Gallbladder Cancer (Carcinoma of the Gallbladder)

The gallbladder, a small organ under the liver, stores the bile juices manufactured by the liver and released during digestion. If it becomes cancerous, there may be no symptoms early on. Later, however, abdominal pain, jaundice, loss of appetite, weight loss, and widespread itching may develop. These symptoms are often mistakenly thought to indicate liver disease.

Gallbladder cancer mainly afflicts people in their late sixties and seventies and is somewhat more common among women than men. Between 70 and 80 percent of those who have the cancer also have chronic gallstones and cholecystitis (gallbladder inflammation). The relationship between gallstones and cancer is not clearly understood, but doctors often advise people with stones to undergo gallbladder removal to prevent a later malignancy.

Diagnostic Studies and Procedures

Because gallbladder cancer can be difficult to diagnose doctors who suspect it usually order several procedures. An ultrasound examination of the gallbladder may show a thickening or an unusual mass in one area. CT scans and an MRI may also reveal abnormalities. To arrive at a definitive diagnosis, a biopsy is necessary. This commonly involves inserting a long, hollow needle into the suspicious area and withdrawing tissue samples for microscopic examination.

When a biopsy confirms cancer, additional diagnostic procedures can determine if it has spread to other organs. These include CT scans and contrast X-ray studies, in which a special dye is used.

Medical Treatments

Treatment depends upon the stage of the disease when it is identified. In stage 1, the cancer is confined to the gallbladder, and removal of the organ may be the only treatment needed. (Surgeons often find such a tumor when removing the gallbladder because of stones or chronic inflammation.)

In a stage II malignancy, the cancer has invaded the gallbladder muscle tissue and mucous membranes, but it has not spread to the bile ducts, liver, and nearby lymph nodes. This cancer can also be cured by removing the gall-bladder. As an extra precaution, the adjacent lymph nodes and a portion of the liver may also be excised, along with the lymphatic tissue that surrounds the bile ducts and the major blood vessels serving the liver.

Gallbladder removal is a relatively simple procedure. Loss of the organ poses no lasting problems, as the flow of bile can be redirected during surgery so that it passes directly from the liver into the intestine. Chemotherapy is sometimes used in addition to surgery.

Unfortunately, the majority of gallbladder cancers are not detected until they reach a more advanced stage, by which time large portions of the liver may also be cancerous. When this happens, chemotherapy is likely to be the sole form of treatment.

If the cancer is confined to the bile ducts, radiation may be combined with surgery or used instead of surgery. If a duct is blocked and surgical removal is not possible, a tube may be inserted to bypass the duct and allow bile to flow from the gallbladder to the intestine.

Medications, including painkillers and drugs to reduce itching, may be prescribed to alleviate symptoms.

Alternative Therapies

No known alternative approach can cure this or any other type of cancer. However, certain therapies can help reduce pain and the stress that comes with having a life-threatening disease.

Acupuncture and Acupressure. Acupuncture is often incorporated into pain management for cancer patients and is generally agreed to be effective.

Hypnotherapy. Hypnosis and self-hypnosis are also well-accepted means of managing pain. Patients who are taught self-hypnosis can often lessen the amount of medication they need to control their pain.

Meditation and Visualization. These techniques may be employed to reduce stress and to make the persistent itching that often accompanies gallbladder cancer more tolerable.

Nutrition. Because loss of appetite is common with gallbladder cancer, a nutritionist may help to plan small, highly nutritious meals that can be eaten frequently. She might also recommend that the patient take special enriched supplements to prevent excessive weight loss, since fats could be difficult to digest. Some patients may require a special feeding tube or intravenous feeding of predigested food.

Self-Treatment

Self-care is not effective in treating gall bladder cancer, but you can take measures to prevent gallstones, which are often related to the cancer.

Other Causes of Gallbladder Symptoms

Hepatitis and other liver disorders can produce symptoms similar to those of gallbladder cancer. Acute abdominal pain is often present in appendicitis, attacks of gastritis, or inflammatory intestinal disorders and other digestive problems. Persistent itching is also associated with allergic reactions, dry skin, liver disease, and leukemia.