Gallbladder cancer: need urgent attention

What causes gallbladder cancer?

Gallbladder cancer is an aggressive GI cancer with early liver and bile duct involvement causing jaundice and rapid spread to other organs. A very common cancer in the cow belt UP, Bihar and Bengal (endemic area with one of the world’s highest incidence) it is now reported with increasing frequency in other parts of country.

What are the risk factors for gallbladder cancer?

A risk factor is anything that affects your chance of getting a disease .But having a risk factor, or even several risk factors, does not mean that a person will get the disease. And many people who get the disease may have few or no known risk factors.

There are several risk factors that make a person more likely to develop gallbladder cancer. Many of these are related in some way to chronic inflammation (irritation and swelling) in the gallbladder.

• Gallstones: Gallstones are the most common association for gallbladder cancer. At least 3 out of 4 people with gallbladder cancer have gallstones when they are diagnosed. But wether they cause gallbladder cancer is debatable.gallstones are very common, and gallbladder cancer is quite rare, Most people with gallstones never develop gallbladder cancer. PREVENTION OF CANCER IS NEVER AN INDICATION FOR GALLBLADDER SURGERY EVEN WITH STONES
  
• Porcelain gallbladder: Porcelain gallbladder is a condition in which the wall of the gallbladder becomes covered with calcium deposits. It sometimes occurs after long-term inflammation of the gallbladder (cholecystitis), which can be caused by gallstones. People with this condition have a higher risk of developing Gallbladder cancer
  
• Female gender: Gallbladder cancer occurs more than twice as often in women. Gallstones and gallbladder inflammation are important risk factors for gallbladder cancer and are also much more common in women than men.
  
• Obesity: Patients with gallbladder cancer are more often overweight or obese than people without this disease.
  
• Older age: Gallbladder cancer is seen mainly in older people, but younger people can develop it as well.
  
• Choledochal cysts: Choledochal cysts are bile-filled sacs that are connected to the common bile duct, the tube that carries bile from the liver and gallbladder to the small intestine.The cysts can grow large over time and may contain as big as 10 cm ( normal bile duct is 6-7 mm) The cells lining the sac often have areas of pre-cancerous changes, which increase a person’s risk for gallbladder cancer.
  
• Abnormalilities in bike duct: such a abnormal pancreatobiliary union increase reflux of pancreatic juice into bileducts causing gallbladder cancer. This can be detected only on imaging
  
• Gallbladder polyps: A gallbladder polyp is a growth that bulges from the surface of the inner gallbladder wall. Some polyps are formed by cholesterol deposits in the gallbladder wall. Others may be small tumors (either cancerous or benign) or may be caused by inflammation. Polyps larger than 1 centimeter (almost a half inch) are more likely to be cancer, so doctors often recommend removing the gallbladder in patients with gallbladder polyps that size or larger.
  
• Primary sclerosing cholangitis: In primary sclerosing cholangitis (PSC), there is inflammation and scarring of the bile ducts. People with this disease have an increased risk of cancer of the gallbladder and bile ducts. Many people with PSC also have ulcerative colitis, a type of inflammatory bowel disease.
  
• Industrial and environmental chemicals: Some studies in lab animals have suggested that chemical compounds called nitrosamines may increase the risk of gallbladder cancer. Other studies have found that gallbladder cancer might occur more in workers in the rubber and textile industries than in the general public. More research is needed in this area to confirm or refute these possible links.
  
• Typhoid: People chronically infected with salmonella (the bacterium that causes typhoid) and those who are carriers of the disease are more likely to get gallbladder cancer than those not infected. This is probably because the infection can cause gallbladder inflammation.
  
• Family history: Most gallbladder cancers are not found in people with a family history of the disease. A history of gallbladder cancer in the family seems to increase a person’s chances of developing this cancer, but the risk is still low because this is a rare disease.