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When long-term survival is not likely, the focus of therapy shifts to improving quality of life. Jaundice and blockage of the stomach are two problems faced by patients with advanced cancer of the gallbladder. These can be treated with surgery, or alternatively, by special interventional techniques employed by the gastroenterologist or radiologist. A stent can be placed across the bile ducts in order to re-establish the flow of bile and relieve jaundice. A small feeding tube can be placed in the small intestine to allow feeding when the stomach is blocked. Pain may be treated with conventional pain medicines or a celiac ganglion nerve block.
Current chemotherapy or radiation therapy cannot cure gallbladder cancer, but they may offer some benefit in certain patients. For cancer that is too advanced for surgical cure, treatment with chemotherapeutic agents such as 5-fluorouracil may lengthen survival for a few months. The limited benefit of chemotherapy must be weighed carefully against its side effects. Radiation therapy is sometimes used after attempted surgical resection of the cancer to extend survival for a few months or relieve jaundice.
After cancer treatment, many patients find that good nutrition, and a strong support system (which may include a support group) improve their quality of life. Treatment team members or hospital social workers can often recommend local resources that can be of assistance to the patient.
More clinical trials are needed to define the role of chemotherapy and radiation therapy after attempted surgical resection of Stage II and III cancer. Some investigators are conducting trials to assess whether extremely radical surgery is beneficial in early Stage IV disease.
After the removal of the gallbladder, patients may experience a temporary change in bowel habits. The bowel movements may be more frequent or more liquid than before surgery. This situation usually resolves within about six months.
Ahrendt, Steven A. and Henry A. Pitt. "Biliary Tract." In Sabiston Textbook of Surgery, edited by Courtney Townsend Jr., 16th ed. Philadelphia: W.B. Saunders Company, 2001, pp. 1076-1111.
Corsetti, Ralph L. and Harold J. Wanebo. "Bile Duct Cancer."In Current Surgical Therapy, edited by John L. Cameron, sixth ed. St Louis: Mosby, 1998, pp.462-468.
"Gallbladder Carcinoma." In Clinical Oncology, edited by Abeloff, Martin D., second ed. New York: Churchill Livingstone, 2000, pp.1730-1737.
National Cancer Institute Cancer Trials web site. <http://cancertrials.nci.nih.gov/system>. <http://www.cancertrials.com>.
Kevin O. Hwang, M.D.
Author Info: Kevin O Hwang M.D., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Cancer, 2002
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