. Blockages of the bile ducts can be done surgically using advanced surgical techniques. A stent or hollow tube can be inserted into the bile ducts to keep them open so they can perform the function of enhancing digestion while you are being treated for gallbladder cancer.