Gallbladder cancer: symptoms, diagnosis and treatment

What is gallbladder cancer?

Gallbladder cancer is a malignant tumour that begins in the cells of the gallbladder — the small organ beneath the liver that stores bile.

How common is gallbladder cancer?

It remains rare overall, but occurs far more frequently in specific regions including India, Pakistan, South America and Eastern Europe. Women are affected more often than men, and most patients present in their sixties or seventies.

What causes gallbladder cancer?

• Gallstones causing chronic inflammation.
• Porcelain gallbladder from long-term calcification.
• Recurrent bile duct infections.
• Gallbladder polyps larger than 1 centimetre.
• Obesity.
• Genetic predisposition.
• Exposure to toxic chemicals.

What are the symptoms?

Early stages typically show no signs at all. As the disease progresses, patients may develop:

• Upper right abdominal pain.
• Nausea and vomiting.
• Jaundice.
• Weight loss and reduced appetite.
• Fever and fatigue.
• A lump in the abdomen.

How is gallbladder cancer diagnosed?

• Ultrasound as the first-line study.
• CT and MRI imaging to define local spread.
• PET scans where distant disease is suspected.
• ERCP and endoscopic ultrasound.
• Blood tests for liver function and tumour markers (CA 19-9, CEA).
• Tissue biopsy for confirmation.

How is it staged?

The cancer progresses from Stage 0, where only the inner lining is involved, through to Stage IV with distant metastasis. Classification rests on tumour size, local spread and lymph node involvement — and it is the stage, not the symptoms, that determines what treatment is possible.

What are the treatment options?

• Cholecystectomy for disease confined to the gallbladder.
• Extended surgical removal of surrounding liver tissue and regional lymph nodes.
• Chemotherapy, before or after surgery depending on stage.
• Radiation therapy in selected cases.
• Palliative care to manage symptoms where cure is not achievable.