Gallbladder Cancer - Early Signs, Risk Factors, Diagnosis, and Treatment Explained

Overview: What Is Gallbladder Cancer?

Gallbladder cancer is a rare but serious form of cancer that begins in the gallbladder, a small, pear-shaped organ located beneath the liver. The gallbladder’s job is to store bile, a digestive fluid made by the liver that helps break down fats.

Gallbladder cancer is uncommon and often silent in the beginning, which means symptoms may be mistaken for regular stomach problems. This delay in diagnosis is why it is usually found at later stages.

Early detection is crucial. When gallbladder cancer is diagnosed at an early stage, treatment options are more effective, and survival rates are significantly higher. Unfortunately, because the disease is often silent, only a small percentage of cases are found early.

What Are the Types of Gallbladder Cancer?

Most gallbladder cancers are adenocarcinomas, which means they begin in the gland-like cells of the gallbladder’s lining. There are different subtypes:

• Adenocarcinoma, not otherwise specified (NOS): The most common type of gallbladder.
• Papillary adenocarcinoma: Grows in small finger-like projections, less likely to spread quickly, generally has a better outcome.
• Mucinous adenocarcinoma: Produces mucus and tends to be more aggressive.
• Squamous cell carcinoma: Rare, develops in the squamous cells of the gallbladder lining.
• Adenosquamous carcinoma: Contains both glandular and squamous cells, tends to grow faster.

Knowing the exact type helps doctors design the best treatment plan.

What Are the Causes of Gallbladder Cancer?

The exact cause of gallbladder cancer is not fully understood. However, doctors believe it develops when changes (mutations) occur in the DNA of gallbladder cells. These changes make the cells grow uncontrollably and form tumors.

Possible contributing factors include:

• Long-term gallbladder inflammation (chronic cholecystitis)
• Gallstones irritating the gallbladder lining
• Bile duct abnormalities
• Genetic mutations that increase cancer risk

Note: While gallstones are very common, only a small fraction of people with gallstones will develop gallbladder cancer. The risk increases when stones are large or present for many years.

What Are the Risk Factors for Gallbladder Cancer?

Certain factors can increase the likelihood of developing gallbladder cancer:

• Gallstones: The most common risk factor. Up to 80% of people with gallbladder cancer also have gallstones.
• Gallbladder polyps: Growths inside the gallbladder that may turn cancerous.
• Age: More common in people over 65.
• Gender: Women are affected more often than men.
• Ethnicity and geography: Higher rates in South America, India, Pakistan, and among Native Americans.
• Chronic gallbladder infection or inflammation.
• Obesity and unhealthy lifestyle.
• Family history of gallbladder cancer.
• Certain bile duct conditions (choledochal cysts, primary sclerosing cholangitis).

What Are the Symptoms of Gallbladder Cancer?

Early gallbladder cancer may not cause symptoms. When symptoms do appear, they often mimic other digestive conditions, making diagnosis difficult.

Common early signs:

• Abdominal pain, especially in the upper right side
• Nausea or vomiting
• Fever (from infection)
• Bloating

Advanced symptoms:

• Yellowing of skin and eyes (jaundice)
• Unexplained weight loss
• Loss of appetite
• Lumps in the abdomen
• Dark urine and pale stools
• Persistent itching

If you experience these symptoms, especially in combination with gallstones or chronic gallbladder issues, consult a doctor promptly.

How Is Gallbladder Cancer Diagnosed?

Doctors use a combination of imaging, blood tests, and biopsies to diagnose gallbladder cancer.

• Ultrasound: Often the first test, it uses sound waves to show abnormal masses, thickening of the gallbladder wall, or enlarged lymph nodes.
• CT or MRI Scan: Uses X-rays to create detailed cross-sectional images, showing the tumor's relationship to nearby organs, blood vessels, and lymph nodes. In some cases, doctors may recommend a PET-CT scan to see if cancer has spread to other organs.
• ERCP (Endoscopic Retrograde Cholangiopancreatography): A procedure used to examine the bile ducts and may help diagnose or treat obstruction causing jaundice.
• MRCP (Magnetic Resonance Cholangiopancreatography): An MRI of the bile ducts, used for visualization and staging.
• Blood tests: Check liver function and tumor markers (CA 19-9, CEA).
• Biopsy: A small tissue sample confirms cancer under the microscope. Often, a laparoscopic biopsy is performed, where a camera and instruments are inserted through small incisions to obtain a tissue sample directly from the tumor.

Staging of Gallbladder Cancer

Staging describes how far the cancer has spread, while grading describes how aggressive the cancer cells look under a microscope.

