What is gallbladder cancer?

Gallbladder cancer is the most common type of malignancy of the bile tract. A malignancy is a harmful, uncontrolled growth of cells. Gallbladder cancer is rare in the U.S. It occurs slightly more in women than in men and in people over the age of 60.

How does it occur?

The digestive tract (mouth, stomach, large and small intestines), 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 blocks the flow of bile, which then leads to many of the symptoms of gallbladder cancer.

There is no known cause for gallbladder cancer. Most of those 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 include the following:

• loss of appetite (anorexia)

• weight loss

• nausea

• vomiting

• pain 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 doctor may be able to feel that you have a large liver and gallbladder. Your doctor may want you to have blood tests. However, gallbladder cancer is difficult to diagnose. It is usually found unexpectedly during surgery to remove gallstones.

Most people who have gallbladder cancer also have gallstones. The formation of gallstones (cholelithiasis) is the most common type of gallbladder disease. Gallstones are most common in older women, but gallbladder cancer is more common in men.

How is it treated?

If the tumor is only in the lining of the gallbladder, you need a cholecystectomy, surgery to remove the gallbladder. If the tumor has spread, you need a radical resection. In a radical resection, your doctor removes the gallbladder in addition to lymph nodes in the area and the rim of the liver. The surgery helps to decrease symptoms caused by the backup of bile.

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 with surgery to remove the gallbladder.

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 doctor about your prospects for cure.

How can I take care of myself?

Talk to your doctor 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 doctor. Ask a friend to go with you who can listen, too. If you don't understand a word or concept, ask your doctor 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?

1. 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?

• What about alternative treatments such as diet, herbs, vitamins?

• Should I be on a special diet?

• May I continue to lead as normal a life as possible as long as I feel up to it? School? Work? Sex? Travel?

• If I begin having pain, will you give me medication to control it?

• What are alternative methods for pain control? What about relaxation techniques, guided imagery, hypnosis?

• Are my children prone to gallbladder cancer?

• Is there a support group in the area for people with cancer and for their family members?

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

For more information, write or call:

• AMC Cancer Information
  Phone: 1-800-525-3777

• American Cancer Society, Inc.
  1599 Clifton Road, NE
  Atlanta, Georgia 30329-4251
  Phone: 1-800-ACS-2345

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.