Gallbladder cancer

What is gallbladder cancer?

Gallbladder cancer is rare. Just under 1000 people in the UK are diagnosed with it each year. It is most common in people over 75. It is more common in women than men.

The gallbladder

The gallbladder is a small pouch that stores bile. Bile is a fluid that helps us digest food and break down fats. It is made by the liver and stored in the gallbladder. A tube called the bile duct connects the gallbladder to the small intestine and the liver.

Liver and surrounding organs

The parts of the gallbladder and bile duct that are outside the liver are called the extrahepatic biliary system. We have separate information about bile duct cancer (cholangiocarcinoma), which is a rare cancer that starts in the bile duct.

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What is cancer?

Symptoms of gallbladder cancer

Early gallbladder cancer does not usually cause symptoms.

Most gallbladder cancers are only found at an advanced stage. We have more information about the symptoms of gallbladder cancer.

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Do I have cancer?

Causes of gallbladder cancer

Doctors do not know the exact causes of gallbladder cancer. But there are risk factors that can increase your chance of developing it.

Having one or more risk factors does not mean you will get gallbladder cancer. Also, having no risk factors does not mean you will not develop gallbladder cancer.

Age

Gallbladder cancer is most common in people aged over 75.
Sex

Gallbladder cancer is more common in women than men.
Gallstones and inflammation

People with a history of gallstones or an inflamed gallbladder (cholecystitis) have a higher risk. But most people with these conditions do not develop gallbladder cancer.
Polyps

These are non-cancerous (benign) tumours of the gallbladder. Having polyps increases the risk of developing gallbladder cancer. Bigger polyps have a higher risk than smaller ones. Doctors are usually more concerned about polyps that are bigger than 1cm.
Porcelain gallbladder

This is when calcium builds up in the wall of the gallbladder. People with this condition have a slightly increased risk of gallbladder cancer.
Abnormal bile ducts

Gallbladder cancer is slightly more common in people born with abnormal bile ducts.
Diabetes

People with type 2 diabetes have a higher risk of gallbladder cancer.
Smoking

People who smoke have a higher risk of gallbladder cancer.
Obesity

Being very overweight can increase your risk of developing gallbladder cancer.
Family history

Close relatives of people with gallbladder cancer have a slightly higher risk. A close relative is a parent, brother or sister.
Ethnicity

People from Peru and Northern India have a higher risk of gallbladder cancer.
Primary sclerosing cholangitis (PSC)

This is a rare condition that causes inflammation of the bile ducts. It can increase the risk of gallbladder cancer.

Diagnosis of gallbladder cancer

Gallbladder cancer may be diagnosed by chance during an operation to remove the gallbladder. You may have this surgery if you have gallstones or inflammation.

Or you may be diagnosed after seeing your GP to have your symptoms checked. Your GP will then refer you to a hospital specialist.

At the hospital

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 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 special type of MRI scan that looks at the gallbladder and nearby organs. If you are going to have this scan, your doctors will tell you more about it.
ERCP (endoscopic retrograde cholangio-pancreatography)

An ERCP allows the doctor to look at the gallbladder, pancreas and bile duct, They can take samples of tissue (biopsies). They can also treat a blockage in the bile duct to help with jaundice.
EUS (endoscopic ultrasound)

An EUS is similar to an ERCP, but ultrasound. It may also be used to take a sample of tissue (biopsy).
PTC (percutaneous transhepatic cholangiography)

A PTC is a test that uses x-rays to look at the bile duct. It can also be used to unblock the bile duct and help with jaundice.
Laparoscopy

A laparoscopy is a small operation used to look at your gallbladder, liver and other organs close to the gallbladder. The surgeon uses a thin tube with a camera on the end, called a laparoscope. They may also take biopsies.

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Staging and grading of gallbladder cancer

The stage of the cancer describes the size and position of the cancer and whether it has spread.

A doctor decides the grade of the cancer by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer may develop.

Knowing the stage and grade of the cancer helps your doctors plan the best treatment for you. We have more information about staging and grading for gallbladder cancer.

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Cancer staging and grading

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).

Your cancer doctor or specialist nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions.

The treatment you have will depend on:

the position and size of the cancer
whether it has spread to other areas of the body
your general health
your preferences.

Treatment for gallbladder cancer may include:

Surgery

Surgery can be used to remove the gallbladder. Often the surgeon also removes some lymph nodes and part of the liver. Sometimes 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 the cancer cells. For gallbladder cancer, it may be used after surgery, to reduce the risk of the cancer coming back (adjuvant treatment). It may also be used if surgery is not possible or if the cancer has come back after surgery (recurrence). This can help shrink or slow down the growth of the cancer. The chemotherapy drugs most commonly used to treat gallbladder cancer are gemcitabine (Gemzar®) and cisplatin. Sometimes chemotherapy and radiotherapy are given together if surgery is not possible.
Radiotherapy

Radiotherapy uses high-energy rays to target the tumour. This helps to destroy the cancer cells, while doing as little harm as possible to normal cells. It may be used to help with symptoms if gallbladder cancer has spread. You may only need a few treatments and the side effects are usually mild.
Stents

If the cancer is blocking your 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 is no longer blocked. We have more information about bile duct stents.

You may have some treatments as part of a clinical trial.

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After gallbladder cancer treatment

After your treatment has finished, you will have regular follow-up appointments. You may also have some scans and x-rays. These may continue for several years. Let your doctor know as soon as possible if you have any problems or notice new symptoms between these times.

Your feelings

You may have many different emotions, including anxiety, anger and fear. These are all normal reactions. They are part of the process that many people experience when dealing with cancer. We have more information to help you cope with your emotions.

Everyone has their own way of coping with difficult situations. Some people find it helpful to talk to family or friends. Others may prefer to seek help from people outside their situation. Some people prefer to keep their feelings to themselves.

Macmillan is also here to support you. If you would like to talk, you can:

Call the Macmillan Support Line on 0808 808 00 00.
Chat to our specialists online.
Visit our gallbladder cancer forum to talk with people who have been affected by gallbladder cancer, share your experience, and ask an expert your questions.

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes such as eating well and keeping active can improve your health and wellbeing and help your body recover.

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Finishing treatment

About our information

References

Below is a sample of the sources used in our gallbladder cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

Biliary Cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up. 2016. Vol 27, 5. pp.28-37.

Uptodate: Surgical management of gallbladder cancer. 2018. www.uptodate.com/contents/surgical-management-of-gallbladder-cancer

Reviewers

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Dr Paul Ross, Consultant Medical Oncologist.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.