By Dr Ananya Mandal, MD
Gallbladder cancers are notoriously difficult to detect early. These cancers usually do not cause symptoms in its early stages. By the time symptoms manifest the cancer may have advanced to later stages.
At diagnosis the cancer has often spread outside the gallbladder itself to areas nearby. The affected gallbladder is difficult to feel from above the abdomen as it lies deep within underneath the liver. In most cases a gallbladder cancer is detected by chance during a surgery for gallstones.
Most of the symptoms appear in later stages and other illnesses like liver disease may also cause similar symptoms.
Symptoms of gallbladder cancer include abdominal pain, nausea and vomiting and so forth.
The pain is typically aching and occurs on the right side. These may be a dragging feeling. There is a sharper pain or biliary colic that may be sudden and severe in onset in case the cancer or gallstones block the bile duct. This condition needs immediate emergency treatment.
Nausea and vomiting
In later stages of gall bladder cancer as well as in early stages there is intense nausea, vomiting and lack of appetite. There may be bloating, abdominal discomfort particularly after a heavy or fatty meal.
This means the liver is unable to function or there is a blockage in the biliary system and the bile seeps into the blood. The bile pigments are yellowish green and they get deposited at various parts of the body.
For example, when these pigments are deposited in the eyes they lead to yellowing of the whites of the eyes. They may be deposited elsewhere leading to yellowing of the skin, yellowing of the nail beds etc. The bile chemicals under the skin also lead to severe itching.
The urine may be dark or deep yellow in color due to excess bile pigments and the stools may be white, pale and chalky due to lack of bile pigments secreted in the digestive tract. Nearly half the people diagnosed with gallbladder cancer have jaundice. This is often a sign that the cancer is in its later stages.
However, having jaundice does not always mean that the patient has cancer. A viral infection of the liver, liver ailments, alcoholic liver disease etc. also causes jaundice. A viral hepatitis is the commonest cause of jaundice.
Enlargement of the gallbladder
If the biliary system of bile ducts is blocked with cancer the gallbladder will fill up with bile and get swollen and enlarged. This enlarged gall bladder may be felt during a physical examination or visualized during an ultrasound scan.
Other symptoms of gallbladder cancer
Other symptoms include loss of appetite, unexplained weight loss and a swollen abdomen.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)