• Bookmark and Share

Gallbladder cancer

Gallbladder cancer is rare. Around 500 people in the UK are diagnosed with gallbladder cancer each year.

Seven in every 10 people diagnosed with gallbladder cancer are women.

Gallbladder cancer is most common in people aged between 70 and 75. It's very rare in people under 50. It's rare in Western countries but is more common in India and Mexico.

  • About gallbladder cancer
  • Symptoms
  • Causes
  • Diagnosis
  • Treatment
  • Living with gallbladder cancer
  • Further information
  • Sources
  • Related topics

About gallbladder cancer

The gallbladder

The gallbladder is a small pear-shaped pouch in the upper right part of your abdomen (tummy). It stores bile produced by your liver. Bile is a digestive fluid that helps to break down fatty food, and it's carried from the gallbladder to your bowels through a tube called the bile duct. Bile is yellow/green because it contains something called bilirubin. If bile isn't removed from your blood it builds up and you become jaundiced (yellow skin).

What is gallbladder cancer?

A gallbladder tumour is a lump created by an abnormal and uncontrolled growth of cells. It can either be malignant (cancerous) or benign.

Cancerous tumours can grow through your gallbladder and spread to other parts of your body through the bloodstream or lymph system where they may grow and form secondary tumours. This spread of cancer is called metastasis.

Benign tumours don't spread to other areas of the body.

Types of gallbladder cancer

There are several different types of gallbladder cancer.

The most common type is adenocarcinoma, which starts in the gland cells of your gallbladder lining. In every 100 people, 85 diagnosed with gallbladder cancer have adenocarcinoma. There are three types of adenocarcinoma:

  • non-papillary carcinoma
  • papillary adenocarcinoma
  • mucinous adenocarcinoma

There are also several rare types of gallbladder cancer which affect 15 out of every 100 people with gallbladder cancer:

  • squamous cell cancer
  • adenosquamous carcinoma
  • small cell carcinoma
  • sarcoma
  • neuroendocrine tumour
  • lymphoma and melanoma of the gallbladder can also occur but are very rare

Symptoms

You may not have any symptoms during the early stages of gallbladder cancer. One in five people are diagnosed with gallbladder cancer after surgery to remove gallstones.

If you have gallbaldder cancer, you may have some of the following symptoms:

  • feeling sick
  • vomiting
  • pain in the upper right side of the abdomen (tummy) which can come and go
  • your skin and the white of your eyes are yellowed (jaundice)
  • dark urine
  • pale coloured faeces
  • itchy skin
  • loss of appetite
  • unexplained weight loss
  • swollen abdomen

Although not necessarily a result of gallbladder cancer, if you have any of these symptoms you should visit your GP.

Causes

The causes of gallbladder cancer aren't fully understood at present. There are though certain factors that make gallbladder cancer more likely and are listed below.

Gallbladder cancer is more likely if you have had gallstones or gallbladder polyps. Eight out of 10 people who get gallbladder cancer will also have gallstones.

It's slightly more common if you have been born with abnormal bile ducts.

Your risk increases if you are a smoker or have been exposed to particular industrial chemicals used in the metal or rubber industry.

If calcium has formed in the wall of your gallbladder (porcelain gallbladder), there is an increased risk.

Diagnosis

Your doctor will ask you about your symptoms and will examine you. Your GP may give you a blood test and may refer you to a doctor who specialises in gallbladder conditions for further tests, including the following.

  • Blood tests to check your general health and the levels of bilirubin (a chemical found in bile) in your blood.
  • An ultrasound scan, which uses high frequency sound waves to produce an image of the gallbladder.
  • A CT (computerised tomography) scan uses X-rays to build up a three-dimensional picture of the abdomen.
  • Your doctor may use an ultrasound scan to guide a needle to the gallbladder to take a biopsy. A biopsy is a small sample of tissue. This will be sent to a laboratory for testing.
  • Endoscopic retrograde cholangio-pancreatography (ERCP) is a test using a narrow, flexible, tube-like telescopic camera called an endoscope which is used to check your digestive system.
  • An MRI (magnetic resonance imaging) scan uses magnets and radiowaves to produce two- and three-dimensional pictures of the inside of the body.
  • Other tests may also be needed such as an angiogram, this is when a fine tube is inserted into an artery in your groin and a dye is injected. It will highlight all the blood vessels when an X-ray is taken to see if they are affected. Some people may need a laparoscopy or a laparotomy; this is when a small incision is made in your abdomen (tummy) to look at the gallbladder. For this you will need a general anaesthetic.

Ask your doctor to explain the tests you will have. The results of the tests will determine your course of treatment.

Treatment

The treatment for gallbladder cancer depends on the type, stage and grade of cancer that you may have.

Surgery

This is the main type of treatment for gallbladder cancer. The gallbladder and a number of lymph nodes will be removed. If the cancer has spread to any surrounding tissue this may also be removed. If cancer is found in the removed lymph nodes you may need another operation to remove further lymph nodes. Your doctor may remove the gallbladder during a laparoscopy or a laparotomy instead of having a separate operation. Ask your doctor to explain this to you.

Radiotherapy

This uses radiation to destroy cancer cells but isn't generally suitable for gallbladder cancer. It's sometimes given with chemotherapy.

Chemotherapy

Medicines to attack cancer cells are given to some people with certain types of cancer. Chemotherapy medicines may be given if the cancer can't be completely removed or has spread to another part of the body. In some patients it can shrink the tumour for a short time. You may be offered this treatment as part of a clinical trial.

Stent insertion

A stent (a small hollow tube) may be inserted to help bile drain properly into the digestive system and prevent jaundice. This can be added during an ERCP or you may need a small operation. A catheter (a longer tube which drains to the outside of the body) can also be placed for palliative treatment.

Clinical trials

Sometimes you may be able to be involved in clinical trials to help treat gallbladder cancer. You can discuss this with your doctor.

For more information on treatments, please see Related topics.

Living with gallbladder cancer

After treatment for the cancer you will have regular check ups with your doctor to detect any evidence of the cancer returning. If the cancer has already spread you may be seen regularly by doctors or specialist nurses to arrange treatments that can deal with any symptoms you might develop.

Being diagnosed with cancer can be distressing for you and your family. Specialist cancer doctors and nurses are experts in providing the care and support you need. There may be support groups so you can meet people who may have similar experiences to you. Ask your doctor for advice.

Further information

Cancerbackup

Sources

  • Gall bladder cancer. Cancerbackup. www.cancerbackup.org.uk, accessed 3 October 2007
  • Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2005: 446
  • Risks and causes of gallbladder cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 3 October 2007
  • Gallbladder carcinoma. GP Notebook. www.gpnotebook.co.uk, accessed 4 October 2007
  • Types of gallbladder cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 3 October 2007
  • Symptoms of gallbladder cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 3 October 2007
  • Tests for gallbladder cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 3 October 2007
  • Souhami R, Tobias J, Cancer and its Management. 5th ed. Oxford: Blackwell, 2005
  • Which treatment for gallbladder cancer? Cancer Research UK. www.cancerhelp.org.uk, accessed 3 October 2007

Related topics

  • Chemotherapy
  • CT scan
  • Gallbladder removal
  • General anaesthesia
  • Local anaesthesia and sedation
  • Radiotherapy
  • Abdominal ultrasound