What Is Gall Bladder And Bile Duct Cancer? 

The gall bladder is a small pearl-shaped organ beneath the liver whose function is to store bile that is produced by the liver. Bile helps in the digestion of fat and is released to the small intestines through the bile duct which is a small tube connecting the liver and the gallbladder to the small intestine.

Cancer of the gallbladder and bile duct occurs when malignant (cancerous cells) develop and multiply rapidly and uncontrollably. Bile duct cancer is also referred to as cholangiocarcinoma. It originates from the inside or outside of the liver.

Types of Gallbladder and Bile Duct Cancer 

Most gallbladder and bile duct cancers are adenocarcinoma meaning they begin in the mucus glands that line the inside of the gallbladder and the bile duct. Bile duct cancer/ cholangiocarcinoma can either occur in the main bile duct outside the liver (extrahepatic) or within the liver (intrahepatic).

  1. Extrahepatic bile duct cancer: Most of them occur outside the liver, in the perihilar region, where the two main bile ducts meet. These tumours are referred to as Klastin tumours while those that occur closer to the small intestine are called Distal tumours.
  2. Intrahepatic bile duct cancer: These are rare and are often confused with primary liver cancer because they occur within the liver in the small duct branches.

Symptoms of Gall Bladder and Bile Duct Cancer

These cancers may not cause signs in the early stages but as they progress, the followings signs and symptoms may occur:

  • Jaundice
  • Lack of appetite
  • Abdominal pain
  • Abdominal swelling
  • Itching
  • Unintentional loss of weight
  • Dark urine
  • Light- coloured stool
  • Fever
  • Nausea and vomiting

It is important to note that having any of the symptoms listed above does not necessarily mean that either of the two cancers is present. One should seek medical advice or have a test done to be certain.

Causes of Gall Bladder and Bile Duct Cancer

Like most cancers that do not have exact causes, there are some risk factors that can increase a person’s chance of getting gallbladder cancer. These include:

  • Gallstones and inflammation: People who are diagnosed with gallstones (especially large gallstones), are more likely to develop gallbladder cancer than people without gallstones.
  • Typhoid: People who are chronically infected with salmonella have a higher risk of developing gallbladder cancer than those who are not infected.
  • Porcelain gallbladder: This condition occurs when the gallbladder is covered with calcium deposits causing inflammation of the gallbladder.
  • Gallbladder Polyps: These are growths that protrude from the gallbladder’s mucous membrane and can be precancerous. Having these growths increase the risk of getting gallbladder cancer.
  • Obesity: People who are overweight have an increased risk of getting gallbladder cancer.
  • Family history: If your family has had history with cancer before your risk of getting gallbladder cancer is increased.

Risk Factors for Gall Bladder and Bile Duct Cancer

  1. Ulcerative Colitis: This is an inflammation of the large intestine that is most times associated with bile duct inflammation.
  2. Congenital bile duct cysts: These are bile- filled sacs that often contain precancerous cells that increase the risk of getting cancer.
  3. Chronic Hepatitis C: It causes inflammation of the liver and can increase the risk of getting intrahepatic bile duct cancer.
  4. Diabetes: It can also increase intrahepatic bile duct cancer risks.
  5. Smoking: People who smoke are at a higher risk of getting intrahepatic cancer than those who do not smoke.

Diagnosis of Gall Bladder and Bile Duct Cancer

To diagnose gall bladder or bile duct cancer, the following could be undertaken:

  • Magnetic resonance imaging (MRI): It is used to get images of the internal organs using radio waves and magnetic fields. This test shows clearer images than the CT scan.
  • Computed Tomography (CT): This test uses rotating x- ray beams to take images of the body.
  • Ultrasound: This test uses sound waves to make pictures of the internal organs. It can be combined with laparoscopy and endoscopy.
  • Biopsy: This involves taking a tissue sample from the tumour and examining it in a laboratory to check whether there is any presence of abnormal cells.
  • Endoscopic retrograde cholangiopancreatography (ERCP): It is done to show whether the bile duct is narrowed or blocked. A small tube is inserted into the bile duct through the oesophagus and used to insert a contrast dye which makes the images in the x- ray to outline the bile duct.

Treatments

Before starting a treatment, it is important to consider factors such as whether you wish to have children, your age, and your overall health. Here are some of the gall bladder and bile duct cancer treatment options:

  • Surgery: This done to remove the tumour however, in situations where the person cannot tolerate and recover from surgery, it may not be the best option. 
  • Chemotherapy: This involves using a combination of anti- cancer drugs to kill the cancer cells.
  • Radiation Therapy: In this treatment option, high energy beams are directed to the tumour which can reduce the size of the tumour and stop the cancer from spreading. Radiation is done through the following ways:

1. External radiation which uses a machine outside the body by directing radiation towards the cancer.

2. Internal radiation therapy which involves directing the radiation directly into the cancer cells or near it.

  • Liver transplant: This done to replace the entire liver with a healthy liver especially when the cancer has spread.
  • Palliative Therapy: When the cancer is in its advanced stage, this treatment is done to reduce the symptoms of the disease and stop the cancer from spreading further.

Prevention of Gall Bladder and Bile Duct Cancer

To prevent yourself from getting gallbladder and bile duct cancer or to reduce your risk factors, you should do the following:

  • Ensure that you maintain a healthy diet rich in fruits and fibre.
  • Prevent yourself from getting hepatitis C which can lead to this type of cancer.
  • Abstaining from risky behaviour that could lead to you getting hepatitis such as practising safe sex, and nor sharing needles and other sharp objects.
  • Getting vaccinated for Hepatitis A and B.
  • Do not smoke.
  • Get tested for diabetes regularly if you are at a high risk of getting gallbladder cancer.
  • Maintain a healthy weight.
  • Get regular body check- ups.
  • Treat diseases that can lead to this type of cancer such as liver fluke infection.

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