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Gallbladder cancer

Key points

  • Gallbladder cancer is very rare in the UK, with just under 800 people developing it each year.
  • It’s more common in women, and in people aged over 65.
  • The main treatment for gallbladder cancer is surgery, but you may also be offered radiotherapy or chemotherapy.
  • Gallbladder cancer can be difficult to cure because it’s not usually diagnosed until it’s advanced.

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Gallbladder cancer is caused by an abnormal and uncontrolled growth of cells in the lining of your gallbladder.

How cancer develops

About gallbladder cancer

Your gallbladder is a small, pear-shaped pouch in the upper right part of your abdomen (tummy). It stores bile that is produced by your liver. Bile is a fluid that helps break down fatty food. It’s carried from your gallbladder to your bowel through a tube called the bile duct. Bile contains a substance called bilirubin that is yellow-green in colour – it’s produced when red blood cells are broken down in the liver. If bile isn't removed from your blood, it builds up and your skin will turn a yellow colour. This is known as jaundice.

Illustration showing the position of the gallbladder and surrounding structures

Gallbladder cancer is rare in the UK – just under 800 people were diagnosed with it in 2011. It's more common in countries such as Chile, Japan and India than in European countries.

Gallbladder cancer mostly affects people over 65 but younger people can get it too. It’s more common in women – seven in every 10 people diagnosed with gallbladder cancer are women.

For the majority of people who develop gallbladder cancer, it starts in the cells in the lining of the gallbladder wall. This is called adenocarcinoma. The cancer may spread through the wall of your gallbladder.

Symptoms of gallbladder cancer

You may not have any symptoms during the early stages of gallbladder cancer. Some early-stage gallbladder cancers are found by chance – for example, if a doctor examines your gallbladder after it has been removed to treat gallstones.

Later symptoms of gallbladder cancer can include the following.

  • Pain in your abdomen, especially in the upper right side.
  • Feeling sick and vomiting.
  • Unexplained weight loss.
  • Jaundice – this may cause your skin and the whites of your eyes to turn a yellow colour. You may also have darker urine, your faeces (stool) may become pale and your skin may feel itchy.

These symptoms aren’t always caused by gallbladder cancer but if you have them, see your GP.

Causes of gallbladder cancer

The exact reasons why you may develop gallbladder cancer aren't fully understood at present. However, there are some things that may increase your risk of developing it, which are explained here.

  • Gallstones – these are hard, rock-like lumps that form in your gallbladder.
  • A condition called cholecystitis – this means you have inflammation of your gallbladder, which is often caused by gallstones.
  • Gallbladder polyps – these are non-cancerous lumps that grow on the lining of your gallbladder.
  • Inflamed or abnormal bile ducts.
  • A condition called ‘porcelain gallbladder’ – this is a build-up of calcium on the inside wall of your gallbladder.
  • Having a close relative (parent, brother or sister) who has had gallbladder cancer.
  • Smoking or if you have been exposed to some chemicals, such as those found in the oil, chemical, mining, textile and paper industries.
  • Being obese.
  • Having a diet that is low in fruit and vegetables and high in fat.

Diagnosis of gallbladder cancer

Your GP will ask you about your symptoms and examine you. He or she may also ask you about your medical history. Your GP may do a blood test to check your general health and how well your liver is working. He or she may then refer you to another doctor depending on the results and your symptoms. This may be to a gastroenterologist, a doctor who specialises in identifying and treating conditions that affect the digestive system. Alternatively you may be referred to a surgeon.

You may then be offered further tests to find out whether your symptoms are caused by gallbladder cancer or something else. Some of these are explained below.

