Risk Factors In Having Gallbladder Cancer (Part 2)

8) Obesity. If you are very overweight (about 30 pounds more than your ideal weight), you're at increased risk of gallbladder cancer. It's estimated that as many as one in every four cases of gallbladder cancer is linked to excess weight.

9) Race. American Indians, especially those living in the Southwest, are five times as likely to develop gallstones and gallbladder cancer as whites are. Hispanics also have higher rates of gallbladder cancer than whites do.

10) Primary sclerosing cholangitis (PSC). This autoimmune disorder causes your immune system to attack your bile ducts. PSC creates scar tissue that narrows the bile ducts and prevents bile from reaching your intestines. Over time, repeated injury to bile duct tissue can increase the likelihood of developing cancer.

11) Ulcerative colitis. Another autoimmune disease, ulcerative colitis is characterized by severe bouts of bloody diarrhea with abdominal pain and cramping.

12) Congenital abnormalities of the bile ducts. These include choledochal cysts, which is a dilation or stretching of the common bile duct, and Caroli's disease — a dilation of the bile ducts within your liver (intrahepatic ducts). Over time bile that collects in these dilated spaces may seriously damage the duct lining.

13) Bile duct stones. Gallstones sometimes escape the gallbladder and enter the cystic duct, the common bile duct or, occasionally, the duct leading to your pancreas. These migrating stones can cause serious complications, including an increased chance of developing bile duct cancer.

14) Parasitic infections. These are primarily a concern in Asian countries. Parasitic infections generally occur when humans eat fish containing the cysts of certain flatworms. The worms migrate to the bile ducts, where they damage the duct lining.

Risk Factors In Having Gallbladder Cancer (Part 1)

A number of factors may increase your risk of both gallbladder and bile duct tumors, including:

1) Gallstones. These solid deposits of cholesterol or calcium salts form in your gallbladder, they are the most common risk factor for gallbladder cancer. The stones may cause your gallbladder to release bile more slowly, which increases the amount of time cells are exposed to toxins. Although most people with gallbladder cancer also have gallstones, the vast majority of people with gallstones never develop gallbladder cancer.

2) Age. The chances of developing gallbladder cancer increase as you get older. Most people diagnosed with gallbladder cancer are in their 70s. Bile duct cancer is most common in those over 65.

3) Your sex. Women are at least twice as likely as men are to develop gallbladder cancer. They're also more likely to have gallstones because the female hormone estrogen causes more cholesterol, the main component of most gallstones, to be excreted in bile. But, bile duct cancers are more likely to occur in men than they are in women.

4) Bile duct abnormalities. The pancreatobiliary duct junction is the point where the common bile duct — which carries bile from your liver and gallbladder to your small intestine — joins the pancreatic duct carrying digestive juices from your pancreas. In some people, these two ducts connect in a way that allows pancreatic juices to back up into the bile duct and prevents bile from being quickly emptied into the small intestine. This may irritate the cells lining the gallbladder and bile ducts, increasing the risk of cancer.

5) Gallbladder polyps. These are growths on the inner surface of your gallbladder. Most aren't cancerous, but polyps can contain malignant cells.

6) Diet. Eating food high in carbohydrates and low in fiber may increase your risk of gallbladder cancer.

7) Hazardous chemicals and toxic substances. People exposed to certain industrial chemicals, especially azotoluene, have an increased risk of developing gallbladder cancer. Thorium dioxide (Thorotrast), a dye once used in X-rays, can cause both liver and bile duct cancers. Although Thorotrast hasn't been used for decades, exposure to other toxic materials — including dioxin, nitrosamines and polychlorinated biphenyls (PCBs) — may increase your risk of bile duct cancer.

Causes of Gall Bladder Cancer

Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. Its main function is to store bile, a bitter, yellow-green fluid that's produced in the liver cells. Bile is essential for the proper digestion of fats and is one of the main ways your body eliminates drugs, cholesterol and waste products of metabolism. It flows from your liver through a thin tube called the common hepatic duct and enters your gallbladder through another small tube (cystic duct).

When you eat, your gallbladder releases a highly concentrated form of bile into the common bile duct, a continuation of the hepatic and cystic ducts. The bile flows through this duct to the upper part of your small intestine (duodenum), where it begins to break down the fat in your food.

How gallbladder cancer begins?
Healthy cells grow and divide in an orderly way — a process that's controlled by DNA, the genetic material that contains the instructions for every chemical process in your body. When DNA is damaged, changes occur in these instructions. One result is that cells may begin to grow out of control and eventually form a malignant tumor — a mass of cancerous cells.

Although the exact cause of gallbladder and bile duct cancers isn't clear, researchers believe that DNA in the cells of your biliary tract may be damaged by toxins that are routinely metabolized by your liver. These toxins are released into bile so that they can be eliminated from your body. But if bile empties more slowly than normal, it increases the amount of time your cells are exposed to cancer-causing substances (carcinogens).

Most gallbladder tumors develop in the cells that line the inner surface of the gallbladder. These tumors are most commonly adenocarcinomas — a term that describes the way the cancer cells look when viewed under a microscope.

Gallbladder adenocarcinoma is highly invasive and can quickly penetrate deep into the gallbladder wall, moving through layers of tissue from the inner surface to the outside of the gallbladder. Eventually the cancer may spread to nearby lymph nodes, obstruct the bile duct or invade other organs such as the liver. Cancer cells may also travel through the bloodstream to more remote parts of the body.

Bile duct cancer (cholangiocarcinoma)
Cancer can develop in any part of the bile duct that stretches from your liver to your small intestine. Many tumors occur in the hepatic duct just as it leaves the liver (perihilar tumors). Other tumors may develop in the bile duct near your small intestine (distal tumors) or inside the liver itself (intrahepatic tumors).

The majority of bile duct cancers are adenocarcinomas that originate in the mucous glands lining the inside of the ducts. By the time these cancers are diagnosed, they often have spread to other tissues and organs.

Gallbladder Cancer and its Symptoms

Gallbladder cancer and bile duct cancer are rare cancers of the biliary tract. Your gallbladder stores and your bile duct transports bile, a fluid produced by your liver that's essential to the digestive process.

Gallbladder cancer seldom produces symptoms in the early stages. In fact, early gallbladder cancer is often only discovered when the gallbladder is removed as a treatment for gallstones. Otherwise, gallbladder cancer is often quite advanced by the time it's diagnosed.

When gallbladder cancer is caught early, removing your gallbladder or part of the bile duct may eliminate all the cancerous cells. In advanced cases, treatment won't cure gallbladder cancer but can help relieve symptoms and improve your quality of life.

Gallbladder cancer rarely produces early signs and symptoms. When symptoms do appear, they often resemble those of other, more common, gallbladder problems such as gallstones or infection. Gallbladder cancer symptoms include:

1) Abdominal pain. Many people with gallbladder cancer have some abdominal pain — usually in the upper right part of the abdomen.

2) Nausea and vomiting. These symptoms can occur when a tumor blocks the common bile duct.

3) Yellowing of your skin and the whites of your eyes (jaundice). Jaundice results from high blood levels of bilirubin — the residue from the breakdown of red blood cells. Normally, bilirubin is metabolized in your liver and eliminated through the bile ducts. But a blocked bile duct can cause bilirubin to accumulate in your blood. The built-up pigments may turn your skin and the whites of your eyes yellow and your urine dark brown. Because bilirubin isn't being eliminated through your bile, your stools also may turn pale yellow or white.

4) Unintended weight loss or loss of appetite. Tumors can prevent the normal passage of food or interfere with its absorption by blocking the flow of pancreatic enzymes.