Gallbladder Cancer Treatment

The biliary tract consists of organs that help transport bile, which helps digest food, from the liver to the small intestine. In 2009, the National Cancer Institute estimates that almost 10,000 new cases of biliary cancer will be diagnosed in the United States, but only about 3,000 of these are gallbladder cancer. Gallbladder cancer is rare in the United States. The gallbladder collects bile (a liquid that helps digest fat) and is below the liver. Most gallbladder cancers start in the mucus glands that line the gallbladder, making it an adenocarcinoma, which is a cancer that starts in glandular tissue.

Background

• Gallbladder cancer is often categorized under biliary tract cancers, along with cancer of the bile ducts, which is also called cholangiocarcinoma (Chabner, Lynch, and Longo, 2008). Certain ethnic groups, like Native Americans and Hispanics, have a higher incidence rate of gallbladder cancer, but the causes behind this are not fully known.

Risk Factors and Symptoms

• Risk factors for gallbladder cancer include a history of gallstones, gallbladder polyps, having a chronic salmonella infection and any biliary cysts (Chabner, Lynch, Longo, 2008). Women are more likely to get gallbladder cancer than men, Caucasians are at higher risk than African-Americans, and risk for cancer of the gallbladder also increases with age.

  Symptoms of gallbladder cancer include jaundice, fever, and abdominal pain. Bloating is a common symptom, and nausea and vomiting may be present. Due to the general nature of these symptoms, gallbladder cancer can be difficult to diagnose early. In the early stages of GBC, there may not be any symptoms at all.

Treatment

• The only curative treatment for gallbladder cancer is surgery, but less than 30 percent of patients have disease that can be fully cured (Chabner, Lynch, and Longo, 2008). Once a diagnosis of gallbladder cancer is made, the recommended surgery is a radical cholecystectomy, which is the removal of the gallbladder, plus two centimeters or more of the gallbladder bed (2008). Lymph nodes should also be removed to assess for spread of the illness. If the liver is involved, the affected part of the liver should be removed.
  For individuals whose cancer cannot be completely taken out with surgery, radiation and chemotherapy can be given to control the disease and provide relief from symptoms. Several large cancer centers like Memorial Sloan-Kettering Cancer Center in New York are exploring biologic therapies, which are drugs that affect the reproduction of cancer cells. Many larger cancer centers have clinical trials available.

Prognosis

• The prognosis of patients having surgery for GBC depends on the stage of the cancer. In patients whose disease is completely removed at the time of surgery, the five-year survival rate is between 20 and 50 percent (Chabner, Lynch, and Longo, 2008). Most gallbladder cancers are diagnosed at an advanced stage because of their nonspecific symptoms, and the prognosis for these cancers is poor.

Future Directions

• Due to the relative rarity of this type of cancer, there have been few widespread clinical trials. Most studies on gallbladder cancer have been done at single institutions with small groups of patients.