Gallbladder cancera disease where abnormal cells split without control and spread to other nearby body tissue and/or organs is a type of tumoura tissue mass that forms from groups of unhealthy cells that develops in the gallbladder, which is a small, pear-shaped organ located under the liver. The function of the gallbladder is to store bile, a liquid produced by the liver that aids in digestion and is transported through bile ducts to the small intestinea section of the gastrointestinal tract that recieves food from the stomach and absorbs the nutrients from food, also called small bowel.
There are four classifications of gallbladder cancer, which are categorised by the type of cellsthe basic structural and functional unit of all living things the tumour develops from. The most common type is adenocarcinomacancer arising from mucus-producing glands in organs, whiler rarer forms of gallbladder cancer include squamous cell carcinomacancer arising from tissues that line organs, sarcomacancer arising from bones and/or soft tissue, and lymphomacancers of the lymphatic system.
Gallbladder cancer is most commonly diagnosed in people of 65 years old and is more prevalent in women; however, anyone at any age can develop this type of cancer.
Treatment
If gallbladder cancer is detected, it will be staged and graded based on size, metastasiswhen the cancer has spread to other parts of the body, also known as mets, and how the cancer cells look under the microscope. Stagingthe process of determining how big the cancer is, where it started and if it has spread to other areas and grading helps your doctors determine the best treatment for you.
Cancers can be staged using the TNM staging system:
- T (tumour) indicates the size and depth of the tumour.
- N (nodea small lump or mass of tissue in your body) indicates whether the cancer has spread to nearby lymph nodessmall bean-shaped structures that filters harmful substances from lymph fluid.
- M (metastasis) indicates whether the cancer has spread to other parts of the body.
This system can also be used in combination with a numerical value, from stage 0-IV:
- Stage 0: this stage describes cancer cells in the place of origin (or ‘in situ’) that have not spread to nearby tissuea group of cells that work together to perform a function.
- Stage I: cancer cells have begun to spread to nearby tissues. It is not deeply embedded into nearby tissue and has not spread to lymph nodes. This stage is also known as early-stage cancer.
- Stage II: cancer cells have grown deeper into nearby tissue. Lymph nodes may or may not be affected. This is also known as localisedaffecting only one area of body cancer.
- Stage III: the cancer has become larger and has grown deeper into nearby tissue. Lymph nodes are generally affected at this stage. This is also known as localised cancer.
- Stage IV: the cancer has spread to other tissues and organs in the body. This is also known as advancedat a late stage, far along or metastatic cancer.
Cancers can also be graded based on the rate of growth and how likely they are to spread:
- Gradea description of how abnormal cancer cells and tissue look under a microscope when compared to healthy cells I: cancer cells present as slightly abnormal and are usually slow growing. This is also known as a low-grade tumour.
- Grade II: cancer cells present as abnormal and grow faster than grade-I tumours. This is also known as an intermediate-grade tumour.
- Grade III: cancer cells present as very abnormal and grow quickly. This is also known as a high-grade tumour.
Once your tumour has been staged and graded, your doctor may recommend genetic testinga procedure that analyses DNA to identify changes in genes, chromosomes and proteins, which can be used to analyse tumour DNA to help determine which treatment has the greatest chance of success, which analyses your tumour DNA and can help determine which treatment has the greatest chance of success. They will then discuss the most appropriate treatment option for you.
Treatment is dependent on several factors, including age, stage of disease and overall health. The types of treatments generally don’t vary between adults and children.
Treatment options for gallbladder cancer may include:
- Surgerytreatment involving removal of cancerous tissue and/or tumours and a margin of healthy tissue around it to reduce recurrence, potentially including:
- Tumour resectionsurgical removal of tissue or part/all of an organ.
- Cholecystectomyremoval of the gallbladder.
- Pancreaticoduodenectomyremoval of part of the pancreas (generally the head), the first part of the small intestine (duodenum), part of the stomach, the gallbladder, and part of the common bile duct; also known as a Whipple procedure, also known as a Whipple procedureremoval of part of the pancreas (generally the head), the first part of the small intestine (duodenum), part of the stomach, the gallbladder, and part of the common bile duct; also known as a pancreaticoduodenectomy.
- Radiation therapya treatment that uses controlled doses of radiation to damage or kill cancer cells.
- Chemotherapya cancer treatment that uses drugs to kill or slow the growth of cancer cells, while minimising damage to healthy cells.
- Immunotherapya treatment that uses a person's immune system to fight cancer.
- Targeted therapymedication that targets specific molecular features of cancer cells.
- Clinical trialsresearch studies performed to test new treatments, tests or procedures and evaluate their effectiveness on various diseases.
- Palliative carea variety of practices and exercises used to provide pain relief and improve quality of life without curing the disease.
Risk factors
Some of the riskthe possibility that something bad will happen factors for gallbladder cancer include:
- Previous gallbladder conditions, such as gallstones, gallbladder polyps, choledochal cystsabnormal growths that are usually filled with liquid or air, calcified gallbladder, or inflammation.
- Family history of gallbladder cancer.
- Being overweight or obese.
- Older age.
- Being female.
Not everyone with these risk factors will develop the disease, and some people who have the disease may have none of these risk factors. See your general practitioner (GP) if you are concerned.
Symptoms
Common symptoms of gallbladder cancer include:
- Abdominal pain (usually on the upper right side).
- Jaundiceyellowing of the skin and the whites of the eyes.
- Fever.
- Unexplained weight loss.
- Nauseato feel sick or likely to vomit and/or vomiting.
- Abdominal bloating.
- Unusual abdominal lumps.
- Fatiguea state of extreme tiredness or exhaustion, can be physical or mental.
- Darker urine.
- Clay-coloured stools.
Not everyone with the symptoms above will have cancer, but see your GP if you are concerned.
Diagnosis
If your doctor suspects you have gallbladder cancer, they may order the following tests to confirm the diagnosisthe process of identifying a disease based on signs and symptoms, patient history and medical test results and refer you to a specialist for treatment:
- Physical examinationan examination of your current symptoms, affected area(s) and overall medical history.
- Imagingtests that create detailed images of areas inside the body tests, potentially including:
- Ultrasounda type of medical imaging that uses soundwaves to create detailed images of the body .
- MRI (magnetic resonance imaging)a type of medical imaging that uses radiowaves, a strong magnet and computer technology to create detailed images of the body.
- CT (computed tomography) scana type of medical imaging that uses x-rays and computer technology to create detailed images of the body.
- Cholangiographya type of x-ray used to examine the bile ducts.
- Blood teststesting done to measure the levels of certain substances in the blood.
- Diagnostic laparoscopya minimally invasive surgical procedure that uses small incisions to access the body for procedures, often used for conditions that cannot be confirmed by scans and tests alone.
- Biopsyremoval of a section of tissue to analyse for cancer cells.
