If you’ve recently experienced symptoms that could indicate the presence of gallbladder cancer, you should reach out to a doctor right away. Only a small percentage of gallbladder cancers can be cured, and those that can involve the removal of the cancerous growth before it spreads too extensively. But the longer you wait, the lower your odds are of a treatment plan that cures your gallbladder cancer rather than manages its spread in your body.
How Gallbladder Cancer Is Diagnosed
Gallbladder cancer is rarer than other cancer types, with a prevalence rate of between 0.5 to 1.5 percent of all cancer cases. However, it is extraordinarily lethal, with a 5-year survival rate of under 5 percent. This low rate is due partially to the fact that gallbladder cancer is hard to diagnose in the early stages. Further, common symptoms of gallbladder cancer are often attributed to other common ailments. These symptoms may include:
- Abdominal bloating
- Abdominal pain
- Unexplained weight loss
Unfortunately, by the time most people experience more severe symptoms, gallbladder cancer has often spread more extensively throughout the body in an incurable manner by current medical methods.
When a person reaches out to a doctor to have their symptoms evaluated and diagnosed, a doctor will likely perform a series of tests to screen for cancer and determine its type and severity if present. These tests will generally include an excisional biopsy – a minor surgical procedure in which a small portion of the gallbladder (and potentially other affected organs) is removed with a needle for further study.
Doctors will also use various medical imaging techniques to take pictures of the interior of the body. They may use:
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Positron emission tomography (PET) scan
- Ultrasound scan
- Cholangiography (X-ray of the bile ducts)
- Laparoscopy (insertion of a camera in an incision in the stomach)
By evaluating these images, they can determine what stage the cancer is in and use that information to help them formulate treatment recommendations that can provide the best possible health outcomes. Blood tests and chemical panels can also help them detect and identify different antigens (toxins or foreign substances) associated with different forms of cancer in the body.
Test results are assessed by specialized doctors known as pathologists who are well-versed in the scientific and medical techniques available to detect and identify specific types of cancer. These tests may take several weeks to perform and analyze, which can be challenging for the patient. However, it is important to arrive at an accurate diagnosis to determine the most effective treatment regimen and start it as soon as possible. Detection and treatment of gallbladder cancer when it is in its earliest stages maximizes a patient’s chance of being cured. And if it is detected in later stages, a definitive diagnosis is the first step in determining which treatment method will help the patient achieve the best possible health outcome.
What Are The Five Stages of Gallbladder Cancer?
According to the American Joint Committee on Cancer (AJCC)’s commonly used TNM system, there are five stages of gallbladder carcinoma, denoted as stages 0, I, II, III, and IV. The “TNM” refers to tumor (T), (lymph) nodes, and metastasis to distant sites (M), respectively, and are used to provide further information to medical providers and Gallbladder cancer patients about the progression of the cancer in question.
Additionally, the system provides further information about the different stages of gallbladder cancer as follows:
- The number that follows T refers to the size of the tumor in centimeters.
- Tis is used when the cancer is confined.
- N0 refers to cancer that has not spread to any lymph nodes.
- N1 denotes cancer that has spread to nearby lymph nodes.
- N2 describes cancer that has spread to distant lymph nodes.
At this stage, the cancer is only in the inner layer of the gallbladder and not any deeper. Stage 0 is also accompanied by Tis, N0, and M0.
In Stage I, the tumor has grown into either the lamina propria or the muscularis, both deeper layers of the organ. This stage is also marked as T1, noting the spread further inside the gallbladder and N0 and M0, indicating it has not spread further.
Stages IIA and IIB
In Stage IIA, the tumor has grown into the fibrous tissue along the side of the abdominal cavity. It is denied as T2a, N0, M0. In Stage IIB, the tumor has grown through the fibrous tissue near the side of the liver, though it has not yet penetrated the liver. It is referred to as T2b, N0, M0.
Stages IIIA and IIIB
In Stage III, gallbladder carcinoma has metastasized (spread) outside the gallbladder, though it has not yet reached distant organs. In Stage IIIA, the disease has infiltrated the liver and/or one nearby organ, such as the stomach, colon, small intestine, pancreas, or bile ducts. In this stage (T3, N0, M0), it has not yet invaded a lymph node.
In contrast, Stage IIIB describes a tumor that has reached at least one but no more than three nearby lymph nodes. And this stage (T1, T2, T3; N1; M0) also may or may not have spread to the liver and/or one nearby organ.
