The Gallbladder is a small pear-shaped organ that lies beneath the liver, in the upper abdomen. It helps to store bile, which is produced by the liver, this fluid helps to digest fat. The gallbladder releases bile into the small intestine through the bile duct. The bile duct is a thin tube that connects the liver and the gall bladder to the small intestine. Cancer develops when abnormal cells in these structures proliferate and grow rapidly.

Gall bladder and bile ducts cancers are rare, in 2019, it was estimated In the USA that 12360 adults (5810 men, 6550 women) will be diagnosed with gall bladder and other biliary cancers, 4 out of 10 are specifically gallbladder cancer. More common in women than men.

Most gall bladder and bile duct cancers are adenocarcinomas (cancer of cells that lines the glands and ducts). Bile duct adenocarcinoma forms from mucous glands that lines the duct and it can develop in any part of the duct.

Causes /risk factors

The main cause of gall bladder or bile ducts cancer is unknown but there are some risks factors to watch out for:

  • History of gallstone
  • Liver fluke parasites
  • Scler osing cholangitis (inflammation of the bile duct)
  • Ulcerative colitis and cirrhosis

Initial Signs and symptoms

  • Jaundice
  • Black or tarry stool
  • Lack of appetite
  • Nausea
  • Itching
  • Abdominal pain
  • Unexplained weight loss

Treatments for gall bladder and bile duct cancer

Treatment usually depends on the type, and extent of the cancer, the overall health, Chances of curing the disease, relieving symptoms and improving the patients’ quality of life.

  • Surgery is the main treatment for gallbladder and bile duct cancers, surgery helps to relieve pain and prevent complications. However, it could be a very difficult procedure for both the surgeon and patient, and it should only be done when there is clear evidence that the procedure will significantly extend and improve the patient’s quality of life.
  • Chemotherapy: Maybe given after surgery with radiation therapy to lower the risk of the cancer coming back, this is known as adjuvant treatment, however doctors are not certain about the usefulness of this treatment in curing gallbladder and bile duct cancer.

Chemotherapy can also be given with or without chemotherapy for advanced stage of the cancer that cannot be operated or has spread to other parts of the body, the aim of this treatment is not curative but to prolong the patients’ life., additionally , chemotherapy  can help shrink tumors or slow their growth rate , which helps to relieve symptoms and helps improves the patient’s quality of life this is known as palliative therapy.

Prognosis

The prognosis of gallbladder and bile duct cancers depends on the overall health of the patient (patients with or without co-morbidities), the stage of the cancer and the treatment choice.

The survival rate of 5years and beyond is only about 19% in people with gallbladder and bile duct cancers. The survival rate depends on the location of the cancer and the extent of spread to other parts of the body, there is an 80% survival rate for patients whose cancer is at stage 0 (where the cancer has not spread) and a 4% survival rate for cancers that have to other parts of the body. However, because this cancer usually grows without significant symptom, most patients present at the advanced stages.

Prevention

There are no ways to prevent gall bladder or bile duct cancer. However, the risks could be lowered by:

  • Maintaining a healthy weight and avoiding tobacco use.
  • Preventing and treating liver fluke infection.
  • Prevent and treat hepatitis.
  • Routine checks if you have ulcerative colitis.

References

Statistics adapted from the American Cancer Society’s (ACS) publication, Cancer Facts & Figures 2017: Special Section – Rare Cancers in Adults, and the ACS website (January 2019).

National Cancer Institute. Physician Data Query (PDQ). Gallbladder cancer treatment. 2014