Diagnosing gallbladder cancer

Tuesday 30 April, 2013

Reviewed by: Annie Angle cancer nurse, Diploma Oncology Nursing, Royal Marsden, London

On this page: Diagnostic tests  ι Staging gallbladder cancer ι Treatments ι Research ι Recovery ι Life after treatment


Diagnostic tests

Your doctor will examine you and refer you for tests to see if you have cancer. This can be a worrying and tiring time, especially if you need to have several tests. If the tests show you have or may have cancer, your doctor will refer you to a specialist, who will examine you and may ask you to have more tests.

Your doctor may recommend the following tests.

  • Blood tests:
    the doctor will take a blood sample to check your general health and your blood count (the relative numbers of different cells in your blood) and to see how well your kidneys are working.
  • Ultrasound scans:
    use sound waves to make pictures of the organs in your body. This simple scan can pick up about half of all gallbladder cancers. Having an ultrasound scan is painless and harmless.
  • Computerised tomography (CT) scan:
    a special type of x-ray that gives a three-dimensional (3-D) picture of the organs and other structures (including any tumours) in your body.
  • Endoscopic retrograde cholangiopancreatography (ERCP):
    can show a narrowing or blockage in the bile duct or pancreatic duct. It helps your doctor to plan surgery to remove the gallbladder. You swallow a long flexible tube with a camera light at the end. This will allow your doctor to see inside your small bowel and take samples of abnormal areas. You'll be sedated during this procedure. You may need to have pain-relieving drugs as well.
  • Biopsy:
    this means removing a sample of tissue from the gallbladder and looking at it under a microscope. This can be done either by having a procedure called a laparoscopy or during an ERCP. You may not need to have a biopsy if your doctor is certain from other tests that you have gallbladder cancer. If your gallbladder is inflamed or you have gallstones and your gallbladder is being taken out anyway you won't need to have a biopsy.

Your doctor may order other tests such as a magnetic resonance imaging (MRI) scan or a magnetic resonance cholangiopancreatography (MRCP). Your doctor will discuss any recommended tests with you.

Staging gallbladder cancer

The test results will show whether or not you have cancer. They'll show where the primary cancer is and whether the cancer cells have spread to other parts of your body (this is known as metastasis). This helps your doctors ‘stage' the disease so they can work out the best treatment for you.

The staging system used for gallbladder cancer is known as the ‘TNM system' (T=tumour, N=nodes, M=metastases).

  • T followed by a number between 1 and 4 describes how far the cancer has spread into the liver and nearby tissue. A higher number after the T (for example, T3 or T4) means it has spread further.
  • N plus a number from 0 to 3 describes whether the cancer has spread to lymph nodes near the liver and, if so, the amount of cancer in the nodes. Higher numbers are used for nodes that are more affected by the cancer.
  • M followed by 1 shows that the cancer has spread to other organs or to lymph nodes that are not near the liver. M0 means there is no sign of the cancer having spread in this way.

Doctors combine this information to work out the stage of the cancer, from Stage 1 (I) to Stage 4 (IV). For example, a cancer assessed as T1, N0, M0 (tumour contained within the liver, lymph nodes not affected and no metastasis) would be called a Stage I cancer.

The lower the ‘number' stage, the less advanced the cancer is and the easier it will be to treat.

Ask your doctor to explain the stage of your cancer in a way you can understand. This will help you to choose the best treatment for you.

Treatments

The type of treatment you'll have will depend on the type of cancer you have, your general health as well as the stage of the cancer (how far it's spread). Doctors may recommend surgery (including laser treatment and stent insertions), radiotherapy and/or chemotherapy.

Surgery is the main treatment for gallbladder cancer. It can be used to take out all the cancer if it hasn't spread outside the gallbladder. However, if the cancer has spread, surgery may still help to relieve symptoms and decrease the size of the tumour. Other treatments such as chemotherapy and radiotherapy may also be helpful.

Cancers that are found early are easier to control and possibly cure.

Call Cancer Council on 13 11 20 for more information about treatment for gallbladder cancer.

You can also read the information about gallbladder cancer on the following cancer patient websites:

Research

Early detection and better treatment have improved survival for people with gallbladder cancer. Research for gallbladder cancer is ongoing. The CancerHelp UK website has information about research into gallbladder cancer. See also our Forgotten cancers research project.

Cancer Council Victoria supports participation in clinical trials. Clinical trials can test the effectiveness of promising new treatments or new ways of combining cancer treatments.

Always discuss treatment options with your doctor.

Recovery and follow-up care

Your doctors may want to examine you every 3 months for the first year after your treatment, every 6 months between the second and fifth years of your treatment, and once a year after that. They'll examine you and ask about any symptoms you've had, and answer any questions you have. Your doctors may order other tests or scans if needed.

Life after treatment

After treatment for gallbladder cancer you're likely to face several changes in your life. Some people may have short-term changes to cope with. Other changes may be permanent and difficult. Most people find they need information and support about how to best deal with their situations.

For further information see the links below or contact Cancer Council on 13 11 20 to speak with a cancer nurse.:

Updated: 30 Apr, 2013