  • A scan, such as an ultrasound, CT or MRI, can produce images of your gallbladder and the surrounding tissues.
  • An endoscopic retrograde cholangio-pancreatography (ERCP) can check if there is a narrowing or blockage in your bile duct or pancreatic duct. In this test, your doctor will use a narrow, flexible, tube-like telescopic camera called an endoscope. This is passed into your mouth, through your stomach and down to reach into your bile duct. Before this is done you will have a local anaesthetic spray for your throat and a sedative to help you relax. This medicine will make you feel sleepy.
  • A fine needle aspiration biopsy. Your doctor will use a needle to suck out a small sample of cells for testing in a laboratory. Your doctor will use a CT or ultrasound scan to guide the needle to the right place.
  • In a laparoscopy (keyhole surgery), your surgeon will make a small cut in your abdomen to look at your gallbladder and the surrounding tissues. He or she will take small samples of tissue, which will be sent to a laboratory for testing. You will have a laparoscopy under general anaesthesia.

If you're found to have cancer, other, more specific tests may be recommended to you to find out how advanced the cancer is. This process, known as staging, takes into account whether the cancer has spread and how big it is. You’re likely to be offered a CT scan to do this. This uses X-rays to produce three-dimensional pictures of the inside of your body. The test is painless and only takes a few minutes.

Treatment of gallbladder cancer

The treatment you’re offered for gallbladder cancer will depend on how advanced your cancer is and your general health. Your doctor will discuss your treatment options with you.

Surgery

This is the main type of treatment for gallbladder cancer. If your cancer hasn't spread beyond the wall of your gallbladder, you may only need to have your gallbladder removed. This operation is called a cholecystectomy. However, if your cancer has spread to tissues beyond your gallbladder, you will be advised to have these removed with a bigger operation. Other parts of your body that may need to be removed include:

  • lymph nodes (part of your immune system that helps to fight infection)
  • parts of your liver
  • other organs, such as your pancreas or part of your bowel

It’s possible that your cancer may have already spread too far to surrounding tissues for it to be possible to remove it with surgery. Instead, your surgeon will aim to relieve your symptoms and prevent jaundice. This is called palliative therapy.

Your surgeon may recommend having a stent (a small, hollow tube) inserted to help bile drain properly into your bowel. Your surgeon may insert the stent through an endoscope or through your skin, passing through your liver.

Alternatively, you may be offered a bypass operation to prevent your bile duct from becoming blocked. In this operation, your surgeon will cut your gallbladder or bile duct above where it’s blocked and reconnect it to your small bowel. This will allow bile to go around and bypass the cancer.

Non-surgical treatments

It’s possible that you will be offered chemotherapy or radiotherapy. Although neither of these can cure gallbladder cancer, they may help to relieve your symptoms.

Chemotherapy

Chemotherapy uses medicines to try to destroy cancer cells. If your surgeon can’t completely remove your cancer, you may be offered chemotherapy to try to shrink it and so reduce your symptoms. This is known as palliative care.

A clinical trial is currently being carried out to test the effectiveness of using chemotherapy after surgery to prevent the cancer coming back. It’s hoped that this may increase the chance of curing gallbladder cancer.

Radiotherapy

Radiotherapy uses radiation to destroy cancer cells. A beam of radiation is targeted on the cancerous cells, which shrinks the tumour. However, it’s rarely used to treat gallbladder cancer except to try to reduce symptoms if your condition is advanced. You may be offered it in combination with chemotherapy.

Photodynamic therapy

Photodynamic therapy is a new treatment that is currently being tested. It involves using a light-sensitive medicine and a laser to destroy cancer cells. However, at the moment there isn’t enough evidence to say whether or not it’s effective at treating gallbladder cancer so it’s very rarely used.

Clinical trials

As well as the possible new treatments for gallbladder cancer that are mentioned here, many more are being tested in clinical trials. You may be able to take part in a clinical trial – ask your doctor for more information.

Help and support

Being diagnosed with cancer can be distressing for you and your family. An important part of cancer treatment is having support to deal with the emotional aspects as well as the physical symptoms. Specialist cancer doctors and nurses are experts in providing the care and support you need, and may also visit you at home. If you have more advanced cancer, further care is available to you in hospices or at home.


Reviewed by Polly Kerr, Bupa Heath Information Team, March 2014.

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For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.


  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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