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Gallbladder Cancer: Causes, Symptoms, Diagnosis, Treatment, and Prevention

A gallbladder cancer is a rare form of cancer caused by the cells that line the insides of the gallbladder, an organ that stores bile beneath the liver. It is hard to detect gallbladder cancer early, as it usually does not cause any symptoms until it has spread to other organs. This blog post discusses its causes, symptoms, diagnosis, treatment, and prevention.

Causes of Gallbladder Cancer

The exact cause of gallbladder cancer is not known, but some factors may increase the risk of developing it. These include:

• Gallstones: These are hard deposits of cholesterol or bile that form in the gallbladder. They can block the flow of bile and cause inflammation and infection. About 75% of people with gallbladder cancer have gallstones.

• Chronic gallbladder inflammation: This can be caused by gallstones, infections, or other conditions that irritate the gallbladder. Chronic inflammation can damage the cells and make them more likely to become cancerous.

• Family history: Having a close relative with gallbladder cancer may increase the risk of developing it. This may be due to inherited genetic mutations or shared environmental factors.

• Age and gender: Gallbladder cancer is more common in older people, especially those over 65 years old. It is also more common in women than in men.

• Obesity: Being overweight or obese can increase the risk of gallstones and gallbladder inflammation, which can lead to gallbladder cancer.

• Ethnicity and geography: Gallbladder cancer is more common in some ethnic groups and regions of the world, such as Native Americans, Hispanics, and people from India, Pakistan, and Chile. This may be related to genetic, dietary, or environmental factors.

Symptoms of Gallbladder Cancer

Gallbladder cancer may not cause any symptoms in the early stages, when it is easier to treat. When symptoms do occur, they may include:

• Abdominal pain, especially in the upper right side

• Nausea and vomiting

• Abdominal lumps or swelling

• Jaundice, which is yellowing of the skin and eyes

• Weight loss

• Loss of appetite

• Dark urine

• Light-colored or greasy stools

• Fever

• Itchy skin

These symptoms can also be caused by other conditions, such as gallstones, infections, or liver problems. Therefore, it is important to see a doctor if you have any of these symptoms, especially if they persist or worsen.

Diagnosis of Gallbladder Cancer

Your doctor will ask about your medical history, symptoms, and risk factors to diagnose gallbladder cancer. The doctor will also perform a physical exam and look for signs of jaundice, lumps, or swelling in the abdomen. In order to confirm the diagnosis and determine the stage of the cancer, the doctor will order tests and procedures. These may include:

• Blood tests: These can check the liver function and the levels of certain substances, such as bilirubin, that may indicate gallbladder cancer.

• Imaging tests: Images of the gallbladder and other structures around it, such as the liver, pancreas, and bile ducts, can help detect tumors or blockages. These tests include ultrasound, CT scan, MRI, and PET scan.

• Biopsy: This is the process of taking a small sample of tissue from the gallbladder or another organ and examining it under a microscope to confirm the presence or absence of cancer. A biopsy can be done by inserting a thin needle through the skin into the gallbladder (fine needle aspiration) or by passing a flexible tube with a camera and a cutting tool through the mouth, esophagus, stomach, and duodenum into the gallbladder (endoscopic retrograde cholangiopancreatography).

• Laparoscopy: It involves making a small incision in the abdomen and inserting a thin tube with a light and a camera (laparoscope) in order to inspect the gallbladder. This procedure can also involve a biopsy or removal of part of the gallbladder. Laparoscopy can also determine the extent and spread of the cancer.

Gallbladder cancer stages range from 0 to IV, with higher stages indicating more advanced cancer, which affects the prognosis and treatment options.

