If You Have Gallbladder Cancer

What is gallbladder cancer?

Cancer can start any place in the body. In gallbladder cancer, cells in the gallbladder start to grow out of control and crowd out normal cells. This makes it hard for the body to work the way it should.

Cancer cells can spread to other parts of the body. Cancer cells in the gallbladder can sometimes travel to the liver and grow there. When cancer cells do this, it’s called metastasis. To doctors, the cancer cells in the new place look just like the ones from the gallbladder.

Cancer is always named for the place where it starts. So when gallbladder cancer spreads to the liver (or any other place), it’s still called gallbladder cancer. It’s not called liver cancer unless it starts from cells in the liver.

Ask your doctor to use this picture to show you where the cancer is.

The gallbladder

The gallbladder is a small pouch under the liver. It stores bile that’s made by the liver. (Bile helps you digest fat.)

Many people have problems with the gallbladder (other than cancer) and have it taken out. You don't need a gallbladder to live.

Are there different kinds of gallbladder cancer?

There are a few types of gallbladder cancer. Some are very rare. Almost all gallbladder cancers are a type called adenocarcinoma. This type starts from gland cells. Your doctor can tell you more about the type you have.

Questions to ask the doctor

• Why do you think I have cancer?
• Is there a chance I don’t have cancer?
• Would you please write down the kind of cancer you think I might have?
• What will happen next?

How does the doctor know I have gallbladder cancer?

It's hard to find gallbladder cancer early -- when it's small and hasn't spread. Because the gallbladder is deep inside the body, the doctor can’t see or feel it during a physical exam. These cancers usually aren't found until they cause problems that make a person go to a doctor. Many times, they're found after surgery is done to take out the gallbladder.

The doctor will ask you questions about your health and do a physical exam. If signs are pointing to gallbladder problems or gallbladder cancer, more tests will be done.

Tests that may be done

Blood tests: Blood tests can be used to help find out how much bilirubin is in the blood. Bilirubin is the chemical that gives the bile its yellow color. Problems in the gallbladder, bile ducts, or liver can cause a high bilirubin level. Other blood tests can show how well the liver is working.

Ultrasound: For this test, a small wand is moved around on your skin. It gives off sound waves and picks up the echoes as they bounce off tissues. The echoes are made into a picture on a computer screen. This is often the first test used to look at the gallbladder.

CT or CAT scan: This test uses x-rays to make pictures of your insides. It can show the size, shape, and place of any tumors in the gallbladder or near it.

MRI: To make clear pictures, this test uses radio waves and strong magnets instead of x-rays. MRI scans can help show if tumors in the gallbladder are cancer. They can also be used to look at nearby blood vessels and other organs. And they can help find out if the cancer has spread.

Cholangiogram: This test looks at the bile ducts (the tubes from the liver and gallbladder that carry bile) to see if they are blocked, narrowed, or widened. It can be used to help plan surgery. There are many types of cholangiograms, and each has different pros and cons.

Angiogram: This test looks at blood vessels around the gallbladder. It may be used to help plan surgery. It can be done with x-rays or with a CT or MRI scan.

Laparoscopy: In this type of surgery, a thin, lighted tube is put into the belly through a small cut in the skin. A tiny camera on the end of the tube lets the doctor look at the gallbladder and other nearby body parts. This can help plan surgery or other treatments. A biopsy may be done with tools put into the tube.

Biopsy: In a biopsy, the doctor takes out a small piece of tissue to check it for cancer. A biopsy is not always needed for gallbladder cancer. If other tests show a tumor that’s only in the gallbladder, the gallbladder may be taken out and then checked for cancer cells. There are many types of biopsies. Each type has pros and cons.

Questions to ask the doctor

• What tests will I need to have?
• Who will do these tests?
• Where will they be done?
• Who can explain them to me?
• How and when will I get the results?
• Who will explain the results to me?
• What do I need to do next?

How serious is my cancer?

If you have gallbladder cancer, the doctor will want to find out how far it has spread. This is called staging. You may have heard other people say that their cancer was stage 2 or stage 3. Your doctor will want to find out the stage of your cancer to help decide what type of treatment is best for you.

The stage describes how much the cancer has grown in the gallbladder or into nearby structures. It also tells if the cancer has spread to other parts of your body.

Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread outside the gallbladder. Be sure to ask the doctor about the cancer's stage and what it means for you.

