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Gallbladder cancer

Gallbladder cancer is caused by an abnormal and uncontrolled growth of cells in the wall 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 digestive fluid that helps break down fatty food and is carried from your gallbladder to your bowel through a tube called the bile duct. Bile is yellow-green in colour because it contains a substance called bilirubin. 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 – only around 670 people are diagnosed each year. It's more common in countries such as Chile, Japan and India than in European countries.

Gallbladder cancer mostly affects people over 65. It’s more common in women – seven in every 10 people diagnosed with gallbladder cancer are women.

Types of gallbladder cancer

There are several different types of gallbladder cancer. The most common is adenocarcinoma, which starts in the gland cells of your gallbladder lining.

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 include:

  • pain in the upper right side of your abdomen
  • feeling sick and vomiting
  • weight loss
  • jaundice, which may cause your skin and the whites of your eyes to turn a yellow colour, your urine to darken, your faeces to become pale and your skin to 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, you may be more at risk of developing it if you:

  • have gallstones (hard, rock-like lumps that form in your gallbladder) or an inflamed gallbladder (cholecystitis)
  • have a close relative (parent, brother or sister) who has had gallbladder cancer
  • have gallbladder polyps – these are non-cancerous lumps that grow on the inside lining of your gallbladder
  • have inflamed or abnormal bile ducts
  • have a condition called porcelain gallbladder – this is a build up of calcium on the inside wall of your gallbladder
  • smoke, or have been exposed to chemicals that contain nitrosamines, which are used in the metal or rubber industry
  • are obese

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 refer you to a gastroenterologist, a doctor who specialises in identifying and treating conditions that affect the digestive system, or a surgeon who specialises in liver cancer, for further tests. These tests may include the following.

  • A blood test will check your general health and liver function, including bilirubin levels.
  • A scan, such as an ultrasound, CT or MRI scan, can produce images of your gallbladder.
  • 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 ask you to swallow a narrow, flexible, tube-like telescopic camera called an endoscope which he or she will then pass into your bile duct.
  • 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, you may need to have other tests to check if the cancer has spread. The process of finding out the stage of a cancer is called staging.

Treatment of gallbladder cancer

Your treatment for gallbladder cancer will depend on how advanced the cancer is.

Surgery

This is the main type of treatment for gallbladder cancer. If your cancer hasn't spread beyond the wall of your gallbladder, you will need to have your gallbladder removed in a cholecystectomy operation. However, if your cancer has spread beyond your gallbladder, your surgeon may also need to remove tissues to which the cancer has spread to. These may include lymph nodes, part of your liver and depending on how much your cancer has spread, other organs such as your pancreas or part of your bowel.

If your cancer has spread to surrounding tissues (such as your liver, stomach or lymph nodes in the area) and your surgeon can't remove it, he or she will aim to relieve your symptoms and prevent jaundice. This is called palliative therapy. Your surgeon may insert a stent (a small hollow tube) to help bile drain properly into your digestive system. Your surgeon may insert the stent through an endoscope or through your skin, passing through your liver. Alternatively, your surgeon may perform 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

Non-surgical treatments include the following.

  • Radiotherapy uses radiation to destroy cancer cells. A beam of radiation is targeted on the cancerous cells, which shrinks the tumour. However, this isn't generally suitable for early-stage gallbladder cancer. You may have radiotherapy to relieve your symptoms (palliative therapy) if you have advanced gallbladder cancer. You might also have it after surgery to kill any remaining cancer cells. Radiotherapy may be combined with chemotherapy.
  • If your cancer can't be completely removed by surgery, or has spread to another part of your body, you may need chemotherapy treatment. You may be offered this treatment as part of a clinical trial.
  • Photodynamic therapy uses a light-sensitive medicine and a laser to destroy cancer cells. This can help treat the symptoms of gallbladder cancer. Your doctor will inject the medicine into a vein. This will travel around your body and will be taken up by cells (the drug enters more cancerous cells than healthy cells). He or she will then pass a laser over the cells to activate the drug, which will then destroy the cancer cells.

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.

 

Produced by Rachael Mayfield-Blake, Bupa Heath Information Team, June 2012.

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

For sources and links to further information, see Resources.

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  • 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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