Causes Of Gallbladder Cancer: Symptoms, Diagnosis & Treatment

Gallbladder cancer is cancer that develops in gallbladder. It is an aggressive disease often having poor prognosis. Gall bladder cancer is not a common cancer despite being a common malignancy among other biliary tract cancers. Gallbladder is a small pear shaped sac beneath the liver. Its function is to store bile, a digestive juice secreted by liver for digestion of food in the intestine.

Often gallbladder cancer is missed until the disease has reached its advanced stage. This is because it does not produce any significant symptoms in the early stage or if at all they are vague.

Later on symptoms occur as pain in right side of upper abdomen, mild fever, abdominal bloating, jaundice, nausea and loss of appetite etc.

Gallbladder cancer occurs more commonly in obese females. Chronic inflammation of gallbladder due to gallstones and frequent salmonella infection are two important risk factors of gallbladder carcinoma. Gallbladder cancer is extremely lethal disease.

Treatment consists of surgical resection in patients who have been detected of gallbladder cancer in its very early stage. The other form of treatment includes radiation and chemotherapy. Palliative therapy is considered in patients who are symptomatically in advanced stage of cancer.

Causes And Risk Factors Of Gallbladder Cancer

The exact cause of gallbladder cancer is not clear. However, as with any other cancer, there occurs some type of change in the healthy cells of the gallbladder. This change is abnormal and it damages the DNA of the cell. It causes uncontrolled growth of the abnormal cells. The abnormal cells having damaged DNA start to grow and usually develop a tumor.

The abnormal cancer cells have ability to spread to other parts of the body. There are several type of gallbladder cancer because gallbladder is made up of many types of cells. However, almost 80 to 90 percent of gallbladder cancers are adenocarcinoma. It originates from the inner lining consisting of gland cells. Gland cells normally produce mucus in the gallbladder.

Other less common are small cell gallbladder cancer, adenosquamus cell gallbladder cancer etc. All the types are distinguished from their histopathological appearance under the microscope once the cancerous gallbladder is removed.

Although the exact cause is not known, there are several risk factors that have been known to trigger development of gallbladder cancer.

  • Chronic inflammation of gallbladder is indentified as the possible cause in majority of patients. The inflammation can be due to anything such as gallstones or infection in the gallbladder. Usually salmonella is the pathogen involved in such gallbladder infection.
  • Gallbladder carcinoma is commonly seen in women as compared to men.
  • The risk increases with growing age.
  • Patient having history of gallstones.
  • Obese people
  • Gallbladder polyps
  • People who smoke or chew tobacco, people working in heavy metal industry or frequently exposed to heavy metals like cadmium, chromium, nickel and copper are at increased risk of developing gallbladder cancer.
  • People of South American origin and Asian have increased risk.
  • Genetic predisposition.

Signs And Symptoms Of Gallbladder Cancer

Gallbladder cancer in many cases does not produce any significant signs and symptoms till it has reached an advanced stage. However, in some patients the symptoms may appear in the early stage. Following are the common symptoms of gallbladder cancer:

  • Abdomen pain mainly in the right upper quadrant.
  • Nausea and vomiting.
  • Jaundice: It is yellow discoloration of white of an eye and skin.
  • A lump can be palpated on the right upper side of abdomen if the tumor has increased in size. The lump can also be detected on sonogram of abdomen.
  • Loss of appetite
  • Weight loss
  • Fever
  • Dark yellow or brown colored urine.
  • Itching all over the skin.
  • White colored greasy stool.

Most of the above symptoms can also occur in other liver diseases such as viral hepatitis and obstruction of gallstones. Hence patient having these symptoms must consult his physician to find the exact cause.

Diagnosis And Treatment Of Gallbladder Cancer

In majority of cases when the doctor suspects gallbladder disease he recommends ultrasonography and several blood tests. Further other imaging studies are also conducted for evaluation. This includes CT scan of liver and gallbladder, MRI and MRA (magnetic resonance angiography), etc. Once the diagnosis of gallbladder is confirmed, the doctor will proceed for other tests and exploratory surgery which helps in determining the stage of disease so that treatment can be planned accordingly.

Following are the stage of gallbladder cancer:

  • Stage I: In this early stage the cancer is restricted in the inner lining of the gallballder.
  • Stage II: In this stage the cancer cells have spread to the outer layer of gallbladder.
  • Stage III: In this stage the cancer has invaded gallbladder completely and has spread to nearby structures such as the liver, stomach and small intestine. The cells have also invaded the lymph nodes of this region.
  • Stage IV: There is formation of large tumor in the gallbladder. Cancer has spread to nearby structures and other distant organs.

The treatment of gallbladder cancer depends on the stage of cancer, patient’s general health etc. The treatment goal is to remove the gallbladder surgically if the cancer is detected in its early stage. But often the condition is detected late when the cancer has already spread to nearby sites.

When removal of cancer is not possible other mode of treatment such as chemotherapy and radiation are thought of. These treatment measures will help to kill the cancer cells in the gallbladder as well the cancer cells in areas where it has spread.