February is Gallbladder and Bile Duct Cancer Awareness Month. Many people don't know a lot about the two cancers because they are so rare. Only about one or two patients out of 100,000 are diagnosed, according to Dr. Michelle Fillion, a surgical oncologist at New Hanover Regional Medical Center.
“They are so rare, we probably wouldn’t do any screening," Fillion explained.
By the time either cancer is diagnosed, it is often in the later stages. Treatment usually requires surgery, chemotherapy and radiation. Even then, the prognosis for both is poor.
“For those who have gallbladder cancer and do get treatment and can get surgery, about one in five will be alive in five years,” Fillion said.
Gallbladder cancer is extremely difficult to diagnose because there are often no symptoms. When symptoms are present, it’s usually in the late stages of the cancer.
Symptoms, according to the American Cancer Society, include:
• Pain and swelling in the abdomen
• Bloating, indigestion, nausea or vomiting
• Loss of appetite
• Itchy skin
• Lumps in the belly
Gallstones have also been linked to gallbladder cancer, but Fillion says having gallstones does not mean they will turn into cancer.
“Having gallstones is a risk for having gallbladder cancer, but 15 percent of Americans have gallstones, so not everybody is going to get gallbladder cancer,” Fillion said.
According to the Centers for Disease Control and Prevention (CDC), gallbladder cancer is much more common among American Indians and Alaskan Natives. It is also more common among women than men.
About 8,000 people in the U.S. are diagnosed with bile duct cancer each year, according to the American Cancer Society. It is one of the most difficult cancers to treat.
“It’s just a very unfortunate and aggressive cancer,” said Fillion, who explained symptoms are usually late and sudden.
“The bile duct cancers usually end up presenting themselves as what we call painless jaundice,” she said. "All of a sudden someone is turning yellow - yellow in white of the eyes; yellow kind of under the tongue; yellow skin.”
Other symptoms include:
• Weight loss
• Abdominal pain
• Dark urine
• Pale feces
Bile duct cancer is uncommon in the U.S. There is a higher occurrence of the disease in Asian countries.
According to the American Cancer Society, the higher incidence rate is due in part to a parasite. Bile duct cancer is linked to an infection caused when people in some Asian countries eat raw or poorly cooked fish.
Fillion says treating bile duct cancer is complicated, especially when it has moved deep into the duct.
“They’re requiring a big procedure called the Whipple procedure involving the bile duct, the pancreas, the small bile and the gallbladder and really redoing all the plumbing," Fillion explained.
For more information about gallbladder and bile duct cancers, or other types of cancer, click here.
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