Diagnosing Gallbladder Cancer

About Gallbladder Cancer

At Penn's Abramson Cancer Center, patients with gallbladder cancer receive their care from a multidisciplinary team of nationally recognized experts in the diagnosis, treatment and research of gastrointestinal cancer.

Gallbladder cancer is cancer that forms in the tissue of the gallbladder, a pear-shaped organ located near the liver in the upper abdomen that collects and stores bile.

Primary cancer of the gallbladder is very rare. Most gallbladder cancers are adenocarcinomas, meaning they are located in the surface area tissue of the organ. They can be further classified, depending on how the cancer appears under a microscope, as follows:

  • Papillary
  • Nodular
  • Tubular

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right physician.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Read more About Gallbladder Cancer

Diagnosing Gallbladder Cancer

An accurate cancer diagnosis from trusted cancer specialists is the first step in getting personalized treatment options to treat gallbladder cancer.

Patients who choose Penn’s Abramson Cancer Center, benefit from a multidisciplinary team of cancer specialists including gastroenterologists, radiologists, pathologists and surgeons who work together to provide a diagnosis and treatment plan custom designed for each patient with gallbladder cancer.

Cancer specialists at Penn Medicine are highly experienced in using the most advanced techniques for diagnosing gallbladder cancer and are actively researching better and more precise ways to detect gallbladder cancer.

Navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right person. Penn Medicine’s contact center has experienced cancer nurses available and ready to guide patients in finding the cancer specialist right for them.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Screening for Gallbladder Cancer

Currently, there are no general screening tests recommended for gallbladder cancer such as mammograms for breast cancer or colonoscopies for colon cancer. For patients at high risk, the cancer risk evaluation programs at Penn Medicine can help determine if screening tests are needed.

Diagnostic Tools for Gallbladder Cancer

When physicians suspect gallbladder cancer, they may order several tests to make a diagnosis.

  • Medical history and physical exam.
  • Lab tests. Lab tests can help a physician diagnose cancer, determine current organ function, learn how other organs may be affected, and look for signs of cancer. Lab tests ordered by a physician may include gallbladder and liver function panels to look for abnormal levels of substances in the blood that may indicate disease. Lab tests may also include measures for CEA and CA 19-9 that are tumor markers.
  • Imaging tests. Pictures of the inside of the body can help find out whether a suspicious area might be cancerous