Gall Bladder Cancer

Cancer affecting the gall bladder is an atypical occurrence with merely around five hundred individuals being detected with this kind of cancer in the United Kingdom annually. It is rarely found in individuals below fifty years of age and is mostly observed in individuals past the age of seventy. It is prevalent in the female gender more than in males.

Causes and Probable Risk Factors

The reason behind majority of the gall bladder cancers is unclear. There are varied risk factors that could raise the likelihood of developing this form of cancer that include:

• Gall stones and Inflamed gall bladder
  Gall bladder cancer more often occurs among individuals that have a past case of gallstones, or among those who have an inflamed gall bladder or cholecystitis. But, majority of the individuals having gall stones or an inflamed gall bladder would not necessarily develop gall bladder cancer.
• Polyps
  Benign tumours or polyps of the gall bladder would raise the risk of gall bladder occurring.
• Anomalous Bile Ducts
  Those that are born with congenital anomalies in the bile ducts have a slightly greater regularity of developing gall bladder cancer.
• Presence of Porcelain Gall Bladder
  Those having a condition known as porcelain gall bladder wherein the calcium depositions occur in the wall of the gall bladder, additionally raise the risk of developing this form of cancer.
• Smoking
  There is some proof indicating that those who indulged in cigarette smoking are more prone to developing gall bladder cancer.
• Family History of this form of cancer
  Those having close relations like parents, brothers or sisters who have gall bladder cancer are 5 times more prone to developing this form of cancer, though the level of risk is still quite less.
• Being Obese
  Those with weight issues or are obese have known to be at greater risk of contracting several cancers inclusive of gall bladder cancer.

Gall Bladder Symptoms

Gall bladder cancer in its initial stages is mostly asymptomatic and is generally found unpredictably when one is undergoing an operation for removal of gallstones. Nearly one in five gall bladder cancers are detected in this manner. Majority of the gall bladder cancers are only detected while they are in their later stages. They could lead to a host of symptoms namely:

• Feeling sick and fever.
• Abrupt pain in the upper right-hand side of the abdominal region which is the cavity that contains organs like the stomach, gall bladder and liver.
• In case, the cancer obstructs the bile duct it could impede the movement of bile into the small bowel leading to reverse flow of the bile back into the blood and the tissues thus resulting in yellowing of the skin and the white parts of the eyes – a condition known as jaundice. The urine would appear a darker tone of yellow and stools would turn clay-like in appearance. The skin could turn scratchy.
• Slight discomfort could be sensed in the abdomen, depleted appetite and reduction in weight might additionally take place.

Though these symptoms could be due to the presence of other conditions like gallstones or some gall bladder infection, it is imperative to get them evaluated by a doctor.

Gall Bladder Staging

The staging of the cancer depicts the extent and if it has metastasized past its initial location. By identifying the precise type and staging of the cancer, assists doctors in deciding the most apt line of treatment.

Cancer could metastasize either in the bloodstream or via the lymphatic system. The lymphatic system comprises of a mesh of lymph nodes interlinked by infinitesimal ducts containing lymph fluid that assist the body in combating infection and disease. The staging of the cancer is analysed by generally looking at the closely placed lymph nodes for finding the staging of the cancer.

Gall bladder cancer is present in four stages namely:

• Stage 1
  Nearly one in four cancers is detected in this stage wherein the wall of the gall bladder is affected.
• Stage 2
  The cancer has metastasized all the way through the thick wall of the gall bladder, however not reached the closely placed lymph nodes or adjoining organs.
• Stage 3
  The lymph nodes placed near the gall bladder or the liver, stomach, colon or the small bowel have been affected by the cancer.
• Stage 4
  The cancer is deeply seated in 2 or more organs located near the gall bladder or have reached the remotely placed lymph nodes or organs like the liver or the lungs. This is called as metastatic or secondary cancer.

A different TNM system is at times employed wherein:

• T
  Denotes the tumour size.
• N
  Denotes if the cancer has metastasized to the lymph nodes.
• M
  Denotes if the cancer has metastasized to another region of the body like the liver – known as secondary or metastatic cancer. Despite the complexity of this system, it could offer more accurate data regarding the staging of the tumour. In case the cancer relapses subsequent to the first treatment, it is called as recurrent cancer.

Grading

Grading implies how the cancer cells appear microscopically and provides information on how rapidly the cancer could be developing. Low grade translates to the fact that cancerous cells appear alike normal cells; they generally slowly proliferate and are less prone to spreading. In the case of high-grade tumours, the cells appear anomalous and have a likelihood of growing more rapidly and spreading.

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