Q: My 52 years old father in law is suffering from adenocarcinoma of the gall bladder. He has been operated with laparoscopic cholecystectomy. And later we got the biopsy done for the removal of gallbladder. We have done the CA 19-9 test and it came out to 103 u/ml. What are the treatment options for gall bladder cancer?

A:I presume that the adenocarcinoma of the gall bladder in your father's case was an incidental finding, i.e. it was discovered in the biopsy of the operated specimen. In that case he needs to have a second operation done - a more extensive operation known as radical cholecystectomy in which the local lymph nodes and the liver bed where the gall bladder rests need to be removed. This is because a laparoscopic cholecystectomy (removal of gall bladder) is not sufficient for cancer of gall bladder; a radical cholecystectomy if not performed can lead to a very much higher chance of recurrence. After the radical cholecystectomy is done he, in all probability will require additional chemotherapy +/- radiotherapy. You can get it done anywhere in the city where you live, preferably from a cancer surgeon or any surgeon who is experienced enough to undertake such an operation.