Stages IVA and IVB
In Stage IVA, the tumor can now be found inside one of the primary blood vessels that leads into the liver; it can be found in two or more organs outside the liver, or it may have spread to one (but no more than three) lymph nodes. It can also be referred to as T4; N0, N1, M0.
Stage IVB describes a tumor that has spread to multiple organs and lymph nodes (T1-4; N0 or N1; M1). It also describes a tumor that has spread to distant lymph nodes, whether it has or has not spread to distant organs (T1-4; N2; M0 or M1).
How Is Gallbladder Cancer Treated At Each Stage?
Gallbladder cancer is curable by removing the tumor with surgery. However, gallbladder cancer surgery is most successful when completed at Stage 0 or I, when the cancer is localized. Unfortunately, when many people begin to experience severe symptoms from gallbladder cancer, the tumor has already spread into other organs, reducing surgery’s effectiveness and viability as an option. At which point, gallbladder cancer patients would have to consider other standard treatment options.
For example, given its proximity to the liver, tumor cells in the gallbladder can easily spread to the liver and enlarge it. As a result, a person may have a distended stomach and severe abdominal pain. When they visit their doctor, they may learn that they have gallbladder and liver cancer. At this point, more often than not, a doctor will focus less on trying to remove the cancer entirely than controlling its growth and alleviating its most severe symptoms.
Gallbladder cancer in Stages II through IV is generally known as unresectable. Unresectable means that the cancer cannot be completely removed by surgery. However, experienced practitioners will take a close look at the tumor itself rather than just the TNM classification. In some cases, an experienced surgeon may be able to remove a tumor in Stage II or Stage III if it has not spread too far beyond the gallbladder and has not yet invaded one of the major blood vessels.
However, if the tumor has spread extensively into other major organs, blood vessels, or lymph nodes, surgery may be used to remove as much of the mass as possible. Other treatment methods, including radiation therapy and chemotherapy, may be used to control the growth of the remaining cancer cells.
To reduce the physical toll these two treatment types exert on the human body, doctors may recommend targeted therapy drugs. Patients may also take advantage of immunotherapy, a medical approach in which certain substances are synthesized in a laboratory that can help amplify a patient’s immune system to help it fight off cancer more vigorously.
In the later stages of gallbladder cancer, doctors may recommend palliative treatments meant to reduce the severity of cancer symptoms and extend a patient’s life as long as possible.
Determining How Far Your Cancer May Have Advanced
If you’ve received a positive cancer diagnosis and are unclear about your prognosis, we at Immunity Therapy Clinic can help you obtain the clarity you seek. We understand how challenging a time this is for you and pledge to help you determine and implement the cancer care plan that best fits your health and your personal and family considerations. Our skilled surgical staff can help you maximize your chances for successful tumor removal if your gallbladder cancer is at an early stage. We also have substantial experience diagnosing and treating gallbladder cancer at all stages and will help you achieve the best possible health outcome. We strive to provide compassionate, caring, and efficient healthcare service so that you can spend your energy fighting cancer and healing. Aside from gallbladder cancer, we can also help you remove a malignant mesothelioma through alternative treatment methods.
If you need a better understanding of a diagnosis from your current provider or if you need a second opinion, we are here for you. And if you’re looking for skilled medical professionals to provide you with high-quality and affordable cancer care, Immunity Therapy Center is your best option.
Written By: Dr. David Alvarez
Dr. David Alvarez is a Board Certified Medical Doctor from Universidad Xochicalco and Certified by the American Heart Association (Advanced Cardiovascular Life Support).
Dr. Alvarez has been collaborating with Dr. Bautista as an Assistant Medical Director at the Immunity Therapy Center for over 6 years. He provides daily on site patient care and participates on the medical board on research and development of patient treatment plans and programs. Dr. Alvarez is a knowledgeable and compassionate Doctor committed to helping patients get to where they want to be health wise through a more holistic and comprehensive approach.
At Immunity Therapy Center, our goal is to provide objective, updated, and research-based information on all health-related topics. This article is based on scientific research and/or other scientific articles. All information has been fact-checked and reviewed by Dr. Carlos Bautista, a Board Certified Medical Doctor at Immunity Therapy Center. All information published on the site must undergo an extensive review process to ensure accuracy. This article contains trusted sources with all references hyperlinked for the reader's visibility.