Gallbladder cancer
Gallbladder cancer
Gallbladder cancer is rare. Each year, about 1,100 people in the UK are diagnosed with it, most often people over 75. It is also more common in women than men.
The gallbladder is a small pouch that sits under the right side of the liver. It stores bile, a fluid made in the liver that helps digest food and break down fats. Bile travels through the bile ducts, tubes that connect the liver and gallbladder to the small bowel.
Together, the gallbladder and bile ducts are known as the biliary system, or biliary tree. Macmillan Cancer Support has separate information about cancer that starts in the bile duct, called cholangiocarcinoma.
Common Symptoms
⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
Medicines Commonly Used
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
Causes
What causes gallbladder cancer?
Doctors don't know the exact causes of gallbladder cancer, but certain risk factors can raise the chance of developing it.
Having one or more risk factors doesn't mean you will get gallbladder cancer, and having none doesn't mean you're safe from it either.
Age
Gallbladder cancer is most common in people over 75 years old.
Sex
It is more common in women than in men.
Gallstones and inflammation
People with a history of gallstones or an inflamed gallbladder (cholecystitis) have a higher risk, though most people with these conditions never develop gallbladder cancer.
Primary sclerosing cholangitis (PSC)
PSC is a rare condition that causes inflammation and narrowing of the bile ducts. People with this condition have an increased risk of gallbladder cancer.
Porcelain gallbladder
Sometimes calcium builds up in the wall of the gallbladder, a condition called porcelain gallbladder. People with this condition have a slightly increased risk of gallbladder cancer.
Polyps
Polyps are non cancerous (benign) growths in the gallbladder. Having polyps raises the risk of developing gallbladder cancer, and bigger polyps carry a higher risk than smaller ones. Doctors are usually more concerned about polyps larger than 1cm.
Chronic infection
Certain types of chronic infection are linked to a higher risk of gallbladder cancer.
Abnormal bile ducts
Gallbladder cancer is slightly more common in people born with abnormal bile ducts.
Smoking
People who smoke have a higher risk of gallbladder cancer.
Obesity
Being very overweight can increase the risk of developing gallbladder cancer.
Family history
Close relatives of people with gallbladder cancer have a slightly higher risk. A close relative means a parent, brother or sister.
Diagnosis
Diagnosing gallbladder cancer
Some people may be diagnosed with gallbladder cancer during surgery to have the gallbladder removed. For example, if they have gallstones or inflammation of the gallbladder.
Some people will see their GP because they have symptoms. The GP can refer them to a hospital specialist and for tests to find the cause of the symptoms.
At the hospital
The doctor will ask you about your general health and any medical problems you have had. The doctor will examine your tummy area (abdomen).
You may have blood tests and some other tests.
Ultrasound scan
An external ultrasound scan uses sound waves to build up a picture of the gallbladder and surrounding organs.
CT scan
A CT scan takes a series of X-rays which build up a three-dimensional (3D) picture of the inside of your body.
MRI scan
An MRI scan uses magnetism to build up a detailed picture of areas of your body.
MRCP scan (magnetic resonance cholangiopancreatography)
An MRCP is a type of MRI scan that looks at the gallbladder and nearby organs. Your doctor can tell you more about this test.
ERCP (endoscopic retrograde cholangio-pancreatography)
An ERCP allows the doctor to look at the bile ducts, gallbladder and pancreas. The doctor can take samples of tissue (biopsies) during an ERCP. They can also treat a blockage in the bile ducts to help with jaundice.
EUS (endoscopic ultrasound)
An EUS is similar to an ERCP but uses ultrasound. It may also be used to take biopsies.
PTC (percutaneous transhepatic cholangiography)
A PTC is a test that uses X-rays to look at the bile ducts. It can also be used to unblock a bile duct and help with jaundice.
Laparoscopy
A laparoscopy is a small operation used to look at the bile ducts and the tissue around them. The surgeon uses a thin tube with a camera on the end, called a laparoscope. They may also take biopsies.
