Ask general practitioner Maarten: Tumors in the gallbladder
Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand and writes about medical facts.
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information such as: Age, place of residence, medication, any photos, and a simple medical history. You can send photos to [email protected] everything can be done anonymously, your privacy is guaranteed.
Note: The response option is disabled by default to prevent confusion with non-medically substantiated advice by well-intentioned readers.
Dear Martin,
A Thai friend of mine doesn't know what to do. By means of an ultrasound, a doctor has found that he has 3 small tumors in his gallbladder. No biopsy was done, so not sure if it's malignant, but presumably according to the doctor because this is usually the case with bile tumors.
The doctor has suggested removing those tumors through surgery. My friend thinks it's better to have it lasered, so radiation. He has no symptoms of gallstones that seal the exit to the intestine, so no yellow eyes, discolored stools, pain in the right upper abdomen, radiation to the right side of the back and shoulder, etc.
He takes medication for high blood pressure, before using systolic pressure 220 to sometimes 280!, now that he is taking medication, the systolic pressure is back to 140, also cholesterol medication. When he eats fat, he has, sometimes, a bloated feeling in the abdomen, but no pain. He likes fatty food, would the bile be overloaded for a long time and therefore the tumors?
He is 76 years old, can it be decided not to do anything with bile tumors because the tumors will not grow quickly at his age, as is usually the case with the prostate? What are the negative effects of surgery or radiation? Is chemo aftercare necessary?
The doubt concerns what to do now, operate, irradiate, first a biopsy or do nothing?
Do you have any advice for further follow-up to clear my friend's doubts?
Thank you for your attention and best regards,
B.
*******
Dear B,
If I were your Thai friend, I would listen to the doctor. Have the gallbladder removed, if it really concerns tumors. Gallbladder cancer is very malignant. If it's stones, that explains his bloating from eating fat.
Radiation is useless. Do a CT scan and/or an MRI.
The symptoms you describe, jaundice etc. are those of complete occlusion of the bile duct.
A biopsy is also an operation and in this case you can just as well, or better, remove the gallbladder completely. The negative symptoms of an operation, if no further complications occur, are not very great. Eat fatty food in moderation afterwards, because there is no bile volume present. The liver, of course, continues to produce bile.
Doing nothing is actually not an option because of the serious symptoms that will follow later.
Chemo only works palliatively, which means that it reduces the symptoms.
It is of course always possible that it is only about stones. then waiting is a good choice, but with a fat-free diet.
Conclusion: have a CT scan or MRI made and blood tests of course. Then decide.
Let's hope your friend is lucky.
Yours faithfully,
Martin Vasbinder