Q: I had a surgery last year for gallbladder stones. The biopsy report said that I had Adenocarcinoma of the gallbladder. After the operation I was normal but early this year I had jaundice and the doctor said that I had a blocked CBD. A stent was put for relief from fever and jaundice. The doctors are saying that it is the cancer which has come back and surgery is not possible but I am not convinced. I feel there are better options than stents as it will not treat the disease. Could you please tell me what is the best that can be done in this situation and where will it be best to consult?

A:Stents relieve jaundice but do nothing to treat the disease. Treatment for tumours require either surgical excision or in case of some other tumours, radiotherapy or chemotherapy when it is sensitive to it. For gall bladder cancers surgery is the only known effective treatment. However this tumour has recurred and once this has happened it is usually not possible to remove these tumours because the tumour invades major blood vessels of the liver or intestine. To be able to assess whether it is resectable one should do a CT angiogram of the liver (triple phase study). There is some evidence of benefit with local radiotherapy but generally none of these therapies are effective.