Q: What is the gallbladder?
A: The gallbladder is a pear-shaped organ found under the liver in the upper-right abdomen.
The gallbladder stores bile, a fluid made by the liver. Bile helps digest the fat in the food you eat. Bile is released from the gallbladder through a tube called the common bile duct. This tube connects the gallbladder and liver to the duodenum, the first part of the small intestine.
Q: Do gallstones cause gallbladder cancer?
A: Gallstones are the most common risk factor for gallbladder cancer. About 3 out of 4 people with gallbladder cancer have gallstones at the time of diagnosis. Doctors believe that large gallstones grow over a long time, irritating the gallbladder wall and increasing the risk for gallbladder cancer. Although gallstones are common, very few people with them will get gallbladder cancer.
Q: Who else is at risk for gallbladder cancer?
A: People who fit into these categories are at higher risk for gallbladder cancer:
Mexican Americans and American Indians
People who are obese
People who work in rubber plants or textile industries
People with bile duct abnormalities
People with a so-called porcelain gallbladder, which occurs when the gallbladder wall contains calcium
People with cysts in the bile duct
Those with chronic typhoid and paratyphoid infection
Those with gallbladder polyps, especially ones that are larger than 1 cm (about one-half inch)
People with a family history of gallbladder cancer
Gallbladder cancer is not common, so just because you have 1 or more risk factors does not mean you will definitely get gallbladder cancer. In fact, you can have many known risk factors and still not develop the disease. On the other hand, you can have no risk factors and still get gallbladder cancer.
Q: What are the symptoms of gallbladder cancer?
A: There may be no symptoms in the early stages. The signs and symptoms of gallbladder cancer are like those of gallstones or an inflamed gallbladder. Common symptoms include the following:
Pain or discomfort in the right side of the upper abdomen
A sense of fullness after eating
Nausea and vomiting
Loss of appetite
Loss of weight without trying
Yellowing of the skin (jaundice) or the white area of the eyes, called the sclera
Q: How is the diagnosis of gallbladder cancer made?
A: If you're having gallbladder-cancer-like symptoms, your doctor will ask you about your medical history, family history of cancer, and other risk factors. The doctor will do a physical exam and may order X-rays and other tests.
Your doctor may order either an ultrasound or a CT scan of your abdomen. If these scans show any abnormality near the gallbladder, the doctor may request a biopsy. A biopsy is the removal of a sample of tissue that a specialist looks at under a microscope to check for cancer cells. It's common for the biopsy to be done with the aid of a CT scan, which locates the tumor. This is called a CT scan-guided biopsy. Your doctor inserts a needle into the tumor to take out some tissue. Sometimes a biopsy needs to be done in an operating room.
Q: What does it mean when my doctor talks about the stage of my gallbladder cancer?
A: Stage is the word doctors use to describe the extent of a cancerous tumor as well as where and how far it has spread. The stage of the cancer affects the choices for treatment.
Q: How is gallbladder cancer treated?
A: Gallbladder cancer may be treated in any of these ways:
A combination of the above
Surgery is a common treatment for gallbladder cancer if it is confined to the gallbladder or has spread only to areas directly around the gallbladder. The goal of surgery is often to take out all or as much of the tumor as possible. The whole gallbladder and surrounding tissues may have to be taken out. More extensive surgery may be done if your cancer is more advanced. Sometimes surgery is done to ease symptoms rather than to remove the whole tumor.
Chemotherapy uses drugs to kill the cancer cells that have spread beyond the gallbladder. It helps reduce the chance that the cancer will spread further.
Radiation therapy may be used after surgery, or it may be used instead of surgery to treat more advanced cancers (often along with chemotherapy). Radiation uses high-energy X-rays to kill cancer cells in a specific area.
Q: Should everyone get a second opinion if they are told they have gallbladder cancer?
A: Many people with cancer get a second opinion from another doctor. There are many reasons to get a second opinion. These are some of those reasons:
Feeling uncomfortable with the treatment decision
Being diagnosed with a rare type of cancer
Having different options for how to treat the cancer
Not being able to see a cancer expert
Q: How can someone get a second opinion?
A: There are many ways to get a second opinion:
Ask your primary doctor. Your doctor may be able to recommend a specialist. This may be a surgeon, medical oncologist, or radiation oncologist. Sometimes these doctors work together at cancer centers or programs.
Call the National Cancer Institute's Cancer Information Service. The number is 800-4-CANCER (800-422-6237). This service provides information about treatment facilities, including cancer centers and other programs supported by the National Cancer Institute.
Seek other options. Check with a local medical society, hospital, medical school, or cancer advocacy group to get the names of doctors who can give you a second opinion. Or ask other people who have had your type of cancer.
Q: What is a cholecystectomy?
A: A cholecystectomy is an operation in which the gallbladder is taken out. A more extensive surgery also takes out part of the liver around the gallbladder, nearby lymph nodes, and sometimes other nearby tissues or organs. The lymph nodes act as filters that help trap and remove cancer cells and other unwanted substances from the body.
Q: What are clinical trials?
A: Clinical trials are studies of new kinds of cancer treatments. Doctors and nurses conduct clinical trials to learn about how well new treatments work and what their side effects are. If a treatment looks promising, it is then compared with the current treatment to see if it works better or has fewer side effects. It is difficult to estimate the benefit that you may have from getting a new treatment. However, people who participate in these studies help further the understanding of cancer and help people who may develop cancer in the future.