Gallbladder Cancer

The most common types of gallbladder cancer are adenocarcinomas. There are other forms of gallbladder cancer such as squamous cell cancer or adenosquamous cancer, but these types are very rare.
 

Adenocarcinoma

Most gallbladder cancers are adenocarcinomas which are cancerous tumors that form in the gland cells inside the gallbladder. Adenocarcinomas make up 90% of gallbladder cancer cases.
 

Papillary Adenocarcinoma

A subtype of gallbladder cancer is papillary adenocarcinoma, which forms in the connective tissues of the gallbladder. This type of gallbladder cancer often has a more positive prognosis since papillary cancers are less likely to spread to other organs making them easier to treat.

What causes gallbladder cancer is unknown, however, there are many factors that can cause chronic inflammation which is linked to a greater risk of gallbladder cancer.
 

Risk Factors

There are several conditions that increase the risk of gallbladder cancer. Risk factors include:
 

• Gallstones - hardened bile can form in your gallbladder as gallstones and often requires surgery to treat
• Porcelain gallbladder - this is an uncommon condition, usually caused by recurrent gallstones, where the gallbladder wall becomes delicate and brittle
• Reflux - defects in the ducts connecting the pancreas to the digestive system can lead to reflux or the backwash of pancreatic fluids into the gallbladder’s bile ducts
• Primary sclerosing cholangitis - this condition leads to inflammation and scarring of the gallbladder’s bile ducts
• Choledochal cysts - these are cysts that form in the bile ducts and can become cancerous
• Gallbladder polyps - polyps are growths along the wall of the gallbladder which aren’t always cancerous, though larger polyps are more likely to be cancerous
• Gender - gallbladder cancer is more frequent in women than in men
• Weight - obesity can increase the risk of many types of cancer, including gallbladder cancer
• Age - the majority of people who develop gallbladder cancer are over age 65
• Family history - genetic history of gallbladder cancer can increase your risk, though as this type of cancer is so rare, it's generally not related to family history

Generally, gallbladder cancer symptoms are difficult to pinpoint until the disease has advanced however signs may appear sooner, in some cases. When gallbladder cancer is caught early, it’s highly treatable. Talk to your Mercy doctor right away if you have unusual abdominal pain or any of the symptoms listed below.
 

Gallbladder cancer signs and symptoms may include:

• Jaundice, which causes yellowing of the skin and white part of the eyes along with darker urine and paler stools
• Aching pain in the abdomen, often in the upper right side where the gallbladder is located
• Loss of appetite
• Abdominal bloating
• Nausea or vomiting
• Lumps on the right side of the stomach
• Unexplained weight loss
• Sharp abdominal pain, which can mean that the bile duct is being blocked by a tumor or a gallstone

There's no known way to prevent gallbladder cancer but there are some things you can do that can help lower your risk.

• Maintain a healthy weight
• Stay active
• Eat a healthy diet (replace sugary foods with fruits and vegetables, avoid processed foods, and control meal sizes)
• Keep regular check-ups with a Mercy primary care provider

Some tests used to detect gallbladder cancer may include the following:

• Lab tests - blood work tests for abnormal levels of bilirubin and other markers.
• Imaging tests - Imaging tests such as diagnostic ultrasounds, CT scans, MRIs and PET scans may be performed for a variety of reasons such as determining how far the cancer has spread, to determine the best course of treatment or to look for cancer recurrence. 
• Cholangiography & biopsy - a cholangiography may be performed during a gallbladder biopsy to identify and locate an obstruction of the bile duct.

Mercy’s team of cancer experts is dedicated to helping you through treatment. Your team will come from a variety of disciplines to provide a well-rounded perspective on how to care for you. Your treatment plan for gallbladder cancer will depend on several factors, including the stage of your cancer, whether it has spread and overall health. Based on a thorough discussion with your doctor, you may be given one or more of the following treatments.
 

Gallbladder Surgery

Surgery is the best treatment for early-stage gallbladder cancer, though many cases aren't detected early enough for surgery. Your gallbladder helps your body digest food, but your digestive system can work without it. Your surgeon will help you understand what to expect before, during and after your operation. Depending on the type of gallbladder cancer, your doctor may recommend one of the following surgeries for cancer.
 

Cholecystectomy

A cholecystectomy is the surgical removal of the entire gallbladder.  This operation is only performed when the cancer is only in the gallbladder and hasn't spread to other areas. 
 

Extended (Radical) Cholecystectomy

An extended, or radical, cholecystectomy is the removal of the entire gallbladder in addition to the removal of liver tissue, regional lymph nodes and additional tissues. This is the most common surgical treatment for gallbladder cancer.
 

Palliative Surgery

When gallbladder cancer has spread too far to be completely removed, palliative surgery can help relieve or prevent symptoms. 
 

Surgical Approaches

Mercy gastrointestinal surgeons are skilled in using the latest surgical oncology procedures and techniques such as:

• minimally invasive laparoscopic surgery
• robotic surgery
• endoscopic surgery

Surgery may be the only part of your cancer treatment plan, however, it's common for radiation and chemotherapy to be used as well.
 

Radiation Therapy

Our radiation oncologists offer advanced radiation therapy for gallbladder cancer to precisely target cancerous tumors. Radiation therapy uses a beam of x-rays or other particles of energy to focus on a specific area of your body. The radiation can focus on your gallbladder to eliminate cancer cells in that area without affecting other areas of your body.
 

Chemotherapy

To prevent gallbladder cancer from returning, chemotherapy (also referred to as “chemo”) may be part of your treatment plan. Chemotherapy for gallbladder cancer uses drugs given by mouth or delivered directly into your veins to fight cancer cells throughout the body.
 

Chemo may be systemic, meaning the medicine travels throughout the entire body, or it can be injected into the main artery in the liver so it reaches the gallbladder more directly.