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Living with cancer· Appointment prep

Appointment sheet: Incidental gallbladder cancer (found after cholecystectomy)

One page to bring and write on: your details, the questions for Incidental gallbladder cancer (found after cholecystectomy) plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

14 questions

Tick the questions to print

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Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

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Appointment sheet

Incidental gallbladder cancer (found after cholecystectomy)

Prepared with OnCo (onco.cc/prep/incidental-gallbladder-cancer/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

14 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example T category on the specimen, Cystic duct margin status, Whether the gallbladder was perforated or bile spilled at the first operation, Interval since cholecystectomy, Residual or distant disease on interval CT, MRI and PET-CT), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Tis or T1a with a clear cystic duct margin
  1. 5.For my situation (tis or t1a with a clear cystic duct margin), which of the standard options do you recommend and why?
T1b, T2 or T3, no metastases
  1. 6.For my situation (t1b, t2 or t3, no metastases), which of the standard options do you recommend and why?
  2. 7.Am I a candidate for Capecitabine, and what side effects should I expect?
  3. 8.How do the results of BILCAP apply to someone like me?
Residual disease found on interval imaging or at re-operation
  1. 9.For my situation (residual disease found on interval imaging or at re-operation), which of the standard options do you recommend and why?
  2. 10.Am I a candidate for Gemcitabine + cisplatin, Durvalumab, Pembrolizumab, and what side effects should I expect?
Any stage
  1. 11.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  2. 12.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  3. 13.I read that “Whether T1b tumours need re-resection: two 2024 to 2026 analyses disagree on disease-specific benefit”. How does that affect my plan?
  4. 14.I read that “How many UK patients with an incidental cancer reach a hepatobiliary centre is not published”. How does that affect my plan?

The words I may hear

  • Port-site metastasis: Cancer growing in the small keyhole wounds of a laparoscopic operation, seeded when a gallbladder containing an unsuspected cancer was pulled out through them.
  • Segment IVb and V liver resection (versus wedge resection): Two ways of removing the piece of liver the gallbladder sits on during a gallbladder cancer operation: a wedge of about two centimetres around the gallbladder bed, or the whole of the two anatomical liver segments (IVb and V) that touch it.
  • Cystic duct margin: The cut end of the short duct that joined the gallbladder to the main bile duct, examined by the pathologist after a gallbladder is removed.
  • Simple cholecystectomy: The standard operation to remove the gallbladder, almost always by keyhole surgery for gallstones.
  • Radical (extended) cholecystectomy: The cancer operation for gallbladder cancer: the gallbladder (if still present) is removed together with a rim of the liver it sits against and the lymph nodes along the bile duct and liver blood vessels.
  • Lymphadenectomy (lymph node dissection): Surgically removing the lymph nodes that drain a tumour, both to stage the cancer and to clear any spread.

Tests and results to bring

Biomarker results to ask for: T category on the specimen (the single decision-maker), Cystic duct margin status, Whether the gallbladder was perforated or bile spilled at the first operation, Interval since cholecystectomy (4 to 8 weeks target), Residual or distant disease on interval CT, MRI and PET-CT.

Scans and tests linked to this cancer: PET/CT.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call