Gallbladder cancer

Gallbladder cancer is a rare cancer that is often only found once the disease is more advanced. According to the most recent data, gallbladder cancer accounts for 1.3% of all cancer diagnoses and 1.7% of all cancer deaths.

No matter what step you’re at, an Advocate care professional can walk you through your diagnosis and next steps for treatment.

What is gallbladder cancer?

The gallbladder is a pear-shaped organ that resides on the right side of the body in the upper abdomen and just under the liver. The organ primarily stores bile, a fluid that helps process fat and aids the liver in breaking down food.

Cancer of the gallbladder occurs as a growth of cells that usually starts in the inner layer of the gallbladder and then progresses to the outer layers as it advances.

What are the stages of gallbladder cancer?

Your doctor can help guide you through the diagnosis process along with determining which stage your cancer is at. Gallbladder cancer staging is typically determined through various tests and procedures at the time of your appointment.

Gallbladder cancer stages are described based on what kind of treatment will be needed. The stages of gallbladder cancer are:

• Stage I: Cancer can be completely removed by surgery
• Stage II: Cancer can’t be completely removed by surgery
• Stage III: Cancer has come back
• Stage IV: Cancer has spread to other parts of the body (metastatic)

What are some signs of gallbladder problems?

The most common symptom associated with gallbladder cancer is abdominal pain. Other gallbladder cancer symptoms that might occur:

• Nausea or vomiting
• Jaundice (if the cancer gets big enough to block the liver’s bile ducts)
• Lumps on the right side of the belly due to swelling of the gallbladder

Less common gallbladder cancer symptoms can include:

• Loss of appetite
• Weight loss
• Swelling or bloating in the abdomen
• Fever
• Itchy skin
• Dark urine
• Light-colored or greasy stools

Risk factors for gallbladder cancer

Cancer of the gallbladder is rare, but certain risk factors can increase your risk of developing the cancer. Some, like smoking, are ones that you can change. Others are less malleable, like your age or family history. Factors and conditions that increase the risk of gallbladder cancer:

• Gallstones
• Porcelain gallbladder (gallbladder wall becomes calcified)
• Biliary cysts
• Abnormality of the pancreatic duct junction
• Gallbladder polyps
• Inflammation of the bile ducts
• Chronic infections
• Being female
• Obesity
• Older age
• Exposure to toxins (cigarettes, radon)

Some of these risk factors can overlap with other conditions and cancers like liver and pancreatic cancer, bile duct cancer, or hepatobiliary cancer.

Gallbladder cancer diagnosis

Despite being difficult to detect early, gallbladder cancer is typically found after experiencing potential gallbladder cancer symptoms. On very rare occasions, gallbladder cancer is found after the gallbladder has been removed due to gallstones or to treat long-term inflammation.

If your provider suspects you have gallbladder cancer, they’ll walk you through a series of tests. Your provider will start by taking a complete medical history to learn more about your symptoms and risk factors.

Additional tests your provider might order:

• Blood tests to determine liver and gallbladder function
• Imaging tests
  • Ultrasound
  • CT scan
  • MRI
  • Cholangiography
  • Angiography
  • Laparoscopy
• Biopsies to remove a tissue sample to see if cancer is present

Gallbladder cancer treatment

Gallbladder cancer is typically treated with surgery, radiation therapy, or chemotherapy depending on the severity and the stage of the disease. Your provider will walk through treatment options.

Surgical treatment options

Gallbladder cancer can be treated by removing the gallbladder and some of the tissues around the organ. Your provider will often first do a laparoscopy to see how much the cancer has spread and to determine if larger surgery is possible. Laparoscopies are a great first choice as they are less invasive than other surgery options.

If the cancer has spread and can’t be removed, your provider will explore palliative care options to help manage your symptoms:

• Biliary bypass: a surgery that creates a new pathway around the blocked bile duct causing buildup in the gallbladder.
• Endoscopic stent: a procedure that places a stent (thin tube) to drain bile fluid that has built up in the area due to blockage.
• Percutaneous transhepatic biliary drainage: a procedure which drains bile from the blocked area when inserting a stent is not possible.

Clinical trial treatment options

Sometimes, you may want to explore other options outside of surgery. Clinical trials can often fill that gap. Participating offers the option of benefiting from a new treatment before it’s available to the public as well as helping to advance medical understanding. Your Advocate care professional can talk to you more about your options.