Gallbladder Cancer

• Gallbladder cancer facts*
• What is gallbladder cancer?
• What are risk factors for gallbladder cancer?
• What are symptoms and signs of gallbladder cancer?
• What exams and tests are used to diagnose gallbladder cancer?
• What factors affects the prognosis for gallbladder cancer?
• How is the staging of gallbladder cancer determined?
• What is the treatment for gallbladder cancer?
• Where can people get more information about gallbladder cancer?

*Gallbladder cancer facts by John P. Cunha, DO, FACOEP

• Gallbladder cancer is a rare disease in which malignant (cancer) cells form in the tissues of the gallbladder.
• Risk factors for gallbladder cancer include being female, and Native American.
• Symptoms of gallbladder cancer include jaundice (yellowing of skin and whites of eyes), pain, fever, nausea and vomiting, bloating, and lumps in the abdomen.
• Gallbladder cancer is difficult to detect and diagnose because there often are no noticeable signs in the early stages. When there are symptoms they often resemble other illnesses, and the gallbladder is hidden behind the liver.
• Ultrasound, liver function tests, carcinoembryonic antigen (CEA) or CA 19-9 assay, CT scan, MRI, X-ray, biopsy, and blood tests can help diagnose gallbladder cancer.
• Gallbladder cancer can be cured only if it is found before it has spread, when it can be removed by surgery. Other treatments include radiation and chemotherapy.

Gallbladder cancer is a rare disease in which malignant (cancer) 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. The gallbladder stores bile, a fluid made by the liver to help digest fat. When food is being broken down in the stomach and intestines, bile is released from the gallbladder through a tube called the common bile duct, which connects the gallbladder and liver to the first part of the small intestine.

The wall of the gallbladder has 3 main layers of tissue.

• Mucosal (innermost) layer.
• Muscularis (middle, muscle) layer.
• Serosal (outer) layer.

Between these layers is supporting connective tissue. Primary gallbladder cancer starts in the innermost layer and spreads through the outer layers as it grows.

Anything that increases your chance of getting a disease is called a risk factor. Risk factors for gallbladder cancer include the following:

• Being female.
• Being Native American.

These and other symptoms may be caused by gallbladder cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

• Jaundice (yellowing of the skin and whites of the eyes).
• Pain above the stomach.
• Fever.
• Nausea and vomiting.
• Bloating.
• Lumps in the abdomen.

Gallbladder cancer is difficult to detect and diagnose for the following reasons:

• There aren't any noticeable signs or symptoms in the early stages of gallbladder cancer.
• The symptoms of gallbladder cancer, when present, are like the symptoms of many other illnesses.
• The gallbladder is hidden behind the liver.

Gallbladder cancer is sometimes found when the gallbladder is removed for other reasons. Patients with gallstones rarely develop gallbladder cancer.

Tests that examine the gallbladder and nearby organs are used to detect (find), diagnose, and stage gallbladder cancer.

Procedures that create pictures of the gallbladder and the area around it help diagnose gallbladder cancer and show how far the cancer has spread. The process used to find out if cancer cells have spread within and around the gallbladder is called staging.

In order to plan treatment, it is important to know if the gallbladder cancer can be removed by surgery. Tests and procedures to detect, diagnose, and stage gallbladder cancer are usually done at the same time. The following tests and procedures may be used:

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
• Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. An abdominal ultrasound is done to diagnose gallbladder cancer.
• Liver function tests: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver. A higher than normal amount of a substance can be a sign of liver disease that may be caused by gallbladder cancer.
• Carcinoembryonic antigen (CEA) assay: A test that measures the level of CEA in the blood. CEA is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of gallbladder cancer or other conditions.
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