Questions to ask the doctor

• Do you know the stage of the cancer?
• If not, how and when will you find out the stage of the cancer?
• Would you explain to me what the stage means in my case?
• Based on the stage of the cancer, how long do you think I’ll live?
• What will happen next?

What kind of treatment will I need?

Most people with gallbladder cancer find out that it's a higher stage and hard to treat. Treatment in many cases helps make symptoms better and slows down the cancer but may not cure it. Talk with your doctor to find out your options. The main ways to treat gallbladder cancer are surgery, radiation therapy, and chemotherapy. Ask your doctor what treatments can help you and what the goal is.

The treatment plan that’s best for you will depend on:

• The stage of the cancer
• The chance that a type of treatment will cure the cancer or help in some way
• Your age
• Other health problems you have
• Your feelings about the treatment and the side effects that come with it

Surgery

If it can be done, surgery is often the best way to treat gallbladder cancer. Surgery can be done to take out the gallbladder and all of the cancer. It can also be used to ease problems the cancer is causing, like blockages. Talk to the doctor about the kind of surgery planned, the goal of the surgery, and what you can expect.

Side effects of surgery

Any type of surgery can have risks and side effects. Ask the doctor what you can expect. Also ask if you might have eating problems after surgery. If you have problems, let your doctors know. Your cancer care team should be able to help you with any problems that come up.

Radiation treatments

Radiation uses high-energy rays (like x-rays) to kill cancer cells. A machine aims x-ray beams at the gallbladder. This is called external beam radiation.

Radiation is often given along with chemo after surgery to kill any cancer cells that may have been left behind. Radiation and chemo may also be used to treat people with cancer that can’t be taken out with surgery. Radiation alone may be used to help ease problems the tumor is causing, like blockages or pain.

Side effects of radiation treatments

If your doctor suggests radiation treatment, talk about what side effects might happen. The most common side effects of radiation are:

• Skin changes where the radiation is given
• Feeling very tired
• Feeling sick to your stomach
• Losing weight

Most side effects get better after treatment ends. Some might last longer. Talk to your doctor about what you can expect.

Chemo

Chemo is the short word for chemotherapy, the use of drugs to fight cancer. The drugs are often given through a needle into a vein. These drugs go into the blood and spread through the body.

Chemo might be used along with radiation after surgery, or it might be part of the main treatment if surgery can’t be done.

Chemo is given in cycles or rounds. Each round of treatment is followed by a break. In some cases, 2 or more chemo drugs are given. Treatment often lasts for many months.

Side effects of chemo

Common side effects are:

• Feeling very tired
• Feeling sick to your stomach
• Hair loss
• Mouth sores
• Low blood counts

There are ways to treat most chemo side effects. If you have side effects, talk to your cancer care team so they can help.

Clinical trials

Clinical trials are research studies that test new drugs or other treatments in people. They compare standard treatments with others that may be better.

If you would like to learn more about clinical trials that might be right for you, start by asking your doctor if your clinic or hospital conducts clinical trials. See Clinical Trials to learn more.

Clinical trials are one way to get the newest cancer treatment. They are the best way for doctors to find better ways to treat cancer. If your doctor can find one that’s studying the kind of cancer you have, it’s up to you whether to take part. And if you do sign up for a clinical trial, you can always stop at any time.

What about other treatments that I hear about?

When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, diets, and other things. You may wonder about these treatments.

Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything you’re thinking about using, whether it’s a vitamin, a diet, or anything else.

Questions to ask the doctor

• What treatment do you think is best for me?
• What’s the goal of this treatment? Do you think it could cure the cancer?
• Will treatment include surgery? If so, who will do the surgery?
• What will the surgery be like?
• Will I need other types of treatment, too?
• What will these treatments be like?
• What’s the goal of these treatments?
• What side effects could I have from these treatments?
• What can I do about side effects that I might have?
• Is there a clinical trial that might be right for me?
• What about vitamins or diets that friends tell me about? How will I know if they are safe?
• How soon do I need to start treatment?
• What should I do to be ready for treatment?
• Is there anything I can do to help the treatment work better?
• What’s the next step?

What will happen after treatment?

For years after treatment, you will see your cancer doctor. Be sure to go to all of these follow-up visits. Your doctor will ask about any symptoms you have and might do exams, blood tests, and maybe other tests to see if the cancer has come back.

Your visits will likely be every few months at first. Then, the longer you’re cancer-free, the less often the visits are needed.

Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.

You can’t change the fact that you have cancer. What you can change is how you live the rest of your life – making healthy choices and feeling as good as you can.