The function of the gallbladder is to store bile. This fluid is produced in the neighboring organ, the liver. Various factors can lead to tumor development. In the case of gallbladder cancer, malignant cells divide uncontrollably and displace healthy tissue. In this case, one speaks of a malignant tumor. This tumor is able to grow from the gallbladder into the liver. It can also spread throughout the body via the bloodstream or lymphatic system.
Gallbladder cancer is comparatively rare. Every year, around three in 100,000 people are diagnosed with gallbladder cancer, with most of those affected being over 70 years old. Women are more frequently affected by gallbladder cancer than men. In Germany, around 2,300 men and almost 3,000 women are diagnosed with this form of cancer every year.
Women suffer more frequently from gallstones, which are risk factors for the development of gallbladder cancer. This is thought to be one reason why women are more likely to develop gallbladder cancer than men.
However, gallstones in themselves are not the cause of gallbladder cancer. However, gallstones can lead to persistent inflammation of the gallbladder. This permanent irritation can lead to the development of gallbladder cancer over the years. For this reason, gallstones are found in around 80 percent of people who suffer from gallbladder cancer.
Gallstones can lead to persistent inflammation of the gallbladder. This irritation can lead to a carcinoma.
If the gallbladder is chronically inflamed, a porcelain gallbladder can form, which in turn favors gallbladder cancer. In the case of bile duct cancer, on the other hand, the following factors can play a role in the development of the tumor:
- Parasites
- Cigarette smoke
- The chronic inflammatory bowel disease ulcerative colitis
People affected by gallbladder cancer rarely notice early symptoms. Patients only complain of symptoms when the tumor has already grown considerably. Then they often experience pain in the upper abdomen or weight loss. Pronounced fatigue or itching can also occur.
It is only when the tumor is very advanced that the outflow of bile into the small intestine is impeded. This is why gallbladder cancer often only causes symptoms at an advanced stage, such as those associated with jaundice. These include pale stools, dark discoloration of the urine and yellowing of the eyeballs and skin.
If it is suspected that the patient is affected by gallbladder cancer, the doctor will first ask them about their medical history. This will include whether the patient has suffered from gallbladder stones in the past. This is followed by a physical examination. During this examination, the doctor will mainly palpate the abdomen to feel for an enlargement of the gallbladder.
Blood is then taken from the patient to determine changes in the bile and liver values. Imaging procedures are also used, such as an ultrasound examination of the abdomen. This makes it possible to visualize the bile ducts and the gallbladder. The doctor can use these examinations to differentiate other diseases, such as gallstones, from gallbladder cancer and make a clear diagnosis. If the situation is unclear, a CT or MRI scan is often performed. This allows the doctor to determine the size and exact position of the tumor.
The size and position of the tumor can be determined with an MRI.
In principle, the choice of treatment for gallbladder cancer depends on how far the tumor has spread. If the tumor growth is still limited, the gallbladder is surgically removed. This is particularly likely at an early stage of gallbladder cancer. However, it is often necessary to remove adjacent parts of the liver as well because the tumor often infiltrates the liver.
If the tumor has already formed offshoots in the body or has grown around vital vessels, gallbladder cancer can no longer be cured. In this case, the main purpose of the therapy is to improve the patient's quality of life. The aim is to alleviate symptoms and prolong life. This is usually achieved with chemotherapy.
Patients who cannot be operated on but still suffer from a bile outflow obstruction can be treated interventional. A drain can usually be inserted using endoscopic techniques. These small tubes help to ensure that the bile can still drain away, which relieves the bile.
Patients in good general health have additional treatment options in the form of radiotherapy or systemic chemotherapy.
The prognosis for gallbladder cancer is highly dependent on the aggressiveness and spread of the tumor. For this reason, it is not easy to make a general statement about life expectancy in gallbladder cancer. However, as gallbladder cancer is often discovered late, the prognosis for many patients is rather poor.
Gallbladder cancer is usually diagnosed by gastroenterologists or surgeons. Interventions - such as endoscopic drainage insertions into the bile duct - are carried out by gastroenterologists. Surgical interventions are performed by visceral surgeons. There are several specialized centers in Germany for diseases of the bile ducts or gallbladder.