Gallbladder cancer
Why in news?
SGPGI Lucknow developed a cost-effective therapy combining chemotherapy with radiotherapy for non-surgical localized cases, nearly doubling life expectancy compared to chemotherapy alone in a five-year study of 140 patients. This approach is proposed as a standard for advanced non-metastatic cases, offering an affordable alternative to immunotherapy in India.
About
- Gallbladder cancer is a rare malignancy that originates in the cells of the gallbladder, often remaining asymptomatic until advanced stages.
- It primarily affects women more than men.
- It is strongly linked to risk factors like gallstones (cholelithiasis), chronic gallbladder inflammation, and certain geographic or ethnic predispositions, such as higher incidence in parts of India and South America.​
Symptoms
- Early symptoms mimic gallstone issues, including abdominal pain, nausea, and jaundice, but are often absent.
- Advanced disease presents with weight loss, fever, bloating, and dark urine due to bile duct obstruction.​
Risk Factors
- Gallstones, especially large ones (>3 cm), increase risk 4-5 times.​
- Chronic inflammation from infections or porcelain gallbladder.
- Obesity, older age (over 65), and primary sclerosing cholangitis.​
Diagnosis and Stages
- Diagnosis typically occurs incidentally during cholecystectomy or via imaging like ultrasound, CT, or MRI, with staging from T1 (confined to mucosa, potentially curable) to stage IV (metastatic).
- Biopsy confirms adenocarcinoma, the most common type.​
Treatment
- Surgery (radical cholecystectomy with liver resection and lymph node removal) offers the best chance for early-stage cure.
- Advanced cases use chemotherapy (gemcitabine plus cisplatin), radiation, or immunotherapy like durvalumab; prognosis is poor, with 5-year survival around 66% for localized vs. 2-3% for metastatic disease.​
