by Swedish Staff and Contributors
Often, symptoms are not present in the early stages of gallbladder cancer. Symptoms associated with bile obstruction frequently develop as the disease progresses. These symptoms include:
- Abdominal pain
- Upper back pain (called referred pain)
- Jaundice (yellowing of your skin, whites of your eyes and under your tongue)
Other symptoms may include:
- Lack of appetite
- Weight loss
- Enlarged liver and spleen
- Increased abdominal girth
Your gallbladder is a small, pear-shaped organ that sits beneath your liver and stores bile until it’s needed by your digestive system. Bile is a greenish-yellow digestive fluid produced by your liver that helps your body digest fat.
Gallbladder cancer is a relatively rare disease that occurs when cells in your gallbladder divide uncontrollably or without order. Normal cells in your gallbladder divide in a regulated manner, but if they keep dividing uncontrollably when new cells are not needed, a growth or tumor (mass of tissue) forms. The term cancer refers to malignant tumors which can invade nearby tissue and spread to other parts of your body. Unlike a malignant tumor, a benign tumor does not invade or spread.
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The exact cause of gallbladder cancer is not known.
Often gallbladder cancer is difficult to diagnose for the following reasons:
- Frequently, there are no early symptoms associated with the disease.
- When there are symptoms, they often mimic those of other gallbladder conditions such as gallstones.
- The gallbladder is hidden by other organs in your abdomen.
A physical exam is needed to diagnose gallbladder cancer. Your doctor will ask about your medical history and any symptoms you may be experiencing. Tests may include:
- Blood tests—done to check levels of bilirubin, which is part of your bile, and your liver enzymes.
- Ultrasound—a test that uses sound waves to examine internal organs, in this case, your gallbladder and bile ducts. A radiologist will examine your gallbladder with an ultrasound probe and may see stones inside; stones often can mask the presence of cancer.
- CT scan—a type of X-ray that uses a computer to make pictures of the inside of your body, in this case, your liver, gallbladder, bile ducts and surrounding tissue. A CT scan can help determine if your gallbladder is calcified or surrounded by a lining of calcium. This condition is called a porcelain gallbladder and can be caused by the growth of cancer cells. The CT scan can also help determine if cancer has spread to your lymph nodes or liver (the two most common places for gallbladder cancer to spread).
- Cholangiography—an invasive test that uses X-rays and a large needle inserted into your liver to examine the gallbladder and bile ducts. The test can be done to collect cells from your bile ducts to help diagnose cancer.
- Endoscopic retrograde cholangiopancreatography (ERCP)—a test that combines X-rays and an endoscope, a long, flexible, lighted tube, that’s inserted down your throat. This is done to examine the duodenum (first part of your small intestine), bile ducts, and pancreatic ducts. It can also be used to collect cells to help diagnose cancer.
- MRI scan —a test that uses magnetic waves to make pictures of structures inside your body
A biopsy, removing a sample of tissue for testing, must be done to definitively diagnose gallbladder cancer. This often requires open surgery. Many times gallbladder cancer is diagnosed by accident. The patient undergoes surgery because of a gallbladder "attack" and the surgeon may find cancer or it may only be found once a pathologist has sliced into pieces the entire gallbladder.
Treatment for this disease depends on the stage of the cancer – whether it has spread and if so, to what extent. For advanced cancers, treatment is done only to help relieve symptoms.
The surgical removal of your gallbladder is called a cholecystectomy. In addition to your gallbladder, part of your liver and lymph nodes located near the gallbladder may also be removed. Sometimes surgery is done to relieve symptoms by opening obstructed bile ducts. ERCP may also be used for this purpose.
To kill cancer cells and shrink tumors, radiation therapy may be used. Radiation is most often administered from an external source outside your body.
Chemotherapy is not considered a cure for gallbladder cancer, but it may prove effective in relieving symptoms for some patients. Chemotherapy involves taking medicines that are toxic to fast-growing cancer cells. The medicines enter your bloodstream and travel through your body killing cancer cells. Some healthy cells may also be killed.
Combined Modality Therapy (CMT)
CMT means several treatments are done at once or in succession. There’s no evidence that chemotherapy and radiation therapy done at the same time are a more effective treatment for gallbladder cancer than radiation therapy alone. However, CMT is a good treatment option for many other kinds of cancers.
Risk factors that may increase your chance of getting gallbladder cancer include:
- Sex: female
- Older age: More than 2 out of 3 people with gallbladder cancer are 65 or older when it is found
- Having gallstones or chronic inflammation of the gallbladder, including calcification of the gallbladder (porcelain gallbladder)
- Ethnicity: Hispanics and Native Americans have a higher incidence of gallbladder cancer and 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 which are found in metal processing and rubber production
Because the exact cause of gallbladder cancer is not known, there are no guidelines for prevention. Gallstones may be associated with the disease, but because gallbladder cancer is rare, the routine removal of gallbladders to prevent cancer in people with asymptomatic gallstones is generally not recommended.
This content was created using EBSCO’s Health Library. Edits to original content made by Swedish.