Gallbladder tumor

A malignant gallbladder tumor, gallbladder cancer, can develop in any segment of this organ. The gallbladder is a small hollow organ in the upper abdomen, located near the liver, that helps us digest food. Prolonged gallstone disease is a risk factor for gallbladder cancer. This disease is characterized by a high potential for malignant degeneration. The prognosis depends on the location of the tumor, its size and its spread.

Gallbladder cancer before the development of its complications may not have obvious symptoms, and if symptoms do appear, they are nonspecific.

The patient may have dyspeptic symptoms such as:

• abdominal discomfort;
• dull pain in the right side of the abdomen;
• abdominal pain may increase periodically;
• abdominal bloating unrelated to food intake.

Similar symptoms can be observed in other diseases that can be combined with irritable bowel syndrome. That is why it is important to see a doctor in time to detect gallbladder cancer.

Progression and spread of the disease can be accompanied by the following symptoms:

• development of jaundice (first on the sclera of the eye), then itching of the skin, darkening of the urine and changes in the color of the stool;
• loss of appetite and seemingly unexplained weight loss;
• fever, sometimes chills;
• lump in the tummy.

Who is more likely to get gallbladder cancer

Anyone can get gallbladder cancer. It's not always clear what causes it. You might be more likely to get it if you:

• Are over the age of 75 (it's most common in people over 85);
• Have certain medical conditions, such as gallstones, polyps in your gallbladder, porcelain gallbladder, chronic inflammation of the gallbladder or bile ducts;
• Genetic factor (gallbladder cancer in close relative);
• have Latin American or Asian heritage.

Tests and next steps

To detect gallbladder cancer, laboratory and radiological, sometimes - endoscopic studies should be performed on the doctor’s recommendation. These tests include blood tests and scans including an ultrasound scan CT scan, MRI scan, an X-ray study of bile  ducts called a cholangiography

Sometimes there is a need to collect cell or tissue samples from the gallbladder (called a biopsy) to be checked for cancer. Also, a small operation to look inside your tummy, called a laparoscopy may be required as well as a test called an ERCP – Endoscopic Retrograde Cholangio Pancreatography.

These tests can also help find problems in other nearby organs, such as your bile ducts, pancreas or liver.

Treatment for gallbladder cancer

Treatment of gallbladder cancer is complex, and the outcome of treatment depends on many factors:

• the size of the gallbladder tumor and its degree of malignancy;
• the localization of the tumor;
• the degree of spread of the tumor process;
• the general health of the patient;

Treatment may include surgery, chemotherapy, and radiotherapy.

During treatment, patients will undergo regular check-ups before and after any therapy with laboratory and instrumental tests. Patients should contact their primary care physician if they experience any symptoms or side effects.

Surgical treatment depends on whether the cancer can be removed or not. If gallbladder cancer is detected early and has not spread, surgery to completely remove the tumor may be performed. This usually involves removing all of the gallbladder as well as lymph nodes around it. Lymph nodes are part of the body's immune system.

Surgery to help control symptoms of gallbladder cancer

If the cancer has spread too far and cannot be removed, surgery may be performed to control some symptoms of gallbladder cancer. This may include surgery to:

• insert a catheter (tube) into the bile duct to evacuate bile outside the body;
• bypass the bile duct “from below”  by installing a plastic or metal stent in the blocked duct with an approach from the duodenum;
• bypass the bile duct “from above” by installing a metal stent into the blocked duct through the skin and liver.

The aim of these operations is to help improve the patient’s symptoms, not to cure the cancer.

Chemotherapy

Chemotherapy uses medicines to kill cancer cells. Chemotherapy for gallbladder cancer may be provided for the following purposes:

• before surgery to prepare for surgery, to help make the cancer smaller;
• after surgery to reduce the likelihood of recurrence;
• If surgery is not possible because of a severe general condition of a patient or because the cancer has spread, chemotherapy can help make cancer smaller and control symptoms.

Radiotherapy

Radiotherapy uses ionizing radiation to kill cancer cells. Radiotherapy is not often used for gallbladder cancer, although its use is sometimes justified to control cancer symptoms.