Gallbladder Cancer

Gallbladder cancer is a rare disease. The American Cancer Society estimates that in the United States, 6,570 women and 5,750 men will be diagnosed with cancer of the gallbladder or nearby large bile ducts in 2023. It occurs more frequently in women than in men, and the incidence is higher for Latinos, Mexican Americans and Native Americans. It is most often found in people over the age of 65; the average age at diagnosis is 72.

A Closer Look
The gallbladder is a small, pear-shaped organ under the liver, located behind the right lower ribs. By adulthood, it is usually about three to four inches long and no wider than one inch. Its basic function is to store bile, a fluid produced by the liver that helps break down fatty foods as they pass through the small intestine.

Interestingly, while the gallbladder helps to digest food, we don’t need the organ to live. Many people have their gallbladders removed due to chronic inflammation and go on to live normal lives.

Nearly all gallbladder cancers are adenocarcinomas that start when cells in the inner layer of the gallbladder grow out of control and spread through the outer layer. It is not usually found until it has become advanced and spread outside of the gallbladder and causes symptoms. In fact, only about one of five cases are found in the early stages.

Chronic Inflammation: A Common Risk Factor
Many of the risk factors that make a person more likely to develop gallbladder cancer are related to chronic inflammation in the gallbladder.

The majority of people with gallbladder cancer have gallstones at the time of diagnoses. People with porcelain gallbladder, a condition in which the wall of the gallbladder becomes covered with calcium deposits after long-term inflammation often caused by gallstones, have a higher risk of developing gallbladder cancer.

Even though gallstones are very common, most people with gallstones never develop gallbladder cancer.

Detecting & Diagnosing Gallbladder Cancer
Because there are no signs or symptoms in the early stages, gallbladder cancer is difficult to find and diagnose before it becomes advanced. Its location deep inside the body does not allow for early tumors to be seen or felt during routine physical exams, and there are no blood tests or other screenings that reliably detect early gallbladder cancers.

Symptoms of gallbladder cancer often become known when bile ducts become blocked, and the most common symptoms include:
• Pain in the stomach, often in the upper right part of the belly.
• Jaundice (yellowing of the skin and whites of the eyes).
• Nausea and/or vomiting.
• Lumps in the abdomen.
• Fever.

Other less common symptoms can include:
• Weight loss and/or loss of appetite.
• Abdominal swelling .
• Dark urine.
• Light-colored or greasy stools.
• Itchy skin.

It’s important to remember that gallbladder cancer is rare, and many of these symptoms can occur with other more common illnesses. Regardless, it is important to contact your health care provider if you experience any of these problems.

If your doctor suspects gallbladder cancer is present, a complete health history and medical exam will be among the first steps. Blood tests may be ordered to measure liver function and/or the presence of certain substances that can signal disease. A variety of imaging tests, such as CT scan, ultrasound or magnetic resonance imaging (MRI), may also be helpful to confirm a diagnosis.

Treatment
When gallbladder cancer is confirmed and the stage is determined, it is placed into one of two treatment groups.

If cancer is localized, meaning it is found in the wall of the gallbladder, it may be treated with a cholecystectomy, a surgical procedure to remove the organ and some of the tissue around it. If the cancer has spread and cannot be removed, other surgical procedures may be used to drain bile and help relieve symptoms. Radiation therapy and chemotherapy can also be used to destroy cancer cells.

Treatment decisions are also dependent on the age, general health and personal preferences of each patient.

New Treatment Options Through Clinical Trials
Researchers are constantly seeking new ways to treat and prevent cancer, and an important part of that research is informed by clinical trials. These studies, supervised by clinicians who are cancer experts, can offer patients access to safe and effective new treatments that may be better than the existing standard treatments and not available elsewhere. Doctors can guide patients to identify whether a clinical trial exists and may be recommended.

An Ounce of Prevention
Many of the known risk factors for gallbladder cancer are things we cannot control, such as gender, age, ethnicity and bile duct conditions. However, lifestyle habits and choices can help minimize the risk for all forms of cancer:

• Stay physically active and maintain a healthy weight.

• Follow a healthy diet that includes plenty of vegetables, fruits and whole grains, and limits highly processed foods, sugar and red meat.

• If you drink alcohol, limit consumption.

• If you don’t smoke, don’t start, and if you do smoke, do your best to quit.

Staying in tune with your body and regular checkups with your health care provider increase your chances of staying healthy and identifying cancer and other illnesses early, when treatment options are at their best.

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