What is the Gallbladder?
The gallbladder is a small, pouch-like organ in the upper right part of your abdomen just beneath the liver. The job of the gallbladder is to store bile, a fluid made by the liver that helps break down fatty foods.
While the gallbladder plays an important role in digestion, you can actually live without it. Without the gallbladder, your body will adjust to the change in the digestion process and it will typically only cause temporary minor side effects.
About Gallbladder Cancer
Although gallbladder cancer is very rare – only about 12,000 cases are diagnosed in the U.S. each year – our experts in the Boston Liver, Pancreas and Biliary Center at St. Elizabeth’s are specially trained in caring for patients with this form of cancer.
Gallbladder cancer is often diagnosed in its later stages because it tends to have no symptoms. The gallbladder is also “hidden” behind the liver so gallbladder tumors are not easy to detect.
Risk factors, things that increase your chance of getting a disease, for gallbladder cancer include being female and/or Native American. Additionally, people with a history of gallstones, especially larger ones, may carry an increased risk. But gallbladder cancer is still very uncommon in people who have had gallstones. Finally, inflammation of the bile ducts that drain bile from the gallbladder and liver can increase the risk of getting gallbladder cancer.
Signs and Symptoms of Gallbladder Cancer
Symptoms of gallbladder cancer often do not appear in the early stages of the disease, but when and if symptoms do appear, they can include:
- Jaundice (yellowing of the skin and whites of the eyes)
- Pain above the stomach
- Fever
- Nausea and vomiting
- Bloating
- Lumps in the abdomen
Information on the Diagnosis and Treatment of Gallbladder Cancer
Diagnosis
Many tools are available to help diagnose gallbladder cancer, all of which are available at the Boston Liver, Pancreas and Biliary Center through our center’s multidisciplinary team and our close collaboration with specialists at the Dana-Farber Cancer Institute. Most patients will be diagnosed either by their primary care physician or by one of our gastroenterologists or radiologists.
If gallbladder cancer is suspected, patients can expect to receive one or more of the following tests:
- Physical exam and medical history: your doctor will discuss your health history with you and look for signs of gallbladder cancer by examining your belly, looking for jaundice and feeling various lymph nodes in your body.
- Blood tests: Blood tests may be done and sent to our labs to determine how much bilirubin, the chemical that causes jaundice, is in your blood. The blood test may also check your liver function, which can help to diagnose liver, bile duct or gallbladder disease.
- Tumor markers: Tumor markers are substances made by cancer cells that can sometimes be found in the blood. People with gallbladder cancer may have high blood levels of specific markers.
- Imaging tests: Imaging like x-rays, MRI, CT scans or ultrasound can be helpful in diagnosing gallbladder tumors.
A special type of endoscopic imaging test, an endoscopic retrograde cholangiopancreatography, or ERCP, is often quite useful in that it gives doctors a clear look at the gallbladder. During an ERCP, a doctor passes an endoscope, a long, flexible tube, down your throat, through your stomach, and into the first part of the small intestine. A small catheter (tube) is passed out of the end of the endoscope and into the common bile duct. A small amount of contrast dye is injected through the catheter. The dye helps outline the bile ducts and pancreatic duct as x-rays are taken.
Treatment
Generally, surgery, radiation or chemotherapy and other drug therapy are the standard treatments for patients with gallbladder cancer. Our surgeons, radiation oncologists and medical oncologists work together with you to help determine which treatment or treatments are right for you.
- Surgery: Gallbladder resection is surgery that removes the entire gallbladder. Surgeons will also try to remove some of the surrounding tissue to ensure that all cancer cells are eliminated. Gallbladder surgery is typically performed minimally invasively, meaning patients will see a smaller scar and have a quicker recovery time. Surgery to remove gallbladder cancer requires the care of highly-skilled physicians, and the surgical oncology team at St. Elizabeth's are experts in the removal of gallbladders.
- Radiation therapy: Radiation uses high energy x-rays or other forms of radiation to kill cancer cells. Your doctor may recommend radiation after having surgery or as the main form of treatment if the gallbladder cannot be removed.
- Chemotherapy: Using drugs to destroy cancer cells, chemotherapy can be given either intravenously in the arm or in the form of a pill. Your doctor could recommend chemotherapy in addition to surgery.
- Targeted drug therapy: Researchers have recently developed new drugs that target the abnormalities within cancer cells. Targeted therapy drugs work differently from standard chemotherapy drugs. They sometimes work when standard chemotherapy drugs don’t, and they often have different and less severe side effects.
Clinical Trials and Research on Gallbladder Cancer
As part of an academic teaching hospital, the hepato-pancreato-biliary team actively participates in a multitude of research opportunities to further our understanding of gallbladder cancer. If you have gallbladder cancer, talk to your provider about whether a clinical trial is right for you.
Recent Research
Vega EA, Vinuela E, Okuno M, Joechle K, Sanhueza M, Diaz C, Jarufe N, Martinez J, Troncoso A, Diaz A, Chun YS, Tzeng CD, Lee JE, Vauthey JN, Conrad C. Incidental versus non-incidental gallbladder cancer: index cholecystectomy before oncologic re-resection negatively impacts survival in T2b tumors. HPB (Oxford). 2019 Aug;21(8):1046-1056. doi: 10.1016/j.hpb.2018.12.006. Epub 2019 Jan 31. PMID: 30711243.
Vega EA, Vinuela E, Sanhueza M, Mege R, Caracci M, Diaz C, Diaz A, Okuno M, Joechle K, Goumard C, Chun YS, Tzeng CD, Lee JE, Vauthey JN, Conrad C. Positive cystic duct margin at index cholecystectomy in incidental gallbladder cancer is an important negative prognosticator. Eur J Surg Oncol. 2019 Jun;45(6):1061-1068. doi: 10.1016/j.ejso.2019.01.013. Epub 2019 Jan 24. PMID: 30704808.
Lee AJ, Chiang YJ, Lee JE, Conrad C, Chun YS, Aloia TA, Vauthey JN, Tzeng CD. Validation of American Joint Committee on Cancer eighth staging system for gallbladder cancer and its lymphadenectomy guidelines. J Surg Res. 2018 Oct;230:148-154. doi: 10.1016/j.jss.2018.04.067. Epub 2018 May 31. PMID: 30100032.
Vega EA, Vinuela E, Yamashita S, Sanhueza M, Cavada G, Diaz C, Aloia TA, Chun YS, Tzeng CD, Okuno M, Goumard C, Vauthey JN, Lee JE, Conrad C. Extended Lymphadenectomy Is Required for Incidental Gallbladder Cancer Independent of Cystic Duct Lymph Node Status. J Gastrointest Surg. 2018 Jan;22(1):43-51. doi: 10.1007/s11605-017-3507-x. Epub 2017 Jul 27. PMID: 28752405.
Vega EA, Yamashita S, Chun YS, Kim M, Fleming JB, Katz MH, Tzeng CW, Raghav KP, Vauthey JN, Lee JE, Conrad C. Effective Laparoscopic Management Lymph Node Dissection for Gallbladder Cancer. Ann Surg Oncol. 2017 Jul;24(7):1852. doi: 10.1245/s10434-017-5773-y. Epub 2017 Feb 6. PMID: 28168387.
Yamashita S, Loyer E, Chun YS, Javle M, Lee JE, Vauthey JN, Conrad C. Laparoscopic Management of Gallbladder Cancer: A Stepwise Approach. Ann Surg Oncol. 2016 Dec;23(Suppl 5):892-893. doi: 10.1245/s10434-016-5436-4. Epub 2016 Jul 25. PMID: 27456958.