Gallbladder Cancer

Gallbladder cancer is one of the biliary tract cancers, and like cholangiocarcinoma, it’s rare and often caused by unknown reasons. Gallbladder cancer makes up 1-2% of all GI cancer cases. If caught early, when it’s small, there’s a good chance for survival, but many of these cancers are aggressive and caught at later stages, making them very difficult to treat.

Symptoms of gallbladder cancer often mirror other conditions, which is why it can be very challenging to identify and treat this cancer. The majority of cases are called "incidental findings” and occur when doctors happen to find the cancer during unrelated procedures or tests.

What is gallbladder cancer?

The gallbladder is a pear-shaped organ found just under the liver, in the upper abdomen. The gallbladder stores bile, a fluid produced by the liver that helps digest fat. Gallbladder cancer forms in cells lining the gallbladder and grows outward as it spreads.

Types of gallbladder cancer

Almost all gallbladder cancers are adenocarcinomas. These are cancers that begin in glands that line internal organs and make mucus and other fluids. 

Adenocarcinoma

Around 90% of gallbladder cancer is classified as adenocarcinoma. There are three types of gallbladder adenocarcinomas:

• non papillary (most common)
• papillary (in the tissues holding the gallbladder in its place; this is rare and less likely to spread)
• mucinous (most rare, in cells that produce mucus)

Rare types of gallbladder cancer

A few other rare types of gallbladder cancer include adenosquamous carcinoma, squamous cell carcinoma, and carcinosarcoma. These cancers form in different cells in the gallbladder and they can be more aggressive than adenocarcinomas. 

Staging gallbladder cancer

If you have gallbladder cancer, you need to know your stage. This helps you understand where the cancer is now, the best treatment plan for your unique situation, and your outlook.

Gallbladder cancer is staged on a scale from 0-4 (many researchers use roman numerals 0-IV)  using the TNM staging system. In general:

• Stage 0 (carcinoma in situ): Cancer is in one spot and has not spread anywhere else.
• Stage 1: Cancer has formed and is only in the gallbladder’s inner layers.
• Stage 2: Cancer has grown to the gallbladder’s outer layers.
• Stage 3: Cancer has spread to one or more nearby organs and possibly lymph nodes.
• Stage 4 (also called “metastatic”): Cancer has grown into blood vessels, lymph nodes, and/or other organs.

What causes gallbladder cancer?

Risk factors put you at a higher risk of getting cancer. Some risk factors can be controlled with lifestyle changes, and others cannot. Older age, smoking, and obesity increase your risk of many cancers.

Just because you have a risk factor, that doesn’t mean you will get gallbladder cancer—especially when it comes to gallstones, as these are very common yet gallbladder cancer is rare.

These are scenarios researchers have found that can increase your risk: 

• Gallstones (up to 90% of patients also have gallstones and a history of inflammation)
• Porcelain gallbladder (wall of gallbladder is covered in calcium deposits)
• Polyps (small growths from the gallbladder’s mucus membrane)
• Biliary cysts (bile-filled sacs that can have pre-cancerous changes)
• Infections (typhoid and H. pylori)

Preventing gallbladder cancer

You can’t prevent gallbladder cancer. However, because gallstones are a risk, they should be removed and treated. 

As with every cancer, there are steps you can take to adopt a healthy lifestyle and reduce your overall cancer risk, such as maintaining a healthy weight, not smoking, and limiting or eliminating alcohol. 

Learn more about cancer prevention from the American Institute for Cancer Research.

How common is gallbladder cancer? 

Gallbladder cancer is a rare disease.

The American Cancer Society estimates approximately 5,000 cases per year in the United States.

The average age of diagnosis is 72 years old. Women are 3-4 times more likely to be diagnosed than men.

What are my odds of surviving it?

Gallbladder cancer is often caught at late stages, when it’s most difficult to treat. Doctors use what’s called “survival statistics” to understand the likelihood of a patient beating the disease.

Approximately 20% of patients are alive five years after a gallbladder cancer diagnosis.

Detailed survival statistics are based on where the cancer is located and if it has spread:

Localized

The cancer hasn’t spread

• 69% of patients are alive five years after diagnosis

Regional

The cancer spread to nearby lymph nodes

• 28% of patients are alive five years after diagnosis

Distant

The cancer has spread to lymph nodes and/or organs

• 3% of patients are alive five years after diagnosis

What types of tests should I expect to undergo?

Doctors will use these tests to diagnose gallbladder cancer:

• Physical exam
• Blood tests checking bilirubin, liver enzymes, and tumor markers

Biopsy, endoscopy, laparoscopy, surgery, cholangiography, and angiography may also be used to identify and diagnose gallbladder cancer.

Once you’ve been diagnosed, you can expect these tests:

• CT scan
• Ultrasound
• MRI
• PET scan

Ask your doctor about these additional tests—ideally before you begin treatment.

• Biomarker testing
• Genetic testing

I’m facing a diagnosis: What are my next steps?

If you’re facing a diagnosis, the GI Cancers Alliance is here for you. 

If you’re newly diagnosed, work with your doctor to create a treatment plan. It’s important to find an expert who specializes in gallbladder cancer and visit a major cancer center if possible. Gallbladder cancer treatment, especially surgery, is complex. 

Treatment plans may include:

• Surgery (to cure cancer or to reduce symptoms)
• Chemotherapy 
• Radiation (if tumors cannot be removed by surgery)
• Targeted therapy
• Immunotherapy

We strongly encourage you to get a second opinion from another trusted doctor so you feel confident moving forward.