Definition

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.

The Gallbladder

Copyright © Nucleus Medical Media, Inc.

Causes

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.

Risk Factors

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)
• Obesity
• 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

Symptoms

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

Diagnosis

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:

• Ultrasound
• CT scan
• Cholangiography
• Endoscopic retrograde cholangiopancreatography (ERCP)
• MRI scan

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

Treatment depends on the stage of the cancer. For advanced cancers, treatment is done only to help relieve symptoms. Treatments include:

Prevention

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.