3 Essential Things to Know About Gallbladder and Bile Duct Cancer

By Dr. Donna Powell & Dr. Renee M. Marchioni Beery

February is Gallbladder and Bile Duct Cancer Awareness Month, and unlike many other forms of cancer, many people have a general lack of knowledge about these two relatively rare diseases. While still uncommon in the United States, there are approximately 4,800 cases of gallbladder cancer and 8,000 cases of bile duct cancer diagnosed each year, according to the American Cancer Society. The diseases also tend to be severe, as only 1 in 5 patients detect the cancer at an early stage. Let’s explore the three essential things everyone should know about gallbladder and bile duct cancer.

The Anatomy of Gallbladder and Bile Duct Cancer — Where Does it Start?

The gallbladder is a small organ connected to the liver by the bile ducts. Its sole function is to store bile made by the liver to digest fat. Gallbladder cancer occurs when cells in the organ grow out of control. It usually starts in the innermost layer of the gallbladder and can spread to the outer layers as it progresses.

Bile ducts are tree-like structures that extend within and around the liver and gallbladder. They carry bile from the liver to the upper part of the small intestine. Bile duct cancers are classified into two types depending on where they originate. Extrahepatic bile duct cancers occur in the bile ducts outside the liver, while intrahepatic cancers occur within the liver and are often misdiagnosed as liver cancer.

Who is at risk?

While these cancers can affect anyone, certain factors may increase the risk.

Age and Gender

Your risk of developing gallbladder and bile duct cancers increases as you get older. Most gallbladder cancer patients are diagnosed above the age of 80, while most cases of bile duct cancer in the United States are diagnosed in people between the ages of 50 and 70. Bile duct cancer is also slightly more common in men.

Chronic Inflammation

Conditions leading to chronic inflammation, such as gallstones or infections of the bile ducts, can increase the risk of developing these cancers. Scientists are also studying how inflammation over an extended period may cause changes in a patient’s cells, paving the way for tumor growth. Inflammatory bowel diseases, including Crohn’s Disease and Ulcerative colitis, can also be a risk factor.

Gallstones

Gallstones are hardened deposits inside the gallbladder that can cause irritation and chronic inflammation. Many cases of gallbladder are detected after the gallbladder has been removed for persistent gallstones.

Bile Duct Disorders

Disorders of the bile duct, in particular a condition known as primary sclerosing cholangitis (PSC), can cause inflammation and scarring around the liver, eventually narrowing and blocking the bile ducts. When this happens, bile builds up in the liver, causing damage and potentially leading to cancer.

Genetics

Approximately 25% of gallbladder cancers are thought to be genetic. A person with a parent diagnosed with gallbladder cancer is five times more likely to develop the disease themselves. Genetics can also play a role in predisposing patients to bile duct cancers.

Diet & Alcohol Consumption

As with many diseases, obesity and excessive alcohol intake can significantly increase a person’s risk of developing gallbladder and bile duct cancers. This is especially true for patients who have fatty liver disease.

Symptoms Diagnosis and Treatment

Gallbladder cancer is complicated to detect and diagnose because patients rarely have any symptoms during the early stages. The signs that are present are often mistaken for other illnesses. Common symptoms of both gallbladder and bile duct cancer include:

● Jaundice (Yellowing of the skin and eyes)

● Pain above the stomach

● Fever

● Nausea and vomiting

● Excessive bloating

● Lumps in the abdomen

● Unexplained weight loss

● Changes in bowel habits

Diagnosing gallbladder and bile duct cancers typically involves a combination of imaging studies, blood tests, and biopsy. Ultrasounds, CT scans, and MRI scans can provide detailed images of the affected areas, helping to identify tumors, which can then be sent for biopsy. Blood tests may reveal abnormal liver function, leading doctors to investigate further and uncover the cancer.

Treatment typically involves surgery to remove the cancerous tissue, the gallbladder and any affected portions of the bile ducts. Chemotherapy and radiation are often recommended as well to target cancer cells that may remain and prevent a recurrence.

While less common than other types of cancer, gallbladder and bile duct cancers can be particularly deadly due to their silent nature. By recognizing risk factors and being aware of symptoms and treatment options, individuals can be better equipped to catch these diseases before progressing. Early detection and a comprehensive approach to treatment are essential in improving outcomes and enhancing the quality of life for those affected by gallbladder and bile duct cancer.

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