The gallbladder is a small, pear-shaped pouch that lies beneath the liver, in the upper abdomen that stores bile. This fluid, produced by the liver, helps digest fat. The gallbladder releases bile into the small intestine through the bile duct. This thin tube connects the liver and gallbladder to the small intestine. Cancer develops when abnormal cells in these structures multiply and grow rapidly.

People with gallstones seem to have a slightly higher risk of developing gallbladder and bile duct cancer, for whatever reason, while these cancers also have been linked to infections with the liver fluke parasites. Liver fluke is a parasitic worm infection in humans that usually occurs after eating contaminated raw or undercooked freshwater fish or watercress. After liver flukes have been ingested, they travel from your intestines to your bile ducts in your liver where they then live and grow. They have also been tied to sclerosing cholangitis, ulcerative colitis, and cirrhosis. Gallbladder and bile duct cancers are rare.

Symptoms

When symptoms occur, they can include

• jaundice
• abdominal pain or swelling
• nausea and/or vomiting
• lack of appetite
• losing weight for no reason
• itching
• fever that doesn’t go away

Jaundice is the most common symptom of bile duct cancer, and nearly half of all people with gallbladder cancer have jaundice when they are diagnosed. Jaundice makes the skin and the whites of the eyes look yellow. This happens when the liver cannot get rid of bile. Levels of bilirubin (a dark yellow chemical in bile) then rise in the bloodstream. Bile and bilirubin can also cause itching. Although many people with gallbladder and bile duct cancers have jaundice, the most common cause of jaundice is hepatitis, not cancer. Having a gallstone lodged in the bile duct can also cause jaundice; it can prevent bile from flowing into the small intestine. This is a noncancerous condition American Cancer Society (ACS) (http://www.cancer.org/) National Cancer Institute (NCI), U.S. National Institutes of Health (http://www.nci.nih.gov/)

Prevention

Gallbladder or bile duct cancers cannot be prevented. However, one can lower your risk of gallbladder cancer by maintaining a healthy weight and avoiding tobacco.

Preventing and treating liver fluke infections may help to reduce the risk of bile duct cancer. Do the following:

• Cook or freeze freshwater fish before eating it.
• Purchase shellfish only from reputable stores.
• Take medication as prescribed if you are diagnosed with a liver fluke infection.

Preventing hepatitis may also reduce the risk of bile duct cancer. Do the following:

• Practice safer sex by using condoms.
• Do not inject illegal drugs. If you do, never share needles with anyone.
• Ask your doctor about getting vaccines against hepatitis A and B. There is no vaccine against other forms of hepatitis.

If a person has been exposed to someone with hepatitis A or B, he or she should talk to his or her doctor about getting the vaccine or an immunoglobulin shot as soon as possible.

If a person has an inflammatory bowel disease, such as ulcerative colitis, such a person has an increased risk of gallbladder and bile duct cancers. The doctor may evaluate the person for these cancers during routine exams.