Gallbladder Cancer

Gallbladder Cancer Overview

Eating stimulates bile secretion so problems with the gallbladder often come with symptoms related to eating. The most common risk factor associated for gallbladder cancer includes chronic inflammation and/or gallstones, although less than one percent of people with gallstones go on to develop gallbladder cancer.

Diagnosis

Gallbladder cancer can go undetected until late stages due to a lack of specific symptoms. Subtle symptoms associated with gallbladder cancer include taste disturbances and nausea. Physicians diagnose many gallbladder cancers when they remove the gallbladder for gallstones. Advanced stage gallbladder cancer often manifests as a liver mass and/or jaundice.

Your physicians may use one or more of the following methods to diagnose gallbladder cancer:

• Clinical examination. Your physician looks for yellowing of the complexion, known as jaundice.
• Bloodwork. Your doctor looks for subtle changes in liver function tests.
• Cross-section imaging with computed tomography (CT) scan or magnetic resonance imaging (MRI). Both tests detect abnormalities related to gallbladder cancer. They also help healthcare providers determine eligibility for resection.
• Fine needle aspiration or biopsy. Physicians use a needle to remove tissue or fluid for examination under a microscope.
• Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP).These advanced imaging technologies take pictures of the gastrointestinal tract. EUS combines endoscopy with the imaging capabilities of ultrasound to get high-quality images of organs deep inside the body. ERCP, a minimally invasive imaging procedure, can diagnose conditions of the liver, gallbladder, bile ducts and pancreas. This helps when gallbladder cancer causes jaundice. Learn more about ERCP.
• Genetic counseling. You and your doctor discuss your personal and family medical history of certain gastrointestinal conditions and the possibility of genetic testing.
• Genetic testing. Your doctor identifies specific genetic factors that increase your risk for developing gastrointestinal cancers.

Unlike many cancer specialists, your team focuses solely on gastrointestinal cancers. Members of your team may include:

• Medical oncologists
• Radiation oncologists
• Surgical oncologists
• Gastroenterologists
• Radiologists
• Pathologists

These specialists work together to develop a customized treatment plan for you. Your treatment plan considers the location and extent of your cancer, plus your health and individual needs. Your team also includes a nurse coordinator to help you understand and adapt to a potentially complex plan.

Treatment

At IU Health, your multidisciplinary team will provide a full range of treatment options including:

• Surgery. Removes the cancer.
• Chemotherapy. Destroys cancer cells with special medicine.
• Radiation therapy. Uses high energy, penetrating waves or particles to destroy cancer cells and/or prevent their growth.
• Stent placement. A support device placed in the gastrointestinal tract to keep it from closing.
• Palliative care. Improves quality of life, with relief from pain and other symptoms.

Radiation therapy treatments can include:

• Computed tomography (CT) simulation. A radiation planning process that uses a CT scan to define tumor targets and internal anatomy in three dimensions, allowing the radiation oncologist to target the tumor without harming healthy tissue.
• Four-dimensional CT simulation. A CT simulation that shows internal anatomy changes (such as changes in tumor location with the breathing cycle), allowing the radiation oncologist to accurately target the tumor and avoid damage to healthy tissue.
• Image guided radiation therapy (IGRT). Uses radiographic imaging to precisely target tumors while sparing healthy tissue.
• Cone-beam computed tomography (CBCT). An IGRT technique that uses a limited CT scan prior to treatment to target internal anatomy in three dimensions.
• Three-dimensional conformal radiotherapy. Guided by a computer-generated three-dimensional picture of the tumor, allowing the highest possible dose of radiation while protecting healthy tissue.
• Intensity modulated radiation therapy (IMRT). An advanced radiation technology that uses a computerized optimization algorithm to deliver radiation near or around radiation-sensitive tissue.
• Stereotactic body radiation therapy (SBRT). Special equipment that delivers precise, high-dose radiation to a tumor without affecting healthy tissue.
• Proton beam radiation. Particle radiation that treats tumors located near critical radiation-sensitive tissue.

Research

Clinical researchers at the IU Health Melvin & Bren Simon Cancer Center dedicate their work to finding new, more effective treatments for gastrointestinal cancers. This research provides ongoing improvements to current treatment options.

Researchers at IU Health lead the way for cancer care discoveries. You can benefit from this expertise through access to all current treatments plus new clinical trial options. Current research in gallbladder cancer includes studying biomarkers for risk by evaluating bile and serum in at-risk patients.