Cholangiocarcinoma is the medical name for cancer of the gallbladder. The gallbladder is a small organ that sits nestled under the liver in the upper right part of the abdomen. The job of the gallbladder is to store the bile produced by the liver and release the bile when it is needed to help digest food. While bile is important to the body, the gallbladder is not a necessary organ. When the gallbladder is removed, the bile flows directly from the liver into the small intestine without a problem. Gallbladder cancer is not very common and may be at an advanced stage when diagnosed meaning that it has progressed to a great degree, leading to a poorer prognosis. The cancer often gets to an advanced stage without producing any symptoms. Normally, cells in the body grow and divide in a regulated fashion. In gallbladder cancer, the cells of the gallbladder begin to grow out of control and live much longer than normal, creating a mass. Most often, the cells that begin to grow out of control at the ones lining the inside of the gallbladder. These cancerous cells can then spread to other parts of the body. Risk factors for gallbladder cancer include being a woman, being older, having had gallstones, and having other problems with the gallbladder such as gallbladder infection or porcelain gallbladder.
Abdominal pain, pain in the right upper part of the abdomen, bloating, itching, fever, nausea, weight loss, loss of appetite, yellow discoloration of the eyes and skin
Your doctor will begin by talking to you about your symptoms and medical history then do a physical exam focusing on the abdomen. Your doctor may recommend doing blood tests to look for causes of your symptoms, though no specific blood test for gallbladder cancer is available. Your doctor will likely want to take a picture of the gallbladder using one of several ways of imaging including ultrasound of the gallbladder, computed tomography (CT) scan, or magnetic resonance imaging (MRI). If your doctor finds that you have gallbladder cancer, it will be important to determine how big the tumor is and if your cancer has spread anywhere else. Your doctor may recommend exploratory surgery which involves making small incisions into the skin to place small cameras into the abdomen and look at the gallbladder. Your doctor may also recommend having a test done by a gastroenterologist or surgeon called endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiography (MRCP) which involves injecting dye into the bile ducts to test for blockages produced by a mass from the gallbladder cancer.
Treatment for gallbladder cancer depends on how advanced the cancer has become as well as general health. Whenever possible, the first step is to surgically remove the gallbladder. Sometimes, however, removal of the gallbladder is not possible. Surgery to remove the gallbladder is called cholecystectomy and can be done alone in earlier stages of gallbladder cancer. If the cancer has progressed to the area around the gallbladder, removal of part of the liver may also be necessary. Your doctor may also recommend chemotherapy (medications that fight rapidly dividing cells found in cancer) or radiation therapy (which involves shooting concentrated rays at the cancer cells to kill them). If the cancer is very advanced, treatment may be aimed at relieving symptoms rather than curing the disease. In late stage disease, your doctor or oncologist may recommend chemotherapy to shrink the size of the tumor as well as decrease the size of any cancer that has spread, radiation therapy can also help shrink the size of the tumor or pieces of the cancer that have moved to decrease symptoms and relieve pain. If the ducts that pass bile to the small intestine are blocked, surgeons or gastroenterologist may be able to pass stents into the affected area to allow the bile to pass with a procedure called biliary bypass. You should discuss all of your treatment options with your doctor, gastroenterologist, oncologist (cancer doctor) and surgeon.
