Gallbladder Cancer

What is gallbladder cancer?

Gallbladder cancer is rare but it is the most common type of malignancy of the bile tract. A malignancy is an invasive, uncontrolled growth of cells that can spread.

How does it occur?

The digestive tract (mouth, esophagus, stomach, and large and small intestines) plus the liver, gallbladder, and pancreas make up the digestive system. The gallbladder, which is linked by small ducts to the liver and small intestine, acts as a storehouse for bile, the substance needed to digest fats. After you eat a meal, your gallbladder empties bile into the intestine to help you digest your food, especially fats. A tumor in the gallbladder can invade the liver and block the flow of bile, which then leads to many of the symptoms.

The cause of gallbladder cancer is not known. Most people who have gallbladder cancer also have gallstones. However, for a person with gallstones the risk of getting cancer is very low.

What are the symptoms?

The symptoms of gallbladder cancer are similar to the symptoms of gallstones. The symptoms of gallbladder cancer include:

• loss of appetite
• weight loss
• nausea
• vomiting
• pain or discomfort in the upper right side of the abdomen
• jaundice (a yellow coloring of the skin and whites of the eyes caused by bile building up in the body)
• itching of the skin.

How is it diagnosed?

During a physical exam, your healthcare provider may be able to feel that you have a lump in the upper right part of your abdomen, just below the ribs. You may have special X-ray exams and a blood test. However, gallbladder cancer is difficult to diagnose. Gallbladder cancer is usually found unexpectedly during surgery to remove gallstones.

How is it treated?

If the tumor is only in the lining of the gallbladder, you need a cholecystectomy, which is surgery to remove the gallbladder. If the tumor is more advanced, you need a radical resection. In a radical resection, the surgeon removes the gallbladder and lymph nodes in the area, plus part of the liver. The surgery provides a chance for cure and can relieve symptoms caused by blockage of bile flow from the liver to the small bowel (pain, jaundice, itching, loss of appetite).

Radiation therapy (high doses of radiation to kill the cancer cells) and chemotherapy (anticancer drugs) are not usually used to treat gallbladder cancer because these treatments have not yet been shown to be effective.

How long will the effects last?

If you have a tumor that is only in the lining of the gallbladder, you have a good chance of cure if your gallbladder is removed. If your cancer was large enough to involve the liver or local lymph nodes, then the chance of cure is lower and depends on the success of the radical resection.

If the cancer has metastasized (spread), your chances of recovery are far less. During metastasis, the tumor in your gallbladder sheds cancer cells that travel through the bloodstream and lymphatic system and lodge in other parts of the body, where the cancer cells begin to grow new tumors. If your cancer has metastasized, talk to your healthcare provider about your prospects for cure.

How can I take care of myself?

Talk to your healthcare provider about any concerns you have regarding the course of your illness and treatments. Ask about side effects you may have from treatments. You may want to make a list of questions at home and take it with you when you visit your provider. Ask a friend to go with you who can listen, too. If you don't understand a word or concept, ask your provider to explain it. Take notes if you need to.

When compiling a list of questions, you might consider the following:

• How far advanced is the cancer? Your healthcare provider may talk about the stage of the cancer. Ask what this means.
• To where has it metastasized (spread)?
• What type of treatment is possible?
• How effective is the treatment for gallbladder cancer?
• What are the benefits and risks of having treatment or of not having treatment?
• What are the complications of treatment?
• By how many months or years will the treatment increase my life span?
• If I begin having pain, will you give me medicine to control it?
• Is there a support group in the area for people with cancer and for their family members?
• May I continue to lead as normal a life as possible as long as I feel up to it? School? Work? Sex? Travel?
• What are alternative methods for pain control? What about relaxation techniques, guided imagery, hypnosis?
• Are my children prone to gallbladder cancer?
• What about alternative treatments such as diet, herbs, vitamins?
• Should I be on a special diet?

It is important to eat a balanced diet, get plenty of rest, and follow the advice of your healthcare provider. It is helpful to lessen stress in your life and take time to relax.

For more information, contact:

• American Cancer Society, Inc.
  800-ACS-2345 (800-227-2345)
  http://www.cancer.org
• AMC Cancer Research Center and Foundation
  800-525-3777
  http://www.amc.org
• Cancer Information Service
  800-4-CANCER (800-422-6237)
  http://cis.nci.nih.gov

What can be done to help prevent gallbladder cancer?

Since gallbladder cancer is a rare cancer of unknown cause, there is no known way to prevent it.