Gallbladder Cancer

It’s relatively rare and there aren’t routine screenings for it, but that doesn’t mean we can’t fight it with the region’s best collection of therapies, technology and specialists.

Fighting an uncommon cancer with uncommon capabilities.

A Rarity

Gallbladder cancer is relatively rare, and there aren’t routine screenings to check for it. But that doesn’t mean we can’t fight it with the region’s best collection of therapies, technology, physicians and specialists. In fact, at INTEGRIS and the INTEGRIS Cancer Institute, that’s exactly what we will do. We’ll be with you every step of the way, from diagnosis and education to treatment, therapy and even rehabilitation designed specifically for cancer survivors.

Understanding Gallbladder Cancer

The symptoms of gallbladder cancer usually don't occur until the cancer is at an advanced stage. Many of these symptoms can also be caused by other health problems like gallstones or gallbladder inflammation, so talk to your doctor if you experience any these symptoms:

  • Pain or discomfort in the right side of the upper abdomen
  • Lumps in the belly (abdomen)
  • A sense of fullness after eating even small amounts
  • Nausea
  • Vomiting
  • Poor appetite
  • Unexplained weight loss
  • Fever
  • Yellowing of the skin (jaundice) or the white area of the eyes (scleral icterus)
  • Severe itching

Due to the location of the gallbladder and the fact that many people don’t have symptoms in the early stages of the disease, gallbladder cancer is often hard to find. If your physician thinks you might have gallbladder cancer, you will need certain exams and tests to be sure. Diagnosing gallbladder cancer starts with your healthcare provider asking you questions about your health history, symptoms, risk factors and family history of disease. Other tests include:

  • Ultrasound: This test uses sound waves and a computer to create images of the inside of the body to look for cancer.
  • Endoscopic Ultrasound (EUS): This test combines ultrasound with a long bendable tube with a light and camera called an endoscope. It's placed into the mouth or the rectum to reach the digestive tract, where it creates images of the digestive tract and nearby tissue and organs, helping your doctor tell the difference between benign and malignant tumors. Biopsies can also be taken during EUS.
  • Computed Tomography (CT) Scan: A CT scanner takes many X-rays as it rotates around you. A computer combines these images to create detailed images. A CT scan can help show a gallbladder tumor or tell if the cancer has spread.
  • Magnetic Resonance Imaging (MRI) Scan: An MRI scan uses radio waves and strong magnets to create detailed images of the inside of your body. Your doctor may use an MRI scan to look at organs, blood vessels, and lymph nodes.
  • Cholangiography: This test uses X-rays and a dye injected into the bile ducts to see if they are blocked or narrowed. These tests can also be used to get samples of cells or fluid to look for cancer, or to place a stent (small tube) inside a duct to keep it open. The kinds of this test are magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography.
  • Magnetic Resonance Cholangiopancreatography (MRCP): This is a non-invasive way to take images of the bile ducts. It uses the same type of machine used for MRI scans. Your doctor may use MRCP image only the bile ducts. This test can't be used to get biopsy samples or to place small tubes (stents) in the ducts to keep them open.
  • Endoscopic Retrograde Cholangiopancreatography (ERCP): The ducts are reached by passing an endoscope down the throat and into the small intestine.
  • Percutaneous Transhepatic Cholangiography (PTC): The ducts are reached by passing a needle through the skin and into the liver.
  • Laparoscopic Cholecystectomy: This is a surgery to remove the gallbladder using a thin, lighted tube called a laparoscope. The doctor makes a small cut just above your belly button to insert the tube. Tools are then passed through other cuts in the skin to take out the gallbladder. A pathologist then checks the gallbladder for cancer.
  • Biopsy: A biopsy is when a small amount of tissue is removed to be checked for cancer. This may be done during a laparoscopy, or with a fine needle inserted into the tumor with the aid of CT scan. A pathologist looks at the tissue under a microscope to check for cancer cells.
  • Liver Function: These are blood tests that help show how well the liver is working. They can help diagnose liver and bile duct diseases. The most common liver function tests are:
    • Albumin
    • Alanine Aminotransferase (ALT)
    • Aspartate Aminotransferase (AST)
    • Alkaline Phosphatase (AP)
    • Bilirubin
    • Gamma Glutamyl Transpeptidase (GGT)
    • Prothrombin Time (PT)
  • Tumor Markers: These tests look for increases in certain substances called tumor markers. Some cancers make these substances. High tumor markers may indicate cancer or another disease, but a normal level of tumor markers doesn't always mean there is no cancer. Your doctor may repeat this test during your treatment to see how your treatment is working.

Several types of treatment can be used for gallbladder cancer. Which may work best for you? It depends on a number of factors. These include the type, size, location, and stage of your cancer. Other important factors include your age and overall health, how well the rest of your liver is working and what side effects you find acceptable. Your doctor can answer any questions or concerns you have.

The two main kinds of treatments are local treatments and systemic treatments. Local treatments like surgery and radiation remove, destroy or control cancer cells in one area of the body. Systemic treatments like chemotherapy destroy or control cancer cells throughout the whole body.

  • Surgery: The goal of surgery is often to remove as much of the tumor as possible. The gallbladder may need to be removed. This is called a simple cholecystectomy. Nearby tissues may also need to be removed. This is called an extended or radical cholecystectomy. That may include some of the liver, the bile duct, and lymph nodes. If the whole tumor can’t be removed, surgery may also be done to ease symptoms.
  • Radiation therapy: Radiation uses X-rays to kill cancer cells in a specific area. This treatment may be used after surgery to try to get rid of any cancer cells that are left. It can also be used to treat cancer that can’t be removed with surgery. It also may be used along with chemotherapy to help relieve symptoms from advanced cancer.
  • Chemotherapy: The goal of this treatment is to reduce the chance that the cancer will spread to other parts of your body. It is also used to kill cancer cells that may have already spread beyond the gallbladder. Chemotherapy is usually given along with surgery or radiation. Lose doses of chemotherapy may given with radiation. This can make the radiation work directly on tumor cells. Chemotherapy may be given by itself if the cancer has spread from the gallbladder and can’t be fully removed with surgery.
  • Clinical trials: New ways to treat gallbladder cancer are being tested in clinical trials. Before starting treatment, ask your doctor if there are any clinical trials you should consider.
  • The Multidisciplinary Cancer Clinic: The INTEGRIS Cancer Institute’s Multidisciplinary Gastrointestinal clinic brings together medical oncologists, gastroenterologists, radiation oncologists and radiologists as a team to provide specific services to the patient with the aim of ensuring that the patient receives optimum care and support.

At INTEGRIS, we offer a wide variety of support programs and services along with the Troy and Dollie Smith Wellness Center to help patients with breast cancer and their loved ones manage the physical and emotional effects of a cancer diagnosis and treatment.

Support services for gallbladder cancer include:

  • Cancer screenings
  • Clinical social work services
  • Counseling
  • Integrative medicine clinic
  • Mind, body therapies including acupuncture, massage, and yoga
  • Multi-disciplinary clinic coordination
  • Nutrition consultations
  • Pastoral care, spiritual support and relaxation techniques
  • Patient and family support groups
  • Patient navigation and survivor care planning
  • Research and clinical trials
  • Resource Room

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