Gallbladder Cancer

Cancer is made of changed cells that grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. And they can spread to other parts of the body. This is called metastasis.

Gallbladder cancer starts in the cells that form the gallbladder. This organ stores bile, a fluid made in the liver to help digest fats. It connects to the liver and the small intestine.

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change. 

The risk factors for gallbladder cancer include:

• Gallstones.

• Calcium deposits in the gallbladder (seen on an X-ray).

• Being a woman.

• Obesity.

• Older age.

• Family members with this cancer.

• Being Mexican American or Native American.

• Bile duct cysts.

• Bile duct reflux.

• Gallbladder polyps.

• A disease called primary sclerosing cholangitis.

• Typhoid infection.

Talk with your healthcare provider about your risk factors for gallbladder cancer and what you can do about them

There is no sure way to prevent gallbladder cancer. Some risk factors can be controlled or treated to help reduce risk.

Are there screening tests for gallbladder cancer?  

There are currently no regular screening tests for gallbladder cancer. Screening tests are done to check for disease in people who don’t have symptoms.

You can have gallbladder cancer with no symptoms. The symptoms of gallbladder cancer usually don’t occur until the tumor is big or the cancer has spread. The symptoms of gallbladder cancer may include: 

• Pain or discomfort in the right side of the upper abdomen (belly).

• Lumps in the abdomen.

• A sense of fullness after eating even small amounts.

• Nausea and vomiting.

• Poor appetite.

• Loss of weight without trying.

• Fever.

• Yellowing of the skin or the white part of the eyes (jaundice).

• Severe itching.

Many of these may be caused by other health problems. It is important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

The most common way to find gallbladder cancer is when symptoms cause a person to see a doctor. The doctor will do a physical exam with a focus on the belly. Blood tests will be done. You will need some imaging tests, such as an ultrasound and CT scan, to look at the inside of your belly.

Special scopes can be put into your body to get a closer look at the gallbladder. A scope is a long, thin, flexible tube with a camera on the end. Small bits of tissue can be taken out through the scope. This is called a biopsy. The pieces of tissue are checked for cancer cells. It’s the only way to know if a lump or change is cancer. Your results will come back in about 1 week.

After a diagnosis of gallbladder cancer, you may have other tests. These help your healthcare providers learn more about the cancer. They can help determine the stage of the cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. It is one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.

Stage groupings are determined by combining the T, N, and M values from the TNM system. These groupings give an overall description of your cancer. A stage grouping can have a value of 0 or of Roman numerals I through IV (1 through 4). The higher the number, the more advanced the cancer is. Letters and numbers can be used after the Roman numeral to give more details.

These are the stage groupings of gallbladder cancer and what they mean:

Stage 0. Cancer cells are only found in the inside layer of the gallbladder. This stage is also called carcinoma in situ.

Stage I. The cancer is growing into the wall of the gallbladder and has reached the muscle layer. It hasn't spread to nearby lymph nodes or distant parts of the body.

Stage II. The cancer hasn't spread to nearby lymph nodes or distant parts of the body. It's divided into one of these groups:

• Stage IIA. It has grown through the muscle layer and into the lining of the abdomen (belly), called the peritoneum.

• Stage IIB. It has grown through the muscle layer and into the tissue that covers the outside of the liver, but it's not in the liver.

Stage III. The cancer hasn't spread to distant parts of the body. It's divided into one of these groups:

• Stage IIIA. It has grown through the outside covering of the gallbladder and into the liver and/or another nearby organ, such as the stomach, intestine, or pancreas. It has not spread to nearby lymph nodes.

• Stage IIIB. It has not grown into the liver or other nearby organs, but it has spread to one to three nearby lymph nodes.

Stage IV. The cancer is divided into one of these groups:

• Stage IVA. It has grown into one of the main blood vessels that go to the liver or it has grown into at least two other organs, but not the liver. It may or may not have spread to one to three nearby lymph nodes. It hasn't spread to distant parts of the body.

• Stage IVB. This stage is either of these:

  • The main tumor may or may not have grown through the outside of the gallbladder, but it has spread to four or more nearby lymph nodes. It hasn't spread to distant parts of the body.

  • The main tumor may or may not have grown through the outside of the gallbladder, and may or may not have spread to nearby lymph nodes. It has spread to distant parts of the body, like the lungs, liver, or peritoneum.

Your treatment choices depend on the type of gallbladder cancer you have, test results, and the stage of the cancer. Other things to think about are if the cancer can be removed with surgery and your overall health. The goal of treatment may be to cure you, control the cancer, or help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control the cancer cells in 1 area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy is a systemic treatment. Many people with gallbladder cancer are treated with surgery. Some will also need chemo or radiation after surgery. If surgery can’t be done, radiation may be the main treatment.

You may have just one treatment or a combination of treatments.

Talk with your healthcare providers about your treatment options. Make a list of questions. Consider the benefits and possible side effects of each option. Discuss your concerns with your healthcare provider before making a decision.

Cancer treatment such as chemotherapy and radiation can damage normal cells. This causes side effects such as hair loss, mouth sores, and vomiting. Talk with your healthcare provider about side effects you might have and ways to manage them. There may be things you can do and medicines you can take to help prevent or control side effects.

Surgery for gallbladder cancer is very complex. Ask what you can expect to happen and what side effects you may have.

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effects of cancer and its symptoms on your daily life.

Here are tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak to a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with a focus on high-protein foods.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse.

• Signs of an infection, such as a fever.

• Side effects of treatment that affect your daily function or don’t get better with treatment.

Ask your healthcare provider what signs to watch for, and when to call. Also be sure you know how to get help after office hours and on weekends and holidays.