Stages of gallbladder cancer:

• Stage I: Limited to the gallbladder wall.
• Stage II: Grown deeper into the gallbladder tissue.
• Stage III: Spread to nearby organs (like liver, stomach, or intestines) or lymph nodes.
• Stage IV: Spread to distant organs such as lungs or bones.

Staging helps guide treatment decisions and predict outcomes.

What Are the Treatment Options for Gallbladder Cancer?

Treatment depends on the stage, overall health, and type of gallbladder cancer.

• Surgery:
  • Radical Cholecystectomy: This is a major surgery that removes the gallbladder, part of the liver, nearby lymph nodes, and potentially parts of the bile duct.
  • Extended Cholecystectomy: Involves removing more surrounding organs and tissue if the cancer has spread to them.
• Chemotherapy: Uses drugs to kill cancer cells, often recommended after surgery (adjuvant therapy) or for advanced cancer. Common drugs: gemcitabine, cisplatin, fluorouracil.
• Radiation Therapy: Uses high-energy beams to destroy cancer cells. Sometimes combined with chemotherapy (chemoradiation).
• Targeted Therapy: Newer drugs attack specific cancer cell changes, such as HER2-positive gallbladder cancers.
• Immunotherapy: Drugs like immune checkpoint inhibitors help the body’s immune system fight cancer, used in advanced cases.

Proton Therapy: When Is It Applicable?

Proton therapy is a type of radiation therapy that uses protons instead of X-rays. It is more precise and may reduce damage to surrounding tissue. While not standard for gallbladder cancer, it may be considered in clinical trials or specific cases.

What Is the Prognosis for Gallbladder Cancer?

The outlook depends on stage, overall health, and treatment success.

• Early-stage gallbladder cancer: 5-year survival rates can be 50–80%.
• Advanced-stage cancer: Survival rates drop significantly, often below 10%.
• Papillary type cancers: Have better outcomes than other types.

Prognosis improves when cancer is caught early and treated aggressively.

Screening and Prevention of Gallbladder Cancer

Currently, there is no standard screening test for gallbladder cancer.

Prevention strategies include:

• Managing gallstones early
• Maintaining a healthy weight
• Eating a diet rich in fruits, vegetables, and whole grains
• Avoiding smoking and excessive alcohol
• Treating gallbladder infections promptly

People with gallbladder polyps, strong family history, or bile duct abnormalities may need regular check-ups and imaging.

For International Patients

People from around the world come to Apollo Hospitals for the treatment of gallbladder cancer. Our international patient services team will guide you all the way from seeking the first virtual connect all the way to treatment in India and then returning home post treatment.

Services include:

• Medical opinions and scheduling
  • Pre-arrival medical review of reports and imaging.
• Travel and logistics
  • Assistance with visa invitation letters, airport transfers, and nearby accommodation options.
  • Dedicated international patient coordinators to guide through each step.
• Language and cultural support
  • Interpreter services in multiple languages.
  • Clear, simple explanations at every stage with written care plans.
• Financial coordination
  • Transparent treatment estimates and packages when possible.
  • Support with international payment methods and insurance coordination.
• Continuity of care
  • Shared records, imaging, and treatment summaries for home doctors.
  • Telemedicine follow-ups for convenience after returning home.

Frequently Asked Questions (FAQs)

1. What is the survival rate of gallbladder cancer?

The survival rate depends on the stage at diagnosis. Early detection offers survival rates of 50–80%, while advanced cancer has lower rates.

2. Can gallbladder cancer be cured?

Yes, if detected early and removed completely by surgery. In later stages, treatment focuses on controlling symptoms and extending life.

3. What are the side effects of gallbladder cancer treatment?

Side effects vary. Surgery may cause pain, fatigue, or digestive issues. Chemotherapy and radiation may cause nausea, hair loss, diarrhea, or lowered immunity.

4. What is the recovery time after gallbladder cancer surgery?

Recovery depends on the type of surgery. Simple gallbladder removal may take 2–4 weeks, while radical surgery may take several months.

5. Can gallbladder cancer come back after treatment?

Yes, recurrence is possible, especially in advanced cases. Regular follow-up scans and blood tests help detect it early.

6. How much does gallbladder cancer treatment cost in India?

Costs vary depending on type, hospital, and treatment plan. At Apollo, costs are significantly lower compared to the US or Europe, while maintaining international standards.

7. Who is most at risk for gallbladder cancer?

People over 65, women, those with gallstones, obesity, or family history are at higher risk.