Gallbladder Cancer

Factors that can increase the risk of gallbladder cancer include:

• Female sex. Gallbladder cancer is much more common in women than in men. Experts think it may be related to the hormone estrogen, which increases the risk of gallstones. People who are assigned female at birth most often have higher levels of estrogen in their bodies than do people assigned male at birth.
• Increasing age. Your risk of gallbladder cancer increases as you age. It’s more common after age 65. But it can happen in children.
• A history of gallstones. Gallbladder cancer is most common in people who have gallstones or have had gallstones in the past. Larger gallstones may carry a larger risk. Gallstones are common. But even in people with gallstones, gallbladder cancer is rare.
• Other gallbladder conditions. Other gallbladder conditions that can increase the risk of gallbladder cancer include polyps, infections, and ongoing swelling and irritation, called chronic inflammation.
• Inflammation of the bile ducts. Primary sclerosing cholangitis causes inflammation of the ducts that drain bile from the gallbladder and liver. This condition increases the risk of gallbladder cancer.

Healthcare professionals have not found ways to prevent gallbladder cancer.

Gallbladder cancer diagnosis might start with a discussion about your symptoms. A healthcare professional might use blood tests to understand how your organs are working and imaging tests to look for signs of cancer in the gallbladder.

Blood tests

Blood tests to check how your liver is working may help your healthcare professional find what’s causing your symptoms.

Imaging tests

Imaging tests that may be used to make pictures of the gallbladder include ultrasound, CT scan and MRI.

Finding the extent of gallbladder cancer

Once your healthcare professional diagnoses your gallbladder cancer, the next step is to find the extent of the cancer. This is called staging. Your gallbladder cancer’s stage helps show your prognosis and helps with treatment choices.

Tests and procedures used to stage gallbladder cancer include:

• Tests to look at the bile ducts. Your healthcare professional may suggest procedures to put dye into the bile ducts. An imaging test then records where the dye goes. These tests can show if the bile ducts are blocked.

  These tests may include magnetic resonance cholangiography and endoscopic retrograde cholangiopancreatography.

• Other imaging tests. Most people with gallbladder cancer will have a series of scans to help see if the cancer has spread. Common scans include CT and MRI scans of the belly area and chest.

• Exploratory surgery. If surgery is a treatment option for you, your healthcare professional first may recommend surgery to look inside your belly to see if gallbladder cancer has spread.

  In a procedure called laparoscopy, the surgeon makes a small cut called an incision in your belly and puts in a tiny camera. The camera lets the surgeon check organs around your gallbladder for signs that the cancer has spread.

Your healthcare team uses these procedures to give your cancer a stage. The stages of gallbladder cancer range from 0 to 4. A lower number generally means the cancer is small and likely to be cured.

A stage 1 gallbladder cancer means the cancer is only in the gallbladder. As the cancer grows larger and grows beyond the gallbladder, the stages go up. A stage 4 gallbladder cancer means the cancer has grown through the gallbladder and into nearby organs. Stage 4 also may mean the cancer has spread to other parts of the body.

Treatment for gallbladder cancer often involves surgery. If the cancer grows into nearby organs, surgery might not be possible. Treatment might start with radiation therapy or medicines, such as chemotherapy, instead. What gallbladder cancer treatments are best for you depend on the stage of your cancer, your health and what you prefer.

Surgery

Surgery is used to treat gallbladder cancer that hasn’t spread beyond the gallbladder. Types of surgery include:

• Surgery to remove the gallbladder. Early gallbladder cancer that hasn’t grown beyond the gallbladder is treated with an operation to remove the gallbladder. This operation is called cholecystectomy.
• Surgery to remove the gallbladder and part of the liver. Gallbladder cancer that grows beyond the gallbladder and into the liver is sometimes treated with surgery to remove the gallbladder, as well as parts of the liver and bile ducts that surround the gallbladder.

If your gallbladder cancer is small and all of it can be removed with cholecystectomy, you may not need other treatments.

Chemotherapy

Chemotherapy treats cancer with strong medicines. Most chemotherapy medicines are given through a vein. Some come in pill form.

Your healthcare professional might suggest chemotherapy after surgery if there’s a risk that some gallbladder cancer cells might remain. Sometimes, healthcare professionals give chemotherapy before surgery. It also can be used to control the cancer when surgery isn’t possible.

Radiation therapy

Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources.

Radiation therapy is sometimes used with chemotherapy after surgery for gallbladder cancer if all the cancer couldn’t be removed. Radiation therapy also can control gallbladder cancer that’s causing pain and jaundice when surgery isn’t possible.

Targeted therapy

Targeted therapy for cancer is a treatment that uses medicines that attack certain chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die.

Targeted therapy medicines are used only in people whose cancer cells have certain changes that can be targeted. Your cancer cells may be tested to see if targeted therapy is likely to help you.

Immunotherapy

Immunotherapy for cancer is a treatment with medicine that helps the body’s immune system kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn’t be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system find and kill the cancer cells.

Immunotherapy is typically used for gallbladder cancers that grow very large or spread to other parts of the body.