Gallbladder cancer

Gallbladder cancer can be difficult to diagnose in its early stages because it may not cause noticeable symptoms. Symptoms of gallbladder cancer may include:²

• Abdominal (stomach) pain, usually in the upper right side of the abdomen
• Nausea or vomiting
• A high temperature (fever)
• Jaundice, including yellowing of the skin and the whites of the eyes
• Dark yellow urine or pale-coloured stools
• Itchy skin, without a visible rash
• A lump or swelling in the abdomen
• Feeling weak or fatigued
• Unexplained weight loss

Having one or more of these symptoms does not necessarily mean you have gallbladder cancer. However, if you have ongoing symptoms or concerns, it is important to speak with your GP or specialist.

It is not always clear what causes gallbladder cancer. However, a number of factors may increase a person’s risk, including:^2,3

• A family history of gallbladder cancer, particularly in a first-degree relative such as a parent or sibling
• Being overweight or obese, which increases the risk of gallstones and may, in turn, increase the risk of gallbladder cancer
• A history of gallstones or inflammation of the gallbladder
• Smoking
• Gallbladder or bile duct conditions, including gallbladder polyps, choledochal cysts (bile-filled cysts), or a calcified gallbladder (also known as porcelain gallbladder)
• Increasing age, as the risk of gallbladder cancer rises as people get older

Having one or more risk factors does not mean you will develop gallbladder cancer. If you have questions or concerns about your risk, speak with your GP or specialist.

After an appointment with your GP, you may be referred to a specialist for further tests and scans to help diagnose gallbladder cancer.² These tests may include:²

• A physical examination
• Blood tests
• Imaging scans, which may include a computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, ultrasound, or endoscopic ultrasound
• Cholangiography, an X-ray test used to examine the bile ducts
• Laparoscopy, a type of minimally invasive (keyhole) surgical procedure that allows doctors to examine the gallbladder and surrounding organs

Surgery is the main treatment option for gallbladder cancer when the cancer is detected early and can be completely removed.^2,4 The type and extent of surgery will depend on how far the cancer has spread and whether nearby tissues or organs are involved.⁵ Surgery is performed under a general anaesthetic, and recovery time will vary depending on the complexity of the procedure.⁶ Your doctor is the best person to explain whether surgery is an option for you and what to expect before and after treatment.

Radiation therapy (also known as radiotherapy) uses high-energy rays to damage or destroy cancer cells. In gallbladder cancer, it may be used after surgery (adjuvant therapy) to help reduce the risk of the cancer returning. Radiation may also be part of combined treatment with chemotherapy for locally advanced or unresectable disease, or used as palliative therapy to help control symptoms such as pain or obstruction when curative treatment is not possible.^5,7

External beam radiation therapy (EBRT), in which radiation is delivered from a machine outside the body, is the most common method used. The timing, purpose, and technique of radiation therapy will depend on individual circumstances and should be discussed with your treatment team.²

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Chemotherapy involves the use of medicines, given either orally or by injection, that aim to kill cancer cells or slow their growth and spread. In gallbladder cancer, chemotherapy may be used after surgery, in combination with other treatments, or when surgery is not possible. Your doctor will discuss whether chemotherapy is suitable for you and how it may be used as part of your overall treatment plan.^2-4