Gallbladder cancer is a disease in which cancer cells grow in the gallbladder. This is a relatively rare form of cancer. The gallbladder is a small pear-shaped organ that sits beneath the liver. It stores bile until it is needed by the digestive system. Bile is a greenish-yellow digestive fluid produced by the liver that helps in digesting fat.
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Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues. Cancer that has invaded nearby tissues can then spread to other parts of the body.
It is not clear exactly what causes these problems in the cells, but is probably a combination of genetics and environment.
Gallbladder cancer is more common in women and those of Native American or Hispanic descent. Other factors that may increase your chances of gallbladder cancer:
- History gallstones or chronic inflammation of the gallbladder, including calcification of the gallbladder (porcelain gallbladder)
- Increasing age—especially 65 years and older
- Physical abnormalities of the gallbladder and ducts, such as choledochal cysts or polyps of the gallbladder
- Exposure to some chemicals, such as azotoluene and nitrosamines, found in metal processing and rubber production
- Typhoid fever or chronic salmonella infection
Gallbladder cancer often shows no symptoms in its early stages. As the disease progresses, symptoms associated with bile obstruction often develop. These include:
- Abdominal pain
- Pain in the upper back (called referred pain)
- Yellowing of the skin and whites of the eyes— jaundice
Other symptoms may include:
- Nausea and/or vomiting
- Loss of appetite
- Weight loss
- Liver and spleen enlargement
- Increased abdominal girth
The doctor will ask about your symptoms and medical history. A physical exam will be done. Gallbladder cancer is often hard to diagnose because there are no early symptoms. Gallbladder cancer is usually discovered incidentally during abdominal surgery for other reasons.
Tests may include:
- Blood tests
- Biopsy —The removal of a sample of tissue for testing. This is usually an open surgery.
Imaging tests evaluate the gallbladder and surrounding structures. These may include:
The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, gallbladder cancer is staged from I-IV (1-4). Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.
Treatment depends on the stage of the cancer. For advanced cancers, treatment is done only to help relieve symptoms. Treatments include:
Surgical removal of the gallbladder is called cholecystectomy. Part of the liver and lymph nodes near the gallbladder may also be removed. In some cases, surgery is done to relieve symptoms by opening obstructed bile ducts. ERCP may also be used for this purpose.
Radiation therapy uses radiation to kill cancer cells and shrink tumors. Radiation is most often administered from a source outside the body.
Chemotherapy is the use of drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. Chemotherapy is not considered curative for gallbladder cancer, but may relieve symptoms in some.
Combined Modality Therapy (CMT)
CMT is a term gaining popularity and meaning several treatments at once or in succession. Although it has not been shown that chemo- and radiation therapy at the same time are better than radiation therapy alone in the treatment of gallbladder cancer. CMT is better with many other kinds of cancers.
There are no current guidelines to prevent gallbladder cancer because the cause is unknown. If you have problems with gallstones, talk to your doctor about the risks and benefits of removing the gallbladder.
American Cancer Society
National Cancer Institute
Canadian Cancer Society
Provincial Health Services Authority
Cholangiocarcinoma and gallbladder cancer. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115320/Cholangiocarcinoma-and-gallbladder-cancer. Updated August 2, 2017. Accessed January 8, 2018.
Gallbladder cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/gallbladder-cancer.html. Accessed January 8, 2018.
Gallbladder cancer. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/liver_tumor_center/conditions/gallbladder_cancer.html. Accessed January 8, 2018.
Tumors of the gallbladder and bile ducts. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/tumors-of-the-gallbladder-and-bile-ducts Updated August 2016. Accessed January 8, 2018.
Last reviewed November 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP Last Updated: 12/20/2014