gallbladder cancer

What is Gallbladder Cancer?

Gallbladder cancer is a rare and serious disease that occurs when malignant cells grow in the gallbladder, a small pear-shaped organ located under the liver in the upper abdomen.

• Definition: Gallbladder cancer is a type of cancer that starts in the gallbladder. [1][2]
• Causes: The exact cause of gallbladder cancer is unknown, but it often arises in the setting of chronic inflammation. [8]
• Types: There are several types of gallbladder cancer, including:
  • Adenocarcinoma: This is the most common type of gallbladder cancer. [7][9]
  • Squamous cell cancer
  • Adenosquamous cancer
  • Small cell cancer
  • Sarcoma
  • Neuroendocrine tumor

Symptoms and Diagnosis

Gallbladder cancer can cause a range of symptoms, including:

• Abdominal pain or discomfort
• Jaundice (yellowing of the skin and eyes)
• Loss of appetite
• Weight loss
• Fever

Diagnosis is typically made through imaging tests such as ultrasound, CT scans, or MRI.

Treatment Options

Treatment for gallbladder cancer depends on the stage and type of cancer. It may include:

• Surgery to remove the gallbladder and surrounding tissues
• Chemotherapy to kill cancer cells
• Radiation therapy to target cancer cells

Prognosis

The prognosis for gallbladder cancer is generally poor, with a 5-year survival rate of around 20-30%. [6]

References: [1] Jul 31, 2024 - Gallbladder cancer is a growth of cells that begins in the gallbladder. [2] Jul 12, 2018 - Gallbladder cancer is a type of cancer that starts in the gallbladder. [3] Gallbladder cancer occurs when malignant (cancer) cells grow in your gallbladder... [4] by SKR Mukkamalla · 2023 · Cited by 11 - Gallbladder carcinoma is a rare malignancy but represents almost 50% of all biliary tract cancer. [5] Cancer that forms in tissues of the gallbladder. [6] Dec 6, 2023 - Gallbladder cancer occurs when cancerous cells develop in the wall of the gallbladder. [7] Adenocarcinoma. This is the most common type of gallbladder cancer. [8] Sep 28, 2023 - Gallbladder cancer is a rare disease that often arises in the setting of chronic inflammation. [9] Most gallbladder cancers are a type called adenocarcinoma.

Common Signs and Symptoms of Gallbladder Cancer

Gallbladder cancer can be a serious condition, and it's essential to recognize the signs and symptoms early on for effective treatment. Here are some common indicators:

• Abdominal pain or discomfort: This is often one of the first symptoms of gallbladder cancer, and it can range from mild to severe [1].
• Jaundice: A yellowing of the skin and whites of the eyes due to a buildup of bilirubin in the body [2].
• Weight loss: Unintentional weight loss is another common symptom, often accompanied by a decrease in appetite [3].
• Fever: Some people may experience fever as a sign of gallbladder cancer [4].
• Loss of appetite: A decrease in appetite can be an early warning sign of the disease [5].
• Bloating or pain in the belly: Abdominal bloating and pain are common symptoms, often accompanied by nausea and vomiting [6].
• Fatigue: Feeling extremely tired or weak is another symptom that may occur due to the cancer's progression [7].

Early Warning Signs

It's essential to note that gallbladder cancer can be difficult to detect in its early stages. However, some early warning signs include:

• Abdominal pain or discomfort
• Bloating or pain in the belly
• Jaundice

If you're experiencing any of these symptoms, it's crucial to consult a healthcare professional for proper evaluation and treatment.

References: [1] - Context result 3: "abdominal pain or discomfort" [2] - Context result 8: "yellowing of the skin and whites of the eyes (jaundice)" [3] - Context result 5: "Weight Loss" [4] - Context result 7: "fever" [5] - Context result 2: "Loss of appetite" [6] - Context result 6: "bloating or pain in the belly" [7] - Context result 1: "Fatigue"

Diagnostic Tests for Gallbladder Cancer

Gallbladder cancer diagnosis involves a combination of medical history, physical examination, and various tests to confirm the presence of cancer and determine its stage.

• Medical History and Physical Exam: A healthcare professional will review your medical history and perform a thorough physical examination to look for any signs or symptoms that may indicate gallbladder cancer. This is often the first step in diagnosing the condition [1].
• Blood Tests: Blood tests can be used to measure the amount of bilirubin, a chemical produced by the breakdown of red blood cells, in your blood. Elevated levels of bilirubin can indicate liver or gallbladder disease [4].
• Imaging Tests: Various imaging tests are used to visualize the gallbladder and surrounding tissues. These include:
  • Computed Tomography (CT) Scan: A CT scan uses X-rays and computer technology to create detailed images of the gallbladder and surrounding tissues [1].
  • Ultrasound: An ultrasound uses high-frequency sound waves to produce images of the gallbladder and surrounding tissues [6][8].
  • Magnetic Resonance Imaging (MRI): An MRI uses magnetic fields and radio waves to create detailed images of the gallbladder and surrounding tissues [9].
• Cholangiography: This test involves injecting a dye into the bile ducts to visualize any blockages or abnormalities [6].
• Biopsy: A biopsy involves removing a sample of tissue from the gallbladder for examination under a microscope. This is often used to confirm the presence of cancer and determine its type [3][9].

