Gallbladder Cancer

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Gallbladder cancer is a relatively rare form of cancer. But at UVA Health, you'll find experts skilled in treating this type of cancer. You'll find the most advanced treatments at Virginia's first cancer center designated as a comprehensive cancer center.

What Is Gallbladder Cancer?

The gallbladder is a small pear-shaped organ. It sits beneath the liver and stores bile until it is needed by the digestive system. Bile is a greenish-yellow digestive fluid. It's produced by the liver to help in digesting fat.

Cancer occurs when cells in the body (in this case gallbladder cells) 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 tumors. This means they can invade nearby tissue and spread to other parts of the body. A benign tumor means it won't spread.

Who's at Risk for Gallbladder Cancer?

A risk factor is something that increases your chance of getting a disease or condition. Risk factors include:

  • Sex: female
  • Having gallstones or chronic inflammation of the gallbladder, including calcification of the gallbladder (porcelain gallbladder)
  • Ethnicity: Native American and Hispanics have a higher incidence of gallbladder cancer. This may be because they also have a higher incidence of gallstones.
  • Typhoid fever or chronic salmonella infection
  • 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

It is also more common in older individuals.

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)
  • Jaundice (yellowing of the “whites” of the eyes, the skin, under the tongue)
  • Nausea and/or vomiting
  • Loss of appetite
  • Weight loss
  • Liver and spleen enlargement
  • Increased abdominal girth

Diagnosis

Gallbladder cancer is often hard to diagnose because:

  • The disease often shows no early symptoms.
  • The symptoms often mimic those of other gallbladder conditions (such as gallstones).
  • Other organs in the abdomen hide the gallbladder.

Tests may include:

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

A biopsy, which is the removal of a sample of tissue for testing, must be done to definitively diagnose gallbladder cancer. This often requires open surgery. Many times gallbladder cancer is found by accident. The patient is often taken to surgery because of a gallbladder "attack." At surgery, the surgeon may find cancer or it may only be found once the pathologist has sliced the entire gallbladder into very small slices.

Treatment

Once gallbladder cancer is found, your doctor will do staging tests to find out if the cancer has spread. Treatment depends on the stage of the cancer. For advanced cancers, treatment is done only to help relieve symptoms. Treatments include:

  • Surgery
  • Radiation Therapy
  • Chemotherapy
  • Combined Modality Therapy (CMT)