Gall Bladder Cancer Home A-Z Health Information Health Library A-Z Gall Bladder Cancer Overview Cancer of the gall bladder is the fifth most common cancer of the digestive system. In India, its incidence is higher in Northern India. Sometimes, gall bladder cancer is accidentally detected, when gall bladder is removed for gallstone diseases (incidental gall bladder cancer). This by itself is a rare occurrence, but it has been estimated that a silent cancer will reside in 0.2–3% of all cholecystectomies. Gall bladder removal is a very common operation. Rarely, cancer can be discovered in pathological examination of the gall bladder. These patients will then need a definitive treatment, and further surgery for complete removal of cancer. Causes and risk factors Chronic inflammation of the gall bladder – Chronic cholecystitisGall bladder polyps > 1 cm in size: Gall bladder polyps are usually small growths that arise from the gall bladder. Most polyps are usually benign and do not carry cancer risk, but it depends on the polyp size. Polyps > 1 cm are at an increased risk of being cancerous. These patients need surgery to remove the gall bladder. As such, only 0.6% of all gall bladder polyps are malignant. However, when the size exceeds 1 cm the risk of developing cancer increases.Focal thickening and irregularity/induration on the gall bladder wall–as seen on ultrasound and imaging may be associated with gall bladder cancer–and will require a cholecystectomy. Symptoms Only 30% of all gall bladder cancers are discovered preoperatively (non-incidental). The patient may present with vague symptoms including:PainVomitingWeight lossJaundice. Diagnosis Diagnosis is incidental and may be discovered during:Pathological examination: Gallbladder cancer is rarely diagnosed, when a pathological examination of the gall bladder is done. Once this diagnosis has been established, the patient would need detailed imaging tests. CT scan/PET- CT scan: Accurate diagnosis of gall bladder cancer is made on CT scanning. Further imaging (PET-CT) will be required to rule out metastases. CT scan is an accurate modality to stage the disease and define further treatment, which is stage dependent. Treatment The precise treatment plan will depend on the presence/absence of metastatic disease, lymph nodes and local extent of the disease. In most instances, wherein the cancer is localised to the gall bladder (which is usually the case), further surgery is requiredSurgery is the only definitive treatment with potential for cure. Hence, wherever possible, surgery should be done. Furthermore, surgery is only done, when the cancer is localised to the gall bladder and the surrounding structures including regional lymph nodes, and has not extensively spread to either within the abdomen or elsewhere. Since the gall bladder resides at the base of the liver, surgery for cancer involvesGall bladder removalRemoval of part of the liver, wherein the gall bladder resides (segment 4b/5)Regional draining of lymph nodesSometimes more extensive surgery will be required to remove the cancer.Chemotherapy: Surgery remains the cornerstone of management of gall bladder cancer. However, chemotherapy plays a role in the treatment and would be required following surgery. Chemotherapy is also sometimes required preoperatively prior to surgery.