It's worth noting that the specific tests used may vary depending on individual circumstances, such as the severity of symptoms or the stage of cancer.

References: [1] - Computed tomography (CT) scan · Help diagnose gallbladder cancer by showing tumors in the area. · Help stage the cancer (find out how far it has ... [3] - You usually have a number of tests to diagnose gallbladder cancer and find out how far it has grown. Tests can include blood tests, scans and a biopsy. [4] - Diagnosing gallbladder cancer may begin with a test to measure the amount of bilirubin in the blood. Bilirubin is a chemical that comes from the breakdown of ... [6] - Jun 3, 2022 — Tests to detect gallbladder cancer · Physical exam · Lab tests · CT scan · Ultrasound · MRI · X-ray · Cholangiography · Biopsy. In some cases ... [8] - Dec 6, 2023 — How is gallbladder cancer diagnosed? ... Typically, we'll start with an abdominal ultrasound. This will show us if there's any abnormal thickening ... [9] - Diagnosing Gallbladder Cancer · Ultrasound or endoscopic ultrasound (EUS): · Computed tomography scan (CT scan): · Magnetic resonance imaging (MRI): ...

Treatment Options for Gallbladder Cancer

Gallbladder cancer treatment options include surgery, chemotherapy, and targeted therapy. The choice of treatment depends on the stage and location of the cancer.

• Surgery: Surgery is often the primary treatment for gallbladder cancer. If the cancer is localized to the gallbladder, a surgical procedure called cholecystectomy (removal of the gallbladder) may be performed. However, if the cancer has spread to nearby organs or tissues, surgery might not be possible [2].
• Chemotherapy: Chemotherapy involves using medications to kill cancer cells. The standard chemotherapy drugs for gallbladder cancer are gemcitabine and cisplatin [5]. Other drugs like fluorouracil (5-FU) and capecitabine may also be used in some cases.
• Targeted Therapy: Targeted therapy uses medications that specifically target cancer cells. Pembrolizumab, a type of PD-1 inhibitor, may be used in patients whose cancer is locally advanced and cannot be removed by surgery [4].
• Capecitabine: Capecitabine is an oral chemotherapy medication that may be recommended after surgery to prevent the cancer from coming back [6].

RET Inhibitors for Advanced Gallbladder Cancer

For advanced gallbladder cancers with RET alterations, treatment options include selpercatinib (Retevmo) or pralsetinib (Gavreto), which are RET inhibitors. These medications can be used to treat advanced gallbladder cancer [1].

Other Treatment Options

In some cases, chemotherapy may involve the use of cisplatin and gemcitabine. Additionally, surgery may be performed to relieve symptoms if the cancer is blocking the bile ducts or other nearby organs [3].

Differential Diagnosis of Gallbladder Cancer

Gallbladder cancer, also known as cholangiocarcinoma, has a complex differential diagnosis that includes both benign and malignant processes.

• Benign conditions: Acalculous cholecystitis, pericholecystic abscess, xanthogranulomatous cholecystitis, and biliary colic are some of the benign conditions that can mimic gallbladder cancer in terms of symptoms and imaging findings [1][2].
• Malignant tumors: Ampullary carcinoma, bile duct strictures, and bile duct tumors are other malignant conditions that should be considered in the differential diagnosis of gallbladder cancer [3][4].
• Other conditions: Advanced gallbladder cancer must also be included in the differential diagnosis of atypical cholecystitis [5].

Imaging findings

Imaging studies such as MRI and CT scans can help differentiate between these conditions. However, mural thickening has a limited differential but is difficult to distinguish on imaging alone [6]. Therefore, a combination of clinical evaluation, laboratory tests, and imaging studies is essential for accurate diagnosis.

References

[1] C Lopes Vendrami (2021) - The differential diagnosis for this pattern of gallbladder cancer includes benign processes such as pericholecystic abscess related to ...

[2] SKR Mukkamalla (2023) - Differential Diagnosis · Acalculous cholecystitis · Ampullary carcinoma · Bile duct strictures · Bile duct tumors · Biliary colic · Biliary disease.

[3] H Fujita (2022) - The differential diagnosis between gallbladder cancer and xanthogranulomatous cholecystitis remains quite challenging, and can possibly lead to improper surgery ...

[4] A Furlan (2008) - Gallbladder wall thickening can have an expansive differential diagnosis, including acute and chronic cholecystitis (Fig. 8A), xanthogranulomatous cholecystitis ...

[5] J Zemour (2014) - Advanced gallbladder cancer must be included in the differential diagnosis of atypical cholecystitis.

[6] Sep 14, 2024 - Differential diagnosis · intraluminal masses · mural thickening has a limited differential but is difficult to distinguish on imaging alone, ...