Conditions:

Gallbladder Cancer

Gallbladder cancer is the 5th most common cancer in the gastrointestinal tract and is very aggressive in nature. Most tumours are incurable at the time of diagnosis.

What causes gallbladder cancer?

Several risk factors have been identified in the development of gallbladder cancer

1. Gallstones - symptomatic gallstones present for extended periods of time increase the likelihood of cancerous change within the gallbladder by seven fold.
2. Age - increased age increases risk.
3. Sex - two to three times more common in women.

What symptoms does gallbladder cancer cause?

Gallbladder cancer unfortunately is often difficult to diagnose until it is quite advanced. It initially mostly causes symptoms identical to gallstones, that is right upper abdominal pain, nausea and vomiting. It later can cause weight loss, fatigue and jaundice.

How is gallbladder cancer diagnosed?

Most cases of gallbladder cancers are diagnosed following pathological examination following routine cholecystectomy for gallstones. Otherwise, ultrasound and CT scanning is most useful for diagnosis.

How is gallbladder cancer treated?

Like most other cancers of the gastrointestinal tract, the first step in determining treatment options for gallbladder cancer is determining how advanced the cancer is. This is known as staging of the cancer. All of Dr Fenton Lee's patients undergo the following staging procedures.

1. Blood tests - these can give clues to cancer spread to the liver.
2. Chest x-ray - looking for obvious spread to the lung.
3. CT san of the abdomen - this is performed to ascertain spread to the liver.
4. Staging laparoscopy - This is the best test to look for small cancer nodules and lymph node involvement within the abdominal cavity that CT scan can miss. Laparoscopy is a minor procedure that is done when all other staging procedures are clear. It is done to prevent major surgery being performed in patients whose cancer is not curable.

Once these procedures have been performed and cleared, surgery can be considered. Surgery offers the only chance of cure for gallbladder cancer.

Click here to learn more about surgery for gallbladder cancer.

Can gallbladder cancer be cured?

The prognosis of gallbladder cancer is determined by staging that takes three factors into consideration. These factors are

1. Degree of tumour invasion (T staging)
2. Lymph node involvement (N staging)
3. Presence of distant metastases (M staging)

These factors are subcategorised into groups as follows

T staging
T1 - cancer within inner lining of gallbladder only
T2 - tumour involving muscle of gallbladder only
T3 - tumour past gallbladder wall, but less than 2cm into liver
T4 - tumour invading >2cm into liver and/or into two adjacent organs

N staging
N0 - No regional lymph node involvement
N1 - involvement of gallbladder lymph node
N2 - involvement of duodenal, pancreatic or gastric lymph nodes

M staging
M0 - No distant metastases
M1 - Distant metastases

The stage grouping and the 5 year survival for these groupings are as follows

Most patients have advanced, unresectable cancers at the time of diagnosis and the overall 5 year survival is less than 15%.

Are there any other forms of treatment?

Although surgery provides the only chance of cure, other treatments are available as adjuvant or palliative treatment. Palliation is treatment that involves prolonging the length of disease free time, as well as improving the quality of life for patients whose cancers cannot be cured.

Other forms of treatment available include

1. Radiotherapy - can often work very well in slowing down the tumour growth.
2. Stents - a palliative procedure to unblock the bile duct when occluded by cancer that is inoperable.
3. Chemotherapy - unfortunately, chemotherapy seems to have little effect on gallbladder cancers.

Top