Gallbladder Cancer Symptoms can be subtle at first. The gallbladder does not make bile—the liver produces bile while the gallbladder stores and concentrates it to help the body digest fats. Sometimes the cells that line the gallbladder change and grow uncontrollably, leading to cancer. Gallbladder cancer is a rare but serious cancer that may cause symptoms such as right upper abdominal pain, bloating, or jaundice as it progresses. Below we explain causes, common symptoms, how the condition is diagnosed, and treatment options.
What is Gallbladder Cancer?
Gallbladder cancer is a rare cancer that begins when cells in the gallbladder’s inner lining (mucosa) grow abnormally and become malignant. Most gallbladder cancers are adenocarcinomas arising from this mucosal layer; over time the tumor can invade deeper layers of the gallbladder wall and eventually spread to nearby organs or lymph nodes (metastasize).
Because early disease often causes no symptoms, gallbladder cancer is frequently detected at a later stage — sometimes incidentally during imaging or surgery for another problem. People with chronic gallbladder inflammation or gallstones have a higher risk of developing this cancer. For quick navigation, see the Symptoms and Diagnosis sections below to learn what to watch for and which tests doctors use to evaluate suspected disease.
What Are the Symptoms of Gallbladder Cancer?
In the early stages, gallbladder cancer often causes no symptoms. When signs do appear, they are frequently vague and can be mistaken for more common problems such as gallstones or bile duct blockage. Below are the most commonly reported symptoms and how they tend to present.
- Local pain or lump: Persistent right upper quadrant (RUQ) abdominal pain is the most common complaint. Some people notice a palpable lump or fullness under the ribs on the right side.
- Obstructive signs: Jaundice (yellowing of the skin and the whites of the eyes), dark urine, and pale stools can occur if the tumor blocks the bile ducts.
- Digestive symptoms: Bloating, nausea, and episodes of nausea and vomiting are common early complaints.
- Systemic symptoms: Unintended weight loss, loss of appetite, and low‑grade fever or night sweats may be signs of more advanced disease.
Because these symptoms overlap with benign conditions, pay attention to warning signs: persistent RUQ pain, new jaundice, unexplained weight loss, or ongoing nausea and vomiting warrant prompt medical evaluation. Talk to your doctor if any of these signs last more than a few weeks or get worse—early assessment helps with diagnosis and treatment planning.
What Causes Gallbladder Cancer?
Gallbladder cancer develops when genetic mutations cause cells in the gallbladder to grow uncontrollably and become malignant. While the exact sequence of changes is not fully known, researchers have identified several risk factors that increase the chance that these cellular changes will occur.
Some key risk factors include:
- Gallstones and chronic inflammation: Longstanding gallstones and repeated gallbladder inflammation (cholecystitis) are among the strongest links to gallbladder cancer.
- Gallbladder polyps: Small polyps are common and usually harmless, but larger polyps (commonly >1 cm) are more likely to be concerning and may prompt closer evaluation.
- Congenital bile duct cysts and chronic bile duct disease: Long-term bile duct disease and choledochal cysts can raise cancer risk by causing chronic bile stasis and inflammation.
- Porcelain gallbladder (gallbladder calcification): Calcification of the gallbladder wall (sometimes called a porcelain gallbladder) has been associated with an increased risk and may lead clinicians to recommend surgery in some cases.
- Infections and past illnesses: A history of Salmonella typhi (typhoid) infection has been linked in some studies to higher gallbladder cancer risk.
- Demographics and lifestyle: Gallbladder cancer is more commonly diagnosed in women and in older people (risk increases with age). Obesity and certain dietary patterns may also contribute to risk.
Not all people with these risk factors will develop gallbladder cancer, and cases also occur without any known risks. If you have gallstones, polyps, or a history of chronic gallbladder or bile duct problems, talk with your doctor about appropriate surveillance and whether surgery or other measures are recommended based on the size of polyps, symptoms, and overall risk.
Stages of Gallbladder Cancer
After a diagnosis, determining the stage of gallbladder cancer helps guide prognosis and treatment. Staging describes how deeply cancer cells have invaded the gallbladder wall, whether nearby lymph nodes are involved, and whether the cancer has spread to distant organs (metastasized). Stages range from 0 to 4, with higher numbers indicating more advanced disease.
Stage 0: Abnormal cells are confined to the inner lining (mucosa) of the gallbladder; there is no spread. (Early stages — often curable with surgery.)
Stage 1: Cancer invades into the muscle layer of the gallbladder wall but remains localized. (Often treated with surgery; good chance of cure if fully removed.)
Stage 2: Tumor has grown through the muscle into the connective tissue or serosa of the gallbladder wall. (Surgery with removal of nearby tissue is usually recommended; risk of lymph node involvement increases.)
Stage 3: Cancer extends to nearby organs (such as the liver) or to regional lymph nodes. (Treatment commonly includes more extensive surgery and may require adjuvant therapy.)
