Gall Bladder Cancer

Gall Bladder Cancer

India has one the highest incidences of Gallbladder Cancer (GBC) in the world, with approximately 18,727 new cases in India per year. In north and north-eastern parts of India, incidence is double in women than men.

Signs and symptoms:

Gallbladder cancer doesn't usually cause signs or symptoms until later in the course of the disease, when the tumour is large and/or has spread. But sometimes symptoms can appear sooner and lead to an early diagnosis. If the cancer is found at an earlier stage, treatment might work better.

Some of the more common symptoms of gallbladder cancer include:

Abdominal (belly) pain: Most often it's in the upper right part of the belly.

Nausea and/or vomiting: Some people with gallbladder cancer sometimes have vomiting as a symptom.

Jaundice: If the cancer gets big enough to block the bile ducts, bile from the liver can’t drain into the intestines. This can cause a greenish-yellow chemical (called bilirubin) in the bile to build up in the blood and settle in different parts of the body. The yellow coloring of jaundice can often be seen in the skin and the white part of the eyes.

Lumps in the belly: If the cancer blocks the bile ducts, the gallbladder can swell. Gallbladder cancer can also spread to nearby parts of the liver. These changes can sometimes be felt by the doctor as lumps on the right side of the belly. They can also be seen on imaging tests such as an ultrasound.

Our Features Services
  • Loss of appetite
  • Weight loss
  • Swelling in the abdomen (belly)
  • Fever
  • Itchy skin
  • Dark urine
  • Light-coloured or greasy stools
Predisposing Factors:
  • Gallstones
  • Porcelain gallbladder
  • Obesity
  • Older age
  • Ethnicity and geography
  • Choledochal cysts
  • Abnormalities of the bile ducts
  • Gallbladder polyps
  • Primary Sclerosing Cholangitis
  • Typhoid
  • Family history
  • Smoking
  • Exposure to chemicals used in the rubber and textile industries
  • Exposure to nitrosamines
Diagnosis of Gall Bladder Cancer:
  • Medical history and physical examination
  • Liver function test
  • Tumour marker: CEA and CA19.9
  • Tri-phasic CT Abdomen
  • Magnetic resonance cholangiopancreatography (MRCP)
  • Staging Laparoscopy
  • FNAC/Biopsy (if patient not candidate for upfront surgery)
Treatment of Gall Bladder cancer: From treatment point of view GBC can be divided into three types–

Localized disease: Cancer is restricted to gall bladder only. In this case surgery is done to remove gall bladder with liver wedge along with dissection of regional lymph nodes. Chemotherapy may be required after surgery depending upon pathological stage of tumour.

Locally advanced disease: In this case tumour has spread beyond gall bladder to either liver or regional lymph node. In this case staging laparoscopy is done to see that tumour has not spread to distant sites in abdomen. Chemotherapy is given to down size the tumour after that surgery is done.

Advanced/Metastatic Disease: In this case tumour has spread to distant organs and lymph nodes. FNAC/ Biopsy is done to get pathological diagnosis. Treatment is usually chemotherapy. Sometimes stenting of bile duct is required if patient has developed jaundice due to bile duct involvement.

What after treatment of Gall Bladder Cancer?

After completing treatment for Gall Bladder cancer, you have to come for regular follow up at interval of 3 months for initial 3 years and then 6 monthly up to five years. Despite adequate treatment of Gall Bladder cancer chances of recurrence exist. Purpose of follow up is to pick up recurrence at early stage so that adequate salvage treatment can be implemented timely.