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National Cancer Institute

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Gallbladder cancer


Table of Contents

OVERVIEW OF PDQ
What is PDQ?
How to use PDQ
DESCRIPTION
What is cancer of the gallbladder?
STAGE EXPLANATION
Stages of cancer of the gallbladder
Localized
Unresectable
Recurrent
TREATMENT OPTION OVERVIEW
How cancer of the gallbladder is treated
Treatment by stage
LOCALIZED GALLBLADDER CANCER
UNRESECTABLE GALLBLADDER CANCER
RECURRENT GALLBLADDER CANCER
TO LEARN MORE

OVERVIEW OF PDQ


What is PDQ?

PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. It is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.

To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.


How to use PDQ

PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your doctor, who knows you and has the facts about your disease. PDQ can also provide the names of additional health care professionals who specialize in treating patients with cancer.

Before you start treatment, you also may want to think about taking part in a clinical trial. PDQ can be used to learn more about these trials. A clinical trial is a research study that attempts to improve current treatments or finds information on new treatments for patients with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help patients with cancer. Information is collected about new treatments, their risks, and how well they do or do not work. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ.

To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer cancer-related questions.

PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.


DESCRIPTION


What is cancer of the gallbladder?

Cancer of the gallbladder, an uncommon cancer, is a disease in which cancer (malignant) cells are found in the tissues of the gallbladder. The gallbladder is a pear-shaped organ that lies just under the liver in the upper abdomen. Bile, a fluid made by the liver, is stored in the gallbladder. When food is being broken down (digested) in the stomach and the intestines, bile is released from the gallbladder through a tube called the bile duct that connects the gallbladder and liver to the first part of the small intestine. The bile helps to digest fat.

Cancer of the gallbladder is more common in women than in men. It is also more common in people who have hard clusters of material in their gallbladder (gallstones).

Cancer of the gallbladder is hard to find (diagnose) because the gallbladder is hidden behind other organs in the abdomen. Cancer of the gallbladder is sometimes found after the gallbladder is removed for other reasons. The symptoms of cancer of the gallbladder may be like other diseases of the gallbladder, such as gallstones or infection, and there may be no symptoms in the early stages. A doctor should be seen if the following symptoms persist: pain above the stomach, loss of weight without trying, fever, or yellowing of the skin (jaundice).

If there are symptoms, a doctor may order x-rays and other tests to see what is wrong. However, usually the cancer cannot be found unless the patient has surgery. During surgery, a cut is made in the abdomen so that the gallbladder and other nearby organs and tissues can be examined.

The chance of recovery (prognosis) and choice of treatment depend on the stage of cancer (whether it is just in the gallbladder or has spread to other places) and on the patient's general health.


STAGE EXPLANATION


Stages of cancer of the gallbladder

Once cancer of the gallbladder is found, more tests will be done to find out if cancer cells have spread to other parts of the body. A doctor needs to know the stage to plan treatment. The following stages are used for cancer of the gallbladder:


Localized

Cancer is found only in the tissues that make up the wall of the gallbladder, and it can be removed completely in an operation.


Unresectable

All of the cancer cannot be removed in an operation. Cancer has spread to the tissues around the gallbladder, such as the liver, stomach, pancreas, or intestine and/or to lymph nodes in the area. (Lymph nodes are small, bean-shaped structures that are found throughout the body. They produce and store infection-fighting cells.)


Recurrent

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the gallbladder or in another part of the body.


TREATMENT OPTION OVERVIEW


How cancer of the gallbladder is treated

There are treatments for all patients with cancer of the gallbladder. Three treatments are used:

Surgery is a common treatment of cancer of the gallbladder if it has not spread to surrounding tissues. The doctor may take out the gallbladder in an operation called a cholecystectomy. Part of the liver around the gallbladder and lymph nodes in the abdomen may also be removed.

If the cancer has spread and cannot be removed, the doctor may do surgery to relieve symptoms. If the cancer is blocking the bile ducts and bile builds up in the gallbladder, the doctor may do surgery to go around (bypass) the cancer. During this operation, the doctor will cut the gallbladder or bile duct and sew it to the small intestine. This is called biliary bypass. Surgery or other procedures may also be done to put in a tube (catheter) to drain bile that has built up in the area. During these procedures, the doctor may place the catheter so that it drains through a tube to the outside of the body or so that it goes around the blocked area and drains the bile into the small intestine.

Radiation therapy is the use of high-energy x-rays to kill cancer cells and shrink tumors. Radiation for gallbladder cancer usually comes from a machine outside the body (external-beam radiation therapy). Radiation may be used alone or in addition to surgery.

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy for cancer of the gallbladder is usually put into the body by a needle inserted into a vein. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the gallbladder. Chemotherapy or other drugs may be given with radiation therapy to make cancer cells more sensitive to radiation (radiosensitizers).


Treatment by stage

Treatments for cancer of the gallbladder depend on the stage of the disease and the patient's general health.

Standard treatment may be considered because of its effectiveness in past studies, or participation in a clinical trial may be considered. Most patients with gallbladder cancer are not cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in many parts of the country for patients with cancer of the gallbladder. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.


LOCALIZED GALLBLADDER CANCER

Treatment may be one of the following:

1. Surgery to remove the gallbladder and some of the tissues around it (cholecystectomy).

2. External-beam radiation therapy with or without chemotherapy, possibly followed by surgery.

3. A clinical trial evaluating radiation therapy plus chemotherapy or drugs to make the cancer cells more sensitive to radiation (radiosensitizers).


UNRESECTABLE GALLBLADDER CANCER

Treatment may be one of the following:

1. Surgery or other procedures to relieve symptoms.

2. Surgery to bypass the obstructed ducts of the gallbladder.

3. External-beam radiation therapy with or without chemotherapy possibly followed by surgery.

4. Chemotherapy to relieve symptoms. Clinical trials are testing new chemotherapy drugs.

5. A clinical trial evaluating radiation therapy plus chemotherapy or drugs to make the cancer cells more sensitive to radiation (radiosensitizers).


RECURRENT GALLBLADDER CANCER

Treatment for recurrent cancer of the gallbladder depends on the type of treatment the patient received before, the place where the cancer has recurred and other facts about the cancer, and the patient's general health. The patient may wish to consider taking part in a clinical trial.


TO LEARN MORE

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about cancer of the gallbladder, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, trained information specialists can answer your questions.

The Cancer Information Service also has booklets about cancer that are available to the public and can be sent on request. The following general booklets on questions related to cancer may be helpful:

What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again

There are many other places where people can get material and information about cancer treatment and services. The social service office at a hospital can be checked for local and national agencies that help with getting information about finances, getting to and from treatment, getting care at home, and dealing with problems.

For more information from the National Cancer Institute, please write to this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Date Last Modified: 05/1999


If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


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