Waiting for test results can be a difficult time. Macmillan Cancer Support has more information that can help.
Staging and grading of gallbladder cancer
The results of your tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging.
After a biopsy or an operation to remove the gallbladder, the doctor examines the cells under a microscope to find the grade. This gives an idea of how quickly the cancer might grow or spread.
Knowing the stage and grade helps your doctors plan the best treatment for you.
Macmillan Cancer Support have more information about the staging and grading for gallbladder cancer.
Treatment
Treatment for gallbladder cancer
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
After the MDT meeting, you’ll usually meet with your specialist doctor and nurse. They’ll talk to you about your treatment plan.
Your specialist doctor should explain:
- the aim of the treatment – whether it’s to cure the cancer or control it
- the benefits of the treatment
- the disadvantages of the treatment – for example, the risks and side effects
- any other treatments that may be available
- what may happen if you don’t have the treatment
Your doctor or cancer specialist or nurse will explain the different treatments and their side effects. They’ll also talk to you about things to consider when making treatment decisions. Make sure you have a contact number so you know who to call if you have further questions.
Surgery
You may have surgery to remove the gallbladder. The surgeon may also remove some lymph nodes and part of the liver. If the cancer has spread into a nearby organ, the surgeon may remove part or all of that organ too.
Chemotherapy
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. You may have chemotherapy after surgery. This is to reduce the risk of the cancer coming back. This is called adjuvant treatment.
You may also be offered chemotherapy if it’s not possible to have surgery or if the cancer has come back or spread. Chemotherapy can help shrink the cancer or slow its growth.
The chemotherapy drugs most commonly used to treat gallbladder cancer are:
- capecitabine
- gemcitabine
- cisplatin
Some people have chemotherapy and radiotherapy together. This is called chemoradiation.
Some people have chemotherapy with an immunotherapy drug called durvalumab.
Radiotherapy
Radiotherapy uses high-energy rays called radiation to treat cancer. It destroys cancer cells in the area where it’s given.
If gallbladder cancer has spread and there’s only a small area of cancer, you may have radiotherapy to help with symptoms.
Stents
If the cancer is blocking a bile duct, this can cause jaundice. This can often be treated with a tube called a stent. The stent holds the duct open so it’s no longer blocked.
You may have some treatments as part of a clinical trial.
After gallbladder cancer treatment
You’ll have regular check-ups during and after your treatment. You may also have some scans and X-rays. These may continue for several years.
Tell your doctor or specialist nurse as soon as possible if you have any problems or notice new symptoms between appointments.
Macmillan Cancer Support has more information about follow-up care after treatment.
Support after gallbladder cancer
You may have lots of different emotions after finishing gallbladder cancer treatment. You may get anxious between appointments. This is natural.
Everyone has their own way of dealing with illness and the emotions they have. You may find it helpful to talk to family and friends or to your doctor or specialist nurse.
It’s important to know where to get support or information if you need it. To find support:
- ask your GP or someone from your cancer team for advice about support in your area
- find local cancer support services
Macmillan Cancer Support also has further information to support you. You can:
- phone the Macmillan Support Line on 0808 808 00 00
- chat to Macmillan specialists online
- use the Macmillan gallbladder cancer forum – you can talk to others affected by gallbladder cancer, ask questions and share your experience
Macmillan Cancer Support’s course Help to Overcome Problems Effectively (HOPE) helps people during and after cancer treatment. It’s a free, interactive, group-based, self-management support course. It runs for 6 weeks, with each weekly session lasting 2.5 hours.
Complications
After gallbladder cancer treatment, recovery can take a while, and some days will feel better than others.
Even if you already live a healthy lifestyle, you might want to make further positive changes after treatment. Macmillan Cancer Support has more information on this.
Small steps, like eating well and staying active, can support your health and help your body heal.
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