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Gallbladder and Bile Duct Cancers

Seed by Seed, Fruit by Fruit

Hello, Tutti!

We trust you had an amazing and fruitful week, and that this new week is off to a great start. In this newsletter, we delve into the world of Gallbladder and Bile Duct Cancers, reflect on the impactful World Cancer Day, and explore how you can use your voice to make a difference at a higher level.

If you want to be a change-maker and urge your government to champion health equity, improve cancer service access, and reduce disparities, check out this link to submit your letter through the Union for International Cancer Control (UICC).

Our Tutti family is also making a significant impact in David's life for the second time, and we're excited to introduce our next warrior, who we will support during the mint when we reach the 100 mint milestone.

Yesterday, we gathered in a Twitter space to mark something significant – World Cancer Day.

Why does this day matter? It's not just about raising awareness; it's a collective effort to close the gap in cancer care worldwide. Shockingly, half the world lacks access to essential health services. When it comes to cancer, basic care is denied to many, creating a real issue known as the Equity Gap.

Factors like income, education, location, age, and discrimination form barriers for those seeking cancer care. This gap isn't confined to low-income countries; it touches lives everywhere, possibly even someone you know. Bridging this gap is about ensuring everyone, regardless of their circumstances, has the opportunity for quality cancer care.

Gallbladder and Bile Duct Cancers: Navigating Complexity

Gallbladder and bile duct cancers, also known as cholangiocarcinoma or biliary cancers, are relatively uncommon. These cancers manifest in different forms, each named based on their origin. Intrahepatic bile duct cancer initiates in the ducts inside the liver, while extrahepatic bile duct cancer starts in the ducts outside the liver. Gallbladder cancer begins in the walls of the gallbladder.

Understanding the Anatomy:

The liver produces bile, a digestive juice. Tiny passageways called bile ducts collect the bile, forming the main bile duct just outside the liver. The gallbladder, a pouch off the side of the main duct, stores bile between meals.

Types of Biliary Cancers:

  1. Intrahepatic Cholangiocarcinomas: These start in the tiny ducts inside the liver. They often grow into large tumors without causing early symptoms.

  2. Hilar Cholangiocarcinomas: Originating in larger ducts outside the liver, these tumors can cause bile duct narrowing, leading to jaundice. Surgical removal may involve part of the liver.

  3. Gallbladder Cancer: Frequently linked to gallstones causing irritation, these tumors can grow large before detection due to a lack of early symptoms.

  4. Distal Cholangiocarcinomas: These form in the lower part of the bile duct, leading to jaundice. Surgical removal often requires complex procedures like the Whipple procedure.

Intrahepatic cholangiocarcinomas, starting from tiny ducts inside the liver, are known for their adaptability and potential to grow into large tumors before detection. This makes early detection crucial, as symptoms may not manifest until the cancer has progressed significantly.

Risk Factors:

Understanding the risk factors associated with gallbladder and bile duct cancers is crucial for early detection and preventive measures. While some factors are beyond control, awareness can aid in monitoring and timely intervention.

  1. Gallstones: Persistent presence of gallstones can increase the risk of gallbladder cancer. These are solid particles that form in the gallbladder.

  2. Primary Sclerosing Cholangitis (PSC): An autoimmune disease causing inflammation of the bile ducts, elevating the risk of cholangiocarcinoma. PSC is a chronic condition that damages the bile ducts.

  3. Choledochal Cysts: Congenital conditions involving cysts in the bile ducts may increase the risk. These cysts are present at birth and can affect bile flow.

  4. Chronic Bile Duct Infections and Inflammation: Prolonged inflammation and infections can contribute to cancer development. Inflammation in the bile ducts over time may lead to cancer.

  5. Age and Gender: Incidence increases with age, and women are more prone to gallbladder cancer. It is more common in individuals over 70 years of age.

  6. Ethnicity: Certain populations may have a higher predisposition to bile duct cancers. For example, Native Americans have a higher incidence.

  7. Liver Fluke Infection: In regions where liver flukes are prevalent, there's an elevated risk of bile duct cancer. Ingesting raw or undercooked fish containing fluke larvae can lead to infection.

  8. Family History: A family history of these cancers may increase individual susceptibility. If close relatives have had bile duct or gallbladder cancer, there might be a genetic component.

Stay informed about potential risk factors such as age, geographical location, and underlying conditions. Regular health check-ups and lifestyle adjustments can contribute to early detection and prevention.