Stage 4: Cancer has spread to distant lymph nodes or other organs (metastasis). (Often managed with systemic therapy, palliative care, and sometimes radiation to control symptoms.)
Staging is usually determined using imaging (CT, MRI, sometimes PET) and may be confirmed with surgical assessment or pathology after resection. Because staging terminology maps to the TNM system (tumor, node, metastasis), ask your doctor which stage and TNM category apply to your case and how that affects the treatment plan.
How is Gallbladder Cancer Diagnosed?
If a doctor suspects gallbladder cancer, they will use a combination of history, physical exam, blood tests, imaging scans, and sometimes tissue sampling to confirm the diagnosis and determine the stage. Below are the common diagnostic tests, what they show, and their limitations.
- Blood tests (laboratory tests): Liver function tests (LFTs) assess how well the liver is working and can show patterns suggestive of bile duct obstruction. Tumor markers such as CA 19‑9 and carcinoembryonic antigen (CEA) may be elevated with biliary cancers but are nonspecific — they support suspicion and help follow disease over time but cannot confirm diagnosis alone.
- Ultrasound: Abdominal ultrasound is often the first-line scan for people with right upper quadrant pain or jaundice. It can identify gallstones, a thickened gallbladder wall, masses in the gallbladder, and dilation of the bile ducts.
- CT scan (computed tomography): CT of the chest, abdomen, and pelvis provides detailed cross‑sectional images to detect a gallbladder tumor, assess local invasion into the liver or other tissues, and look for metastatic disease in the chest or abdomen.
- MRI and MRCP: MRI gives high-resolution images of soft tissues; MR cholangiopancreatography (MRCP) is especially useful to visualize the bile ducts and detect blockages or ductal involvement by tumor.
- ERCP and percutaneous cholangiography: Endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography can image the bile ducts directly and allow therapeutic maneuvers (stent placement) if obstruction is present. These tests are more invasive and are used selectively.
- Laparoscopy: A minimally invasive surgical inspection of the abdominal cavity can help determine whether the tumor has spread and sometimes guide whether surgery is feasible.
- Biopsy (tissue sampling): Examining tissue under a microscope is the definitive way to diagnose cancer. Biopsies may be obtained during surgery, via image-guided percutaneous needle sampling, or by endoscopic techniques. Note: percutaneous biopsy can carry a small risk of tumor seeding along the needle track, so the approach is chosen carefully by the treatment team.
In practice, doctors usually start with less invasive tests (ultrasound and blood tests) and proceed to CT or MRI for staging. PET scans may be used in selected cases to detect occult metastases. The full workup helps the care team (surgeons, oncologists, radiologists) decide the best treatment plan. If you have symptoms or risk factors, discuss with your doctor which tests are appropriate for you and where to get further evaluation at a hepatobiliary specialty center.
How is Gallbladder Cancer Treated?
Early detection improves the chance that treatment can remove gallbladder cancer. Treatment choices depend on the cancer’s stage, the person’s overall health, and whether the cancer has spread. Below are the main treatment approaches and what they typically involve.
Surgery
Surgery is the primary curative option for early stages. Options range from a simple cholecystectomy (removal of the gallbladder) for very early tumors to extended resections that remove part of the liver and regional lymph nodes for tumors that invade deeper layers. Your surgeon will discuss the recommended operation based on the stage and tissue involvement.
Systemic therapy: Chemotherapy, Targeted Therapy, and Immunotherapy
For more advanced disease or after surgery when there is a higher risk of recurrence, systemic therapy may be recommended. Chemotherapy (intravenous drugs) is commonly used to slow cancer growth or shrink tumors. Targeted therapies and immunotherapy are evolving areas — certain targeted agents or immune checkpoint inhibitors may be options in clinical trials or for tumors with specific molecular features. Ask your oncologist about the latest evidence and whether molecular testing or clinical trials are appropriate.
Radiation therapy
Radiation can be used to help control local tumor growth, relieve symptoms (such as pain or biliary obstruction), or as part of a combined treatment approach after surgery. The role and timing of radiation depend on stage and individual treatment goals.
Palliative care and supportive therapies
When cure is not possible, the focus shifts to symptom control and quality of life. Palliative care teams can help manage pain, nausea, nutritional needs, bile duct obstruction (for example with stents), and other issues. Supportive care is an essential part of any treatment plan.
Clinical trials and treatment planning
Because gallbladder cancer is rare, consider treatment at or in consultation with a hepatobiliary specialist or a center experienced in biliary cancers. Clinical trials may offer access to new targeted therapies or immunotherapy approaches; ask your doctor whether molecular testing or trial enrollment might fit your treatment plan.
If you or a loved one has symptoms or known gallstones, polyps, or a history of bile duct disease, speak with your primary care doctor or a hepatobiliary surgeon about appropriate evaluation, staging scans, and a multidisciplinary treatment plan. Early discussion with specialists can help align the best cancer treatment and supportive care options for each person.
