Gallbladder Cancer

Gallbladder cancer is a rare disease in which malignant cells form in the tissues of the gallbladder. Almost all gallbladder cancers are adenocarcinomas. This type of cancer begins in the glandular cells, which make and release mucus and other fluids. Gallbladder cancer is hard to diagnose in the early stages because there are no signs or symptoms. Sometimes gallbladder cancer is found when the gallbladder is checked or removed for other reasons, such as gallstones, but having gallstones does not increase the risk for developing gallbladder cancer. Women and Native Americans are more likely to develop gallbladder cancer than other populations.

Although gallbladder cancer doesn't usually have symptoms in the early stages, symptoms can develop as the cancer grows. Those symptoms can include:

  • Jaundice, or yellowing of the eyes and skin
  • Pain above the stomach
  • Fever
  • Nausea and vomiting
  • Bloating
  • Lumps in the abdomen

A combination of blood tests and imaging tests may be done to diagnose gallbladder cancer.

Gallbladder cancer can only be cured when it is diagnosed in the early stages. Once the cancer has spread, treatment focuses on symptom relief and quality of life.

Surgery
If gallbladder cancer is diagnosed at an early stage, surgery may be done to remove the gallbladder and some of the surrounding tissues, a procedure called cholecystectomy. Nearby lymph nodes may also be removed.

If the cancer has spread and cannot be removed, palliative surgery may be done to relieve symptoms and improve quality of life. Types of palliative surgery include:

  • Surgical biliary bypass: If cancer is blocking the small intestine and bile is building up in the gallbladder, a biliary bypass may be done. During this surgery, the provider cuts the gallbladder or bile duct and attaches it to the small intestine to create a new pathway around the blocked area.
  • Endoscopic stent placement: If the tumor is blocking the bile duct, surgery may be done to place a thin tube, called a stent, to drain bile that has built up in the area into the small intestine.
  • Percutaneous transhepatic biliary drainage: A procedure done to drain bile when there is a blockage and endoscopic stent placement is not possible. This is where a catheter, or thin tube, is placed from the skin into the gallbladder to allow bile to drain out of the body. An x-ray of the liver and bile ducts is done to locate the blockage. Images made by ultrasound are used to guide placement of a stent, which is left in the liver to drain bile into the small intestine or a collection bag outside the body. This procedure may be done to relieve jaundice before surgery.

Radiation Therapy
Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Only external radiation therapy is used to treat gallbladder cancer.

Chemotherapy
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Systemic chemotherapy, which is taken by mouth or injected into a vein or muscle, targets cancer cells throughout the body. Regional chemotherapy, which is placed directly into the affected organ, targets cancer cells in that specific area, or region, of the body. The type of chemotherapy used depends on the type and stage of the cancer.