Gallbladder Cancer: Get Facts on Stages and Treatment

Gallbladder cancer facts*

*Gallbladder cancer facts by John P. Cunha, DO, FACOEP

Gallbladder cancer is a rare disease in which malignant (cancer) cells form in the tissues of the gallbladder.
Risk factors for gallbladder cancer include being female, and Native American.
Symptoms of gallbladder cancer include jaundice (yellowing of skin and whites of eyes), pain, fever, nausea and vomiting, bloating, and lumps in the abdomen.
Gallbladder cancer is difficult to detect and diagnose because there often are no noticeable signs in the early stages. When there are symptoms they often resemble other illnesses, and the gallbladder is hidden behind the liver.
Ultrasound, liver function tests, carcinoembryonic antigen (CEA) or CA 19-9 assay, CT scan, MRI, X-ray, biopsy, and blood tests can help diagnose gallbladder cancer.
Gallbladder cancer can be cured only if it is found before it has spread, when it can be removed by surgery. Other treatments include radiation and chemotherapy.

Gallbladder cancer is a disease in which malignant (cancer) cells form in the tissues of the gallbladder.

Gallbladder cancer is a rare disease in which malignant (cancer) cells are found in the tissues of the gallbladder. The gallbladder is a pear-shaped organ that lies just under the liver in the upper abdomen. The gallbladder stores bile, a fluid made by the liver to
help digest fat. When food is being broken down in the stomach and intestines, bile is released from the gallbladder through a tube called the common bile duct, which connects the gallbladder and liver to the first part of the small intestine.

The wall of the gallbladder has 3 main layers of tissue.

Mucosal (innermost) layer.
Muscularis (middle, muscle) layer.
Serosal (outer) layer.

Between these layers is supporting connective tissue. Primary gallbladder cancer starts in the innermost layer and spreads through the outer layers as it grows.

Could weight gain increase your risk for gallbladder cancer?

Weight Gain & Cancer Risk

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

Excess weight is a known risk factor for many chronic diseases, such as
diabetesand heart disease. Obesityhas also been linked an increased risk for
developing some cancers. To clarify the effects of weight gain on cancer risk,
researchers in 2007 conducted an analysis of many studies reported in medical
journals that describe 282,137 cases of cancer. The researchers wanted to see if
weight gain had an effect on the risk for certain cancer types.

In particular, the researchers looked at the risk of cancer associated with a
weight gain corresponding to an increase of 5 kg/m² in body mass index (BMI). In
terms of actual pounds gained, a man with a normal-range BMI of 23 would need to
gain 15 kg (33 lbs.) of weight, while a woman with a BMI of 23 would need to
gain 13 kg (28.6 lbs.) to correspond to an increase of 5 in the BMI.

The results, published in the Lancet in February 2008, revealed that weight
gain is positively associated with the risk of developing a variety of types of
cancer as described below.

For women, a weight gain corresponding to an increase of 5 in the BMI
resulted in a significant increase in risk for developing four cancer types:

esophageal adenocarcinoma(double the risk),
endometrial cancer(slightly more than double the risk),
gallbladder cancer (slightly more than double the risk), and
kidney (renal) cancer.

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Treatment Option Overview

There are different types of treatment for patients with gallbladder cancer.

Different types of treatments are available for patients with gallbladder cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.

Three types of standard treatment are used:

Surgery

Gallbladder cancer may be treated with a cholecystectomy, surgery to remove the gallbladder and some of the tissues around it. Nearby lymph nodes may be removed. A laparoscope is sometimes used to guide gallbladder surgery. The laparoscope is attached to a video camera and inserted through an incision (port) in the abdomen. Surgical instruments are inserted through other ports to perform the surgery. Because there is a risk that gallbladder cancer cells may spread to these ports, tissue surrounding the port sites may also be removed.

If the cancer has spread and cannot be removed, the following types of palliative surgery may relieve symptoms:

Surgical biliary bypass: If the tumor is blocking the small intestine and bile is building up in the gallbladder, a biliary bypass may be done. During this operation, the gallbladder or bile duct will be cut and sewn to the small intestine to create a new pathway around the blocked area.
Endoscopic stent placement: If the tumor is blocking the bile duct, surgery may be done to put in a stent (a thin, flexible tube) to drain bile that has built up in the area. The stent may be placed through a catheter that drains to the outside of the body or the stent may go around the blocked area and drain the bile into the small intestine.
Percutaneous transhepatic biliary drainage: A procedure done to drain bile when there is a blockage and endoscopic stent placement is not possible. An X-ray of the liver and bile ducts is done to locate the blockage. Images made by ultrasound are used to guide placement of a stent, which is left in the liver to drain bile into the small intestine or a collection bag outside the body. This procedure may be done to relieve jaundice before surgery.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

New types of treatment are being tested in clinical trials. These include the following:

Radiosensitizers

Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Treatment Options for Gallbladder Cancer

Localized Gallbladder Cancer

Treatment of localized gallbladder cancer may include the following:

Surgery to remove the gallbladder and some of the tissue around it. The liver and nearby lymph nodes may also be removed. Radiation therapy with or without chemotherapy may follow surgery.
Radiation therapy with or without chemotherapy.
A clinical trial of radiation therapy with radiosensitizers.

Check for clinical trials from NCI’s PDQ Cancer Clinical Trials Registry that are now accepting patients with localized gallbladder cancer.

Unresectable Gallbladder Cancer

Treatment of unresectable gallbladder cancer may include the following:

Radiation therapy as palliative treatment, with or without surgery or the placement of stents, to relieve symptoms caused by blocked bile ducts.
Surgery as palliative treatment to relieve symptoms caused by blocked bile ducts.
Chemotherapy as palliative treatment to relieve symptoms caused by the cancer.
A clinical trial of internal radiation therapy or radiosensitizers.
A clinical trial of chemotherapy.

Check for clinical trials from NCI’s PDQ Cancer Clinical Trials Registry that are now accepting patients with unresectable gallbladder cancer.

Recurrent Gallbladder Cancer

Treatment of recurrent gallbladder cancer depends on where the cancer has
recurred. It is usually done in a clinical trial.

Information about ongoing clinical trials is available from the NCI Web site.

Check for clinical trials from NCI’s PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent gallbladder cancer.

QUESTION

Cancer is the result of the uncontrolled growth of abnormal cells anywhere in the body.
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