Treatment of Gallbladder Cancer

The treatment of gallbladder cancer depends on the stage, type, the location, the size, and the spread of the cancer, as well as the patient's age, health, and preferences. Treatment aims to remove cancer, control symptoms, and improve quality of life. The following types of treatment are common:

• The main treatment for gallbladder cancer that has not spread to other organs is surgery. It may be necessary to remove the gallbladder (cholecystectomy), part of the liver, and the bile ducts (hepatic resection), or the entire gallbladder, part of the liver, the bile ducts, the lymph nodes, and sometimes the pancreas and the duodenum (radical resection). In the early stage of gallbladder cancer, surgery is possible, but in advanced stages, it may not be possible.

• In chemotherapy, cancer cells are killed or stopped from growing. Among the many types of chemotherapy, neoadjuvant chemotherapy shrinks the tumor before surgery (neoadjuvant chemotherapy), adjuvant chemotherapy prevents a recurrence of the cancer after surgery (adjuvant chemotherapy), and palliative chemotherapy is the main treatment for advanced gallbladder cancer that cannot be removed surgically. You can give chemotherapy by mouth, by injection, or by infusion.

• High-energy rays or particles are used in radiation therapy to destroy or damage cancer cells. It is possible to use radiation therapy to shrink the tumor before surgery (neoadjuvant radiation therapy), to prevent cancer recurrence after surgery (adjuvant radiation therapy), or to treat advanced gallbladder cancers that cannot be removed by surgery (palliative radiation therapy). In radiation therapy, radioactive materials are placed near the tumor (brachytherapy) or externally by using a machine to direct beams at the tumor (external beam radiation therapy).

• Drugs that are targeted at specific molecules or genes involved in cancer cell growth and spread are used in targeted therapy. A gallbladder cancer with a certain genetic mutation or marker can be treated with targeted therapy alone or with chemotherapy or radiation therapy. You can take targeted therapy by mouth, by injection, or by vein infusion.

• Using drugs to stimulate the immune system to fight cancer cells is known as immunotherapy. Advanced-stage gallbladder cancer with a specific genetic mutation or marker can be treated with immunotherapy alone or in combination with chemotherapy or targeted therapy. Injections or infusions of immunotherapy can be used.

In addition to nausea, vomiting, hair loss, fatigue, infection, bleeding, pain, and scarring, gallbladder cancer treatment can cause side effects. In addition to prescribing medications and suggesting lifestyle changes to help manage side effects and improve the patient's well-being, the doctor will also monitor the patient's condition and adjust the treatment as necessary.

Prevention of Gallbladder Cancer

There is no sure way to prevent gallbladder cancer, but some steps may help reduce the risk of developing it. These include:

• It is important to maintain a healthy weight: Overweight or obesity can increase a person's risk of gallstones and gallbladder inflammation, which can result in gallbladder cancer. This condition can be prevented or treated with weight loss, but it should be done gradually and under the guidance of a doctor. Rapid weight loss or fasting can also increase the risk of gallstones.

• Eating a balanced diet: Eating a diet that is low in fat and high in fiber, fruits, and vegetables can help prevent gallstones and gallbladder inflammation, as well as reduce your risk of other types of cancer. Additionally, avoiding processed meats, smoked foods, salted and pickled foods can help prevent cancer and damage the cells.

• Keeping a healthy weight, improving digestion, and lowering gallstone and gallbladder inflammation can be achieved by exercising regularly. The American Cancer Society recommends getting 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week, or a combination of both.

• As well as many other types of cancer, smoking can increase the risk of gallbladder cancer. Quitting smoking can lower the risk and improve overall health. Doctors can provide advice and support on how to quit smoking.

• It is important to limit alcohol consumption: Too much alcohol can damage the liver and increase the risk of gallstones and gallbladder inflammation, which can lead to gallbladder cancer. It is recommended that women limit their alcohol consumption to one drink a day and men to two drinks a day.

• Checking out your liver and gallbladder regularly can help detect problems like gallstones, infections, and inflammation. If you have gallbladder cancer, your doctor may recommend imaging tests, such as ultrasounds, to detect any signs. Early detection and treatment can make the difference between survival and recovery.