The gallbladder is a small organ in the gastro-intestinal system. It is located just under the liver. Its location is on the right side of the body, just under the right lower ribs. In even fully-grown adults, the gallbladder’s size is only about 3 to 4 inches.
The gall bladder’s function is simple. It collects, gathers and stores bile, a digestive fluid synthesized in the liver. This liquid, bile digests the fats present in foods, as they make their passage in the small intestine. Bile could be released directly from the liver into the small intestine, or it could be stored in the gallbladder for later release.
What is important to know, is that the gallbladder is a supportive digestive organ, but not a mandatory one, which means that it is not necessary for living. Countless people have had their gallbladders removed and have gone on to live absolutely normal lives.
What is cancer of the gall bladder ?
Gall Bladder Cancer is a cancer of the Gall Bladder.
What are the causes of gall bladder cancers ?
- Cholecystitis (or chronic irritation of the gall bladder) is said to play a role in Gall Bladder Carcinogenesis (formation of cancers).
- Cholelithiasis (or gall bladder stone) is frequently associated with carcinoma gallbladder. The risk of carcinoma gall bladder in patients with gall stones may be increased even upto 4 to 7 times and patients with larger gallstones have a much higher risk of developing gall bladder cancer.
- Porcelain gallbladder: There is a higher risk of developing carcinoma gallbladder in patients with calcified or porcelain gall bladder.
- Gallbladder polyp: Recent studies suggest that polyps greater than 10 mm in diameter have a strong malignant potential.
- A congenital malformation of the Gall Bladder: An anomalous Pancreaticobiliary Duct Junction in which the pancreatic duct joins the biliary tract exterior to the duodenal wall.
- Chemical compounds (the nitrosamines) may elevate the gallbladder cancer risk.
What are the types of gall bladder tumours ?
- Adenocarcinomas– Malignant Cancers that initiate in the glandular cells that form the lining of the digestive tract. These are more common in the gall bladder.
- Squamous Cell Carcinomas– These are less common. They are malignant cancers that initiate in the squamous epithelial lining of the gall bladder.
- Even adenosquamous carcinomas, small cell carcinomas or sarcomas can occur in the gall bladder.
What are the clinical features of gall bladder cancers ?
The early tumours of the gall bladder have no specific clinical symptoms and diagnosis before the surgery is difficult. Most of the patients are found to be asymptomatic while a few show benign type of clinical like right upper abdominal pain with occasional attacks of nausea and vomiting.
The diagnosis is commonly made at an advanced stage. Patients with advanced cancers may present with loss of apetite, loss of weight, jaundice, a palpable hard lump in the right side below the ribs and swelling in the abdomen.
How are gall bladder tumours diagnosed ?
- A complete physical examination of the body is mandatory.
- Biochemical tests – A raised bilirubin is a sign of advanced disease.
- Tumor markers – CEA and CA 19-9 indicate presence of cancer in the body.
- Imaging tools- Ultrasound (USG), Computed Tomographic (CT) scan, Magnetic Resonance Imaging (MRI) with Magnetic Resonance Cholangiopancreatography (MRCP) and Magnetic Resonance Angiography (MRA). These are used as required to detect structural changes that include gall bladder polyps, thickening and replacement of the gallbladder lumen by a mass and staging of the cancer.
- Staging laparoscopy should be done in patients to rule out distant metastases.
How are gall bladder tumours treated ?
Surgical resection of the primary tumor is the only potentially curative therapy. However not all patients are surgically resectable at presentation. Simple cholecystectomy (only removal of the gall bladder) or radical cholecystectomy (a more extensive surgery with removal of gall bladder, surrounding soft tissue & lymph nodes) is recommended, based on spread and staging of cancer. Adjuvant Chemotherapy or Adjuvant Radiotherapy can be given, either alone or together following surgery with curative intent.
What is the care to be taken after the removal of a gall bladder tumour ?
Metastatic diagnostic workup and monitoring post-treatment has to include imaging and scanning of the limbs, thorax, chest, retroperitoneum, and abdomen with radiography, MRI or CT scans. Adjuvant chemotherapy or radiotherapy may be required in cases wherein excision cannot be done completely.
How to find and reach cancer specialists for gall bladder cancer treatment ?
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Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