While not all risk factors can be eliminated, adopting a healthy lifestyle can contribute to prevention. Recommendations include:

  1. Healthy Diet: A balanced diet rich in fruits, vegetables, and whole grains. It's essential to minimise the intake of processed foods and saturated fats.

  2. Maintaining a Healthy Weight: Obesity is linked to an increased risk of gallbladder cancer. Regular exercise and a balanced diet can help in weight management.

  3. Regular Exercise: Physical activity supports overall health and may reduce cancer risk. Aim for at least 150 minutes of moderate-intensity exercise per week.

  4. Limiting Alcohol Consumption: Excessive alcohol intake is associated with an increased risk. Moderation is key to minimizing this risk.

  5. Treating and Managing Gallstones: Seek medical attention for gallstone-related issues. Prompt treatment of gallstones can reduce the risk of associated cancers.

Embrace a health-conscious lifestyle, incorporating balanced nutrition, regular exercise, and routine check-ups to minimise the risk of bile duct cancer.


Early detection relies on recognising potential symptoms. While these can vary, common signs include:

  1. Abdominal Pain: Particularly in the upper right side. Persistent or severe pain should be evaluated.

  2. Jaundice: Yellowing of the skin and eyes. This may indicate bile duct obstruction.

  3. Unexplained Weight Loss: Significant weight loss without apparent cause. Sudden and unexplained weight loss should be investigated.

  4. Changes in Bowel Habits: Such as light-colored stools. Changes in bowel habits, especially if persistent, should be addressed.

  5. Nausea and Vomiting: Especially after meals. Persistent nausea and vomiting may be indicative of bile duct issues.

  6. Abdominal Bloating: Feeling full or bloated after eating small amounts. Unexplained abdominal bloating should be evaluated.

    Don't hesitate to prioritise your well-being and seek guidance when needed.


Timely diagnosis involves a combination of medical history, physical examinations, and diagnostic tests:

  1. Imaging Studies: CT scans, MRIs, and ultrasounds help visualize the structures. These imaging techniques provide detailed information about the gallbladder and bile ducts.

  2. Blood Tests: Liver function tests and tumor marker tests may provide relevant information. Abnormalities in liver function tests may indicate bile duct issues.

  3. Biopsy: Tissue samples may be obtained for laboratory analysis to confirm cancer. This involves extracting a small sample of tissue for microscopic examination.

  4. Endoscopic Procedures: Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) can aid in diagnosis. These procedures involve using a flexible tube with a camera to examine the bile ducts.

  5. Exploratory Surgery: In some cases, surgery may be necessary for a definitive diagnosis. Surgical exploration may be required to visually inspect and obtain samples.

Regular check-ups and screenings can significantly contribute to early detection and improved outcomes.

Treatment Approaches:

Biliary cancers are complex, and treatment involves various approaches:

  1. Surgery: Complex surgical procedures are common. Specialized techniques, learned from extensive experience, are applied to reconstruct blood vessels and bile ducts.

  2. Chemotherapy and Radiation: Crucial in treating these cancers, chemotherapy may be administered before or after surgery. Genomic sequencing is performed to target specific genetic mutations, enhancing treatment efficacy. Radiation is employed when surgical removal is challenging.

  3. Transplantation: In cases where surgical removal isn't possible, transplantation is considered, especially for hilar cholangiocarcinoma. Mount Sinai prioritizes such patients on the transplant waiting list, offering a unique treatment approach.

Incidence Rates:

  1. Gallbladder Cancer Incidence:

    • Gallbladder cancer is more prevalent in certain regions, with higher rates reported in parts of South America, Asia, and Eastern Europe.

    • India has one of the highest incidences globally, attributed to factors like gallstones and genetic predisposition.

  2. Bile Duct Cancer Incidence:

    • The incidence of bile duct cancers, also known as cholangiocarcinoma, varies geographically.

    • Regions with a higher prevalence include Southeast Asia, where liver fluke infections contribute to the increased risk.

Survival Rates:

Survival rates for gallbladder and bile duct cancers depend on factors such as stage at diagnosis, treatment options, and individual patient characteristics. Here are general insights into survival rates:

  1. Gallbladder Cancer:

    • Localized Stage: When the cancer is confined to the gallbladder, the 5-year survival rate is around 80%.

    • Regional Spread: If the cancer has spread to nearby tissues or lymph nodes, the 5-year survival rate drops to approximately 50%.

