Gallbladder cancer is rare. The American Cancer Society estimates that in 2007, approximately 9,000 people in the United States will be diagnosed with the disease. The gallbladder is an organ of the gastrointestinal (digestive) system. Almost all gallbladder cancers begin in the tissue on the side of the gallbladder. The tumors become more ominous as they invade deeper into the tissue, pushing through to the outside. The tumor may also grow to fill some or all of the space inside the gallbladder. It may spread to lymph nodes, the liver, and other parts of the body.
Even though gallbladder cancer is rare, physicians at The Cancer Center are highly experienced in diagnosing and treating the disease. The Cancer Center features many unique and innovative services to treat gallbladder cancer:
- board-certified gastroenterologist, surgical oncologist who specialize in gastrointestinal cancers, medical oncologists and radiation oncologists who are skilled at treating gallbladder cancer
- complex surgical procedures
- sophisticated diagnostic testing and imaging studies
- clinical trials to investigate new medications and treatment methods
- a full range of support services
Cancer of the gallbladder can be hard to diagnosis because the gallbladder is hidden behind other organs in the abdomen. Often, gallbladder cancer is found after the organ is removed for other reasons, such as gallstones or long-term inflammation. The Cancer Center provides the following services to diagnose gallbladder cancer:
- physical exam to check for masses or fluid accumulation, signs of jaundice (yellowing of the skin and whites of the eyes), and enlarged lymph glands
- lab tests
- CT scan
- cholangiography (X-rays of the bile ducts using a contrast dye)
- ERCP (endoscopic retrograde cholangiopancreatography), an endoscopic test to view the small intestines, bile ducts, and pancreatic ducts to help plan surgery
- laparoscopy (to plan surgery or stage cancer, remove tissue samples, or remove the gallbladder)
- tissue biopsy or fine needle aspiration biopsy
Gallbladder cancer is more common in women and more common in people who have gallstones.
Cancer of the gallbladder can be hard to find. It is often found after the gallbladder is removed for other reasons. Symptoms include pain above the stomach, loss of weight without dieting, fever, and jaundice (yellowing of the skin and whites of the eyes).
Surgery is the most common treatment for gallbladder cancer. Surgery may be combined with radiation therapy and/or chemotherapy. Surgery for gallbladder cancer can be complicated and should be performed by a surgical oncologist with years of experience such as those at The Cancer Center. Some gallbladder surgery can be accomplished using minimally invasive laparoscopic techniques, which reduce pain, scarring, bleeding, the length of the hospital stay, and the recuperation period.
There are several types of surgery used to treat gallbladder cancer:
- simple cholecystectomy (removal of the entire gallbladder)
- extended cholecystectomy (removal of the gallbladder, some liver tissue, and all lymph nodes in the region)
- radical gallbladder resection (removal of the gallbladder, a section of the liver, the common bile duct, part or all of the ligament that runs between the liver and intestines, lymph nodes around the pancreas, the vein that brings blood to the liver from the stomach and intestines, and around the artery that brings blood to most of the small intestine and to the pancreas)
These types of surgery may be combined with removal of the gallbladder if cancer has spread to surrounding organs and structures:
- segmental hepatic resection
- hepatic lobectomy
- colon resection
- biliary bypass
- biliary stent or catheter
External beam radiation therapy may be used as an adjuvant (additional) therapy to kill remaining cancer cells after surgery. It may be used as the primary treatment for cancers that have spread too far for surgical removal, or as a palliative (ease) treatment to relieve pain and/or other symptoms
In some cases, chemotherapy may be used as an adjuvant (additional therapy) in conjunction with radiation therapy after surgery or to treat cancer that has spread beyond the gallbladder.