About gallbladder cancer

Approximately 11,980 people in the United States will be diagnosed with cancer of the gallbladder and large bile duct cancer in 2021, according to the American Cancer Society. The rate of death from this type of cancer has been decreasing in recent decades. However, because the symptoms of gallbladder cancer do not usually appear until the disease has advanced, about 80 percent of gallbladder cancers are not found in the early stages.

Along with the liver and the bile ducts, the gallbladder forms part of the biliary tract. The gallbladder is a small, pear-shaped organ located under the liver, behind the lower-right ribs. It stores bile made by the liver. Bile is a fluid that helps to digest fats found in food, and it can be released through the common bile duct into the small intestine by either the gallbladder or the liver. Because the liver also performs this function, the gallbladder can be surgically removed without affecting a person’s health.

Although cancer research has not determined the causes of gallbladder cancer, certain factors may increase a person’s risk of developing the disease. Often, these factors relate to chronic inflammation of the gallbladder.

Common risk factors include:

• Obesity
• Chemical exposure
• Gallstones
• Porcelain gallbladder, where calcium deposits cover the gallbladder wall
• Choledochal cysts
• Bile duct abnormalities
• Gallbladder polyps
• Typhoid, a chronic infection caused by salmonella poisoning

Although the genetic cause of gallbladder cancer is unknown, the risk of the cancer seems to increase in families with a history of the disease.

Learn about the risk factors for gallbladder cancer

Gallbladder cancer occurs twice as often in women as in men. This may be related to the increased frequency of gallstones, found in over 75 percent of gallbladder cancer patients. Gallstones are very common in middle-aged women, although most people with gallstones do not develop gallbladder cancer.

Gallbladder cancer develops mainly in individuals over the age of 65. The average age at diagnosis is 73.

Mexican Americans and Native Americans are at higher risk of gallbladder cancer, while African Americans have the lowest risk. Gallbladder cancer is less common in the United States compared with countries in Asia, Eastern Europe and South America.

People exposed to industrial chemicals, particularly those used in the rubber and textile industries, may also be at increased risk of gallbladder cancer.

Almost all forms of gallbladder cancer are adenocarcinomas, a type of cancer that begins in the gland-like cells that line organs of the digestive tract. Gallbladder adenocarcinomas account for 90 percent of gallbladder cancer diagnoses.

Papillary adenocarcinoma is a special subtype of adenocarcinoma that has a better prognosis compared with other types of gallbladder cancers. Its cancer cells are much less likely to spread to other parts of the body, such as nearby lymph nodes or organs.

Besides adenocarcinomas, other types of gallbladder cancer include:

• Adenosquamous carcinomas
• Squamous cell carcinomas
• Small cell carcinomas
• Sarcomas

Learn more about gallbladder cancer types

Possible gallbladder cancer symptoms include:

• Abdominal pain, usually in the upper- or upper-right abdomen
• Jaundice, yellowing of the skin or whites of the eyes
• Gallbladder enlargement
• Nausea, vomiting, loss of appetite, weight loss, abdominal bloating, severe itching or black, tarry stools

Learn more about symptoms of gallbladder cancer

Pathologists use these tools to diagnose gallbladder cancer:

• Laboratory tests, such as liver function tests to determine the levels of bilirubin, albumin, alkaline phosphatase, AST, ALT, GGT and certain proteins known as tumor markers, including CEA and CA 19-9
• CT scan
• Ultrasound 
• Endoscopic ultrasound (EUS)
• Magnetic resonance imaging (MRI)
• Percutaneous transhepatic cholangiography (PTC)
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Biopsy

Learn more about diagnostic procedures for gallbladder cancer

Treatment options for gallbladder cancer include:

• Surgery to remove a tumor or relieve symptoms
• Staging laparoscopy to take images of the tumor
• Simple cholecystectomy to remove the gallbladder
• Extended cholecystectomy to remove the gallbladder, portions of the nearby liver and regional lymph nodes
• Radical resection to remove the gallbladder, portions of the nearby liver, regional lymph nodes, the cystic duct, the common bile duct, the ligament between the liver and intestines and portions of the duodenum
• Chemotherapy
• Radiation therapy

Learn more about treatment options for gallbladder cancer