Gallbladder Cancer

Because there are rarely signs or symptoms in the early stages, and those symptoms resemble other conditions, providers often diagnose gallbladder cancer late. They often discover it because you have gallstones or need your gallbladder removed.

If your provider suspects you might have gallbladder cancer, they’ll examine you and ask about your medical history. Then, they’ll perform tests.

What tests will be done to diagnose gallbladder cancer?

Tests may include lab tests, imaging procedures and minor surgeries.

Lab tests

Lab tests detect substances in your blood that may be signs of cancer.

• Liver function test: Measures the levels of certain substances your liver releases, which may indicate that gallbladder cancer is affecting your liver.
• Carcinoembryonic antigen (CEA) assay: Measures the levels of CEA, a tumor marker released by both healthy and cancerous cells. High levels may be a sign of gallbladder cancer.
• CA 19-9 assay:Measures the levels of the tumor marker CA 19-9 in your blood. High levels could indicate gallbladder or pancreatic cancer.

Imaging tests

Imaging tests allow healthcare providers to look for cancer and signs of cancer spread.

• Abdominal ultrasound: An imaging test that uses sound waves to create pictures of the organs within your abdomen. You may need additional imaging procedures, like a CT scan or MRI, if an ultrasound detects a mass that could be gallbladder cancer.
• CT (computed tomography) scan: A type of X-ray that takes detailed images of internal organs.
• MRI (magnetic resonance imaging): An imaging test that uses a magnet, radio waves and a computer to create pictures of the inside of your body.
• Endoscopic ultrasound: An ultrasound that uses a tube-like instrument called an endoscope to create pictures of your digestive tract.
• Endoscopic retrograde cholangiopancreatography (ERCP): An X-ray procedure that takes pictures of your bile ducts. Gallbladder cancer can cause these ducts to narrow.

Surgeries

Surgical procedures allow healthcare providers direct access to tissue that contains cancer cells.

• Biopsy: A healthcare provider removes a tissue sample and examines it under a microscope for cancer cells. A biopsy is the only way to confirm a gallbladder cancer diagnosis.
• Laparoscopy: A provider inserts a laparoscope (a thin, lighted tube) into your abdomen through a small incision (cut) to look at your gallbladder and nearby tissues. A laparoscopy can help your provider determine how much the cancer has spread.

What are the stages of gallbladder cancer?

Cancer staging allows your healthcare provider to determine whether cancer has spread (metastasized) beyond its original (primary) location. To determine the extent of cancer spread, your provider will assign a number (zero through four) to your cancer. The higher the number, the more the cancer has spread throughout your body.

The stages of gallbladder cancer are:

• Stage 0 (also known as carcinoma in situ):Abnormal, precancerous cells are in your gallbladder’s inner (mucosal) layer.
• Stage 1: Cancer cells are in the mucosal layer and may spread to the muscle wall of your gallbladder.
• Stage 2:Cancer has spread beyond the muscle layer to the connective tissue layers of your gallbladder.
• Stage 3: Cancer has spread to your liver or nearby organs or to the outer (serosal) layer of your gallbladder and possibly to your lymph nodes.
• Stage 4: Cancer has spread to more than three nearby lymph nodes, blood vessels and/or to organs far from your gallbladder.

Healthcare providers describe Stage 1 gallbladder cancer as local, meaning cancer hasn’t spread beyond your gallbladder. Stage 1 cancers are potentially curable. Stages 2 through 4 cancers are much more challenging to treat.

Where does gallbladder cancer spread first?

Gallbladder cancer spreads from the inner layer of your gallbladder to the outer layers. Eventually, it may spread to nearby lymph nodes or organs, such as your liver and bile ducts. Metastatic gallbladder cancer can travel to other organs through your lymphatic system or bloodstream.