Gallbladder Cancer: A Plain-Language Overview

The gallbladder is a small, pear-shaped organ tucked beneath the liver. It stores bile, a fluid that helps digest fat. Gallbladder cancer starts here. It is rare. Nearly all cases are adenocarcinomas, a type that starts in the gland cells lining the inside of the gallbladder.

Gallstones are the most common risk factor. Most people with gallstones never get gallbladder cancer. Still, most people who do get gallbladder cancer have a history of gallstones. Other risk factors include:

• Porcelain gallbladder — calcium deposits that build up on the gallbladder wall over years.
• Gallbladder polyps — growths inside the gallbladder. Larger polyps carry more risk than small ones.
• Primary sclerosing cholangitis, a disease that inflames and scars the bile ducts.
• Chronic infections, including certain bacteria like Salmonella or H. pylori.
• Being female — gallbladder cancer occurs 3 to 4 times more often in women than men.
• Older age — the average age at diagnosis is 72.
• Excess body weight, partly because it raises the risk of gallstones too.

Gallbladder cancer usually causes no symptoms until the tumor has grown large or already spread. When symptoms do appear, they can include:

• Pain in the upper right part of the belly.
• Nausea and vomiting.
• Jaundice, a yellowing of the skin and eyes, caused by a bile blockage.
• A lump that can be felt in the belly.
• Loss of appetite, weight loss, and bloating.
• Fever, itchy skin, dark urine, or pale stools.

These symptoms overlap heavily with gallstones and other common digestive problems, which is part of why gallbladder cancer is easy to miss early. Many cases are actually found by accident, when a gallbladder is removed for gallstones and the tissue is later found to contain cancer under the microscope.

Treatment depends heavily on how early the cancer is found. Sometimes it is caught early, by accident, during gallbladder removal for another reason. In that case, surgery to remove the gallbladder, and sometimes nearby tissue and lymph nodes, can be curative. This is the best-case scenario. It is a real reason to have any suspicious finding fully evaluated, rather than assumed benign.

Cancer found at a later stage is treated differently. Treatment usually combines surgery, when possible, with chemotherapy, radiation, targeted therapy, or immunotherapy. The mix depends on the cancer's extent and specific features. When the cancer cannot be removed, treatment focuses on controlling growth and easing symptoms. This can still meaningfully extend good-quality time.

One subtype is worth knowing about. Papillary adenocarcinoma is a less common form of gallbladder cancer. It tends to have a better outlook than most other types. Part of the reason is that it is less likely to have spread by the time it is found.

• Was my gallbladder cancer found incidentally, or through symptoms — and does that change my treatment?
• Is surgery to remove the cancer possible, and what would it involve?
• Should I be checked for spread to nearby lymph nodes or organs?
• If cure is not possible, what treatments can control the cancer and ease my symptoms?

• American Cancer Society — What Is Gallbladder Cancer?
• American Cancer Society — Gallbladder Cancer Risk Factors
• American Cancer Society — Signs and Symptoms of Gallbladder Cancer