Gallbladder Cancer

Gallbladder cancer is relatively rare worldwide but has one of the world's highest rates in India — particularly in the Gangetic belt (Uttar Pradesh, Bihar, West Bengal, Assam) and among women. It is often diagnosed late because early symptoms are vague or absent.

Risk factors

• Gallstones — long-standing, particularly large stones (>3 cm).
• Porcelain gallbladder (calcified wall).
• Chronic gallbladder infection — typhoid carrier state has been linked.
• Polyps over 1 cm.
• Female sex, age, obesity, diabetes, family history.
• Specific geography — north Indian Gangetic basin has substantially higher rates.
• Chronic exposure — heavy metals in water, tobacco, heavy chilli/mustard oil use (some associations, not fully established).

Symptoms — often late

• Persistent right-upper abdominal pain.
• Loss of appetite, weight loss.
• Jaundice.
• Palpable right-upper lump.
• Nausea, vomiting.
• Early disease may be silent — sometimes found incidentally when a gallbladder is removed for stones.

Diagnosis

Ultrasound, CT, MRI; CA 19-9 (supportive); biopsy or the specimen after surgery. Incidental gallbladder cancer found on pathology after a cholecystectomy for stones is a specific pathway — prompt referral to a hepatobiliary surgeon matters.

Treatment

• Early-stage — surgery (radical cholecystectomy or extended resection) can be curative.
• Advanced-stage — chemotherapy +/- targeted therapy; biliary stenting for jaundice; palliative care.
• Care at a specialised hepatobiliary / GI-oncology centre matters — it changes both surgical decisions and outcomes.
• Ayushman Bharat PM-JAY and state schemes often cover for eligible patients.

Prevention and early detection

• Symptomatic gallstones should be operated — not left for years.
• Gallbladder polyps over 1 cm — surgical removal is generally recommended.
• "Porcelain gallbladder" — often removed preventively.
• Chronic typhoid carrier state — stool test and treatment where relevant.
• Safe water and food hygiene — reduces typhoid in endemic areas.