Gallbladder cancer, though relatively rare, presents a formidable medical challenge, often diagnosed at an advanced stage, leading to poorer outcomes. It develops in the gallbladder, a tiny organ under the liver that stores bile.

It is estimated that about 12,220 new cases of gallbladder cancer will be diagnosed in 2023, with approximately 4,510 deaths, according to the American Cancer Society. Globally, regions like India, Chile, and parts of Central and South America bear a higher incidence of this disease.

This silent and often insidious progression underscores the critical importance of early detection. The 5-year survival rate for localized gallbladder cancer is around 70%, but this number drastically plunges to a mere 5% when the cancer is diagnosed after it has spread. These statistics emphasize the urgency of timely intervention.

As a gastroenterological oncologist with 23+ years of experience, Dr. Deep Geol says that gallbladder cancer surgery, as the primary treatment approach, plays a pivotal role in changing these statistics. He states, “The success rate of gallbladder cancer surgery, when applied appropriately, can significantly impact the patient’s prospects for survival and an improved quality of life.”

In this comprehensive blog, we will delve into the intricacies of gallbladder cancer, its challenges, and the vital role of surgery.

What is a Gallbladder?

The gallbladder is a tiny, pear-shaped organ in the upper right abdomen underneath the liver. It stores and concentrates bile, a digestive fluid produced by the liver, and releases it into the small intestine to aid digestion.

What are Its Functions?

The gallbladder performs numerous essential functions:

• Bile Storage: It is responsible for storing bile generated by the liver.
• Bile Concentration: Bile in the gallbladder is concentrated, making it more efficient for digestion.
• Bile Release: It contracts and releases bile into the small intestine to help in fat breakdown.
• Digestive Aid: Bile aids digestion by emulsifying and breaking down dietary lipids for absorption.
• Non-Essential Organ: The gallbladder is not required for living and can be removed.

What Causes Gallbladder Cancer?

A combination of risk factors and genetic abnormalities often causes gallbladder cancer. Here’s a summary of the major elements of how gallbladder cancer develops:

Risk Factors:

• Gallstones: People with a history of gallstones are more likely to develop them, especially if the stones are big or cause inflammation.
• Chronic inflammation: Conditions such as chronic gallbladder inflammation raise cancer risk.
• Age and Gender: Gallbladder cancer is more common in older people and more common in women.
• Ethnicity: Gallbladder cancer is more common in some ethnicities, such as Native Americans and individuals in several South American countries.
• Pancreatic Duct Anomalies: Anomalous pancreatic ducts can cause bile buildup, thus raising cancer risk.

Genetic Variations:

• Cancer can result from genetic abnormalities in gallbladder cells. These mutations might be inherited or spontaneous.

Chronic Irritation:

• Persistent gallbladder irritation, frequently caused by gallstones or persistent inflammation, can produce alterations in the gallbladder lining, raising the risk of cancer over time.

As per Dr. Goel, it’s vital to remember that gallbladder cancer is frequently identified at an advanced stage, making treatment more difficult and leading to lower results. Early identification and awareness of risk factors are crucial for improving gallbladder cancer prognosis.

What is the Role of Surgery?

The primary treatment method for gallbladder cancer is surgery, which focuses on removing malignant tissue if it is localized or relieving symptoms and suffering if the disease has spread. The surgical strategy is determined by the stage of the malignancy, its extent, and the patient’s general condition.

Staging Laparoscopy

Staging laparoscopy is frequently performed before surgery. This method allows doctors to better look at the spite and surrounding tissues, which aids in determining the most successful surgical strategy. 

Dr. Goel states, “Through a tiny incision, a long tube with a camera is placed into the belly, allowing to analyze cancer’s location and potential spread. Laparoscopy staging is critical in establishing the stage of the malignancy.”

“My experience with Dr. Deep Goel and the staging laparoscopy he performed was exceptional. Dr. Goel’s approach to explaining the procedure and the care he provided were reassuring. The laparoscopy was conducted with precision and minimal discomfort. I truly appreciate Dr. Goel’s expertise and his commitment to patient well-being. Thanks to him, I had a smooth and informative journey through a crucial diagnostic procedure,” said one of the many happy patients of Dr. Goel.

Cholecystectomy

A cholecystectomy is the surgical removal of the gallbladder, which is a joint surgery for non-cancerous diseases such as gallstones. However, in situations of suspected or proven gallbladder cancer, a more comprehensive treatment is frequently required. The gallbladder, a piece of the liver, and regional lymph nodes are all removed during an extended cholecystectomy. 

As per Dr. Goel, if the malignancy has spread, more organ and tissue removal may be required. This comprehensive surgery is designed to lower the likelihood of cancer recurrence.

A happy patient of Dr. Goel expressed his gratitude by stating, “My heartfelt gratitude to Dr. Deep Goel for the successful cholecystectomy he performed. Dr. Goel’s skill and care made the process as smooth as possible. He used advanced techniques to ensure minimal scarring and a quicker recovery. I can’t thank him enough for giving me a new lease on life, free from gallbladder issues. Dr. Goel’s expertise is truly remarkable!”

Factors that Influence Surgical Feasibility

Rather than depending merely on the cancer stage, the likelihood of undertaking cholecystectomy is dependent on whether the surgeon can safely and efficiently remove the tumor. Resectable gallbladder tumors, which can be completely removed surgically, offer improved therapy options. 

Unresectable tumors, or those that cannot be entirely removed, are frequently caused by the size, location, or involvement of important blood arteries. Other essential factors include the patient’s general health and capacity to survive surgery.

Palliative Surgery

Palliative surgery may be considered in circumstances when the malignancy is unresectable to relieve symptoms rather than cure the cancer. 

For example, if a gallbladder tumor blocks a bile duct, a stent (a metal tube) can be surgically implanted within the duct to maintain it open and allow bile to flow. 

Jaundice, or yellowing of the skin and eyes, can be caused by bile duct obstruction, and stent implantation can help alleviate this condition.

How Much Does the Treatment Cost in India?

The treatment’s cost varies substantially. The cost of surgery for patients ranges from 80,000 INR to 2,00000 INR. However, chemotherapy and radiation therapy have a high price of roughly 2,00000 to 20,00000 INR. Gallbladder Cancer Treatment cost in India for Indian Patients is between USD4200 to USD5600. 

However, the expenses might differ based on various factors such as hospital amenities, surgeon expertise, medical necessities, and post-operative care.

Conclusion

Gallbladder cancer surgery plays a pivotal role in managing this challenging disease. While the journey may be complex, advancements in surgical techniques and a comprehensive approach offer hope for patients to regain their health and well-being. If you or a loved one is faced with a gallbladder cancer diagnosis, prompt medical attention, consultation with a multidisciplinary team, and informed decision-making can significantly impact the road to recovery. Gallbladder cancer may be formidable, but with the right approach, it can be met with resilience and determination.

Frequently Asked Questions

1. Is gallbladder cancer surgery the sole choice for treatment?

Surgery is the primary treatment. However, depending on the stage of the disease and the patient’s condition, other therapies, such as chemotherapy, may be prescribed.

2. Is it possible to do gallbladder cancer surgery laparoscopically?

Minimally invasive laparoscopic surgery is viable in some circumstances, although primary operations may necessitate open procedures.

3. How long does it take to recover after gallbladder cancer surgery?

Recovery time varies but can range from several weeks to months, depending on the nature of the treatment.

4. Is gallbladder cancer palliative surgery painful?

Pain is efficiently controlled with medicine to offer patient comfort and symptom reduction.

5. How can I lower my chances of developing gallbladder cancer?