    • Distant Metastasis: In cases where the cancer has spread to distant organs, the 5-year survival rate decreases significantly, often below 20%.

  2. Bile Duct Cancer (Cholangiocarcinoma):

    • Localized Stage: Early detection and localized tumors offer a 5-year survival rate of around 30-50%.

    • Regional Spread: Once the cancer extends beyond the bile ducts, the 5-year survival rate decreases to approximately 10-20%.

    • Distant Metastasis: Advanced stages with distant metastasis result in a much lower 5-year survival rate, often below 5%.

Challenges and Considerations:

  • Both gallbladder and bile duct cancers are often diagnosed at advanced stages, impacting overall survival rates.

  • Limited awareness, nonspecific symptoms, and challenges in early detection contribute to delayed diagnosis.

Coping with diet problems caused by bile duct cancer:

Appetite and Weight Loss: Many warriors with bile duct cancer experience a loss of appetite, and some may undergo weight loss. In cases of jaundice, where it becomes challenging for the body to absorb fat from the diet, dietary adjustments may be necessary. Supplements might be recommended to enhance calorie intake, and avoiding fatty foods until jaundice is addressed could be advised.

Eating Patterns: Opting for numerous small meals throughout the day, rather than adhering strictly to the conventional three meals, can be more manageable. Having a variety of nutritious snacks readily available allows flexibility in eating whenever there is a desire. Choosing full-fat versions of yogurts and puddings is recommended for maximizing calorie intake.

Snack Ideas from L2F:

Our friends at L2F suggest some delightful snack ideas that can be both tasty and nutritious:

Foods to Be Cautious About:

It's important to be mindful of certain foods that may increase the risk of gallbladder problems

If you have specific dietary concerns or restrictions, consulting with a healthcare professional or dietitian is recommended.

Supporting Cancer Warriors: David's Journey

In our ongoing commitment to make a meaningful impact on the lives of cancer warriors, we recently extended our support to David, a talented photographer and a resilient cancer warrior. With the sale of 5% of our ETH collection, we purchased one of David's unique NFTs, contributing to both his artistic endeavors and his journey as a cancer warrior. As a community, we listed David's NFT, and a bid of 0.07 ETH ($162) has been placed. All proceeds from this sale will directly benefit David, providing vital support for his ongoing challenges.

Upcoming Warrior: Donna's Inspiring Story

Our next courageous warrior is Donna, an exceptional photographer and a source of inspiration for all. Donna has faced breast cancer with incredible strength, embodying the spirit of a true warrior. Specialising in captivating black and white Nature and Landscape Photography, she adds her unique touch to the picturesque landscapes of Colorado.

As a community, we are just 35 NFTs away from reaching the 100-mint milestone on #shibarium. Once achieved, we will support Donna by acquiring some of her remarkable NFTs. These will be sold within our community, and all proceeds will go directly to Donna, reinforcing our commitment to stand with her on her journey.

Explore Donna's world and immerse yourself in the captivating beauty she captures through her lens. Visit her Linktree to discover more about her photography, experiences, and the incredible journey she's embraced.

Nurturing Hope and Building Bridges

As we wrap up this newsletter, let's reflect on the diverse spectrum of topics we've explored – from the significance of World Cancer Day and the global efforts to close the cancer care gap to the intricacies of gallbladder and bile duct cancers. We've delved into the statistics, risk factors, symptoms, and prevention strategies, empowering ourselves with knowledge to make informed decisions.

Our collective journey also extends beyond information-sharing; it encompasses real impact through our support programs for cancer warriors like David and upcoming warrior Donna. By leveraging the strength of our community, we're not just raising awareness; we're fostering hope, building bridges, and making a tangible difference in the lives of those affected by cancer.

Thank You for Being the Heartbeat of TFW!

Your presence, engagement, and commitment make TFW the awesome community it is. Thank you for reading this newsletter, for actively contributing to our shared journey towards a healthier community. Your bravery in keeping the conversation alive and breaking the silence around cancer is inspiring. Together, we're making waves, and we're grateful to have you as a vital part of the TFW family. Until next time, stay bold, stay beautiful and keep thriving!

Please note: The information provided in this newsletter is for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your qualified health provider with any questions you may have regarding a medical condition.

If you found this newsletter informative and valuable, please consider sharing it with your friends and family. You can also collect it for just 5 $MATIC, a contribution that goes directly to our donation wallet (0x83F371C97B80BD9BbA4330164F0Bf47E857577DC), supporting cancer warriors on their journey.

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