Gallbladder Cancer

The gallbladder is an organ located beneath the liver which participates in the digestion of food, specifically in the breakdown of fats, which are catalyzed by the liquid stored in the gallbladder known as bile. Cancerous cells can infest the tissue of the gallbladder, although this is a rare condition, which is slightly more common in women than in men. Hard clusters of material can form in the gallbladder (gall stones) and these can be painful and require surgery. The entire gallbladder can be removed if required without causing any particular problems to the patient. It is often during this procedure that any cancer of the organ is detected, because there are no characteristic symptoms of gallbladder cancer and the organ itself is quite difficult to access or to inspect. Some symptoms that can be caused, for example, jaundice, fever, weight loss, loss of appetite, and others, may arise from a number of different causes and, indeed, diagnosis is likely to attribute the symptoms to one of the more common conditions. People with a history of passing gallstones may have a slightly higher susceptibility to gallbladder cancer, but the underlying cause of the cancer is not fully known.

Gallbladder cancer is best treated, as in the case of most cancers, if the disease is detected at an early stage and, particularly, before the cancer spreads or metastasizes. The extent to which the cancer has spread before it is detected will determine the nature of the treatment chosen. Surgery is possible if the disease remains localized in the gallbladder, which may be excised in a cholecystectomy, which might also involve removing part of the nearby liver. An alternative is to bypass the bile ducts where the passage has been blocked by cancerous cells. Some other surgical procedures may be effective depending on the spread of the disease. A catheter may be used to reroute the bile in some cases. It is also possible that surgery can be used to relieve painful or distressing symptoms caused by the buildup of cancerous masses in the body. If the cancer can be resected (excised) by surgery, then patients may have an 80 percent chance of survival; if this cannot be managed either because of the extent or the configuration of the spread, then survival chances can fall to 5 percent in some cases. Of course, advice from medical practitioners should be sought for a particular diagnosis and because of [Page 697]the possibility of the introduction of effective new techniques. It is also possible for the cancer to recur even when excised. Tests for recurrence are difficult to conduct effectively for similar reasons to those that make initial detection problematic.

Surgery may be used in addition to either or both of chemotherapy and radiotherapy. External-beam radiation therapy may be used to attack the cancerous cells, but given the location of the gall bladder, this is once again often practically difficult to implement. Some drugs may act to make the relevant cells more sensitive to the radiotherapy and these are generally injected intravenously. As the cancer spreads, it may lead to general ill health and weakness which make the patient less resistant to the side effects of any such treatment and its sometimes debilitating effects. Drugs that have been used with some success include Mitomycin c and 5-FU, although these are associated with side effects, while capecitabine, a drug that is administered orally, shows promise in attacking gallbladder cancer. However, this drug is also associated with many side effects which will require careful management. Attention to general health issues such as diet and nutrition, exercise, and a positive psychological approach can in some cases assist in enabling the body to resist these effects. Specific remedies at this stage may include assistance with sleeping to overcome sleep disorders and nausea, frequent small meals to combat reduced size of the stomach, diuretics to reduce swelling, and often quite high dosages of pain-relief medications. Pain-relief drugs may require careful management because these are metabolized in the liver and the patient may suffer from an imperfectly working liver as a result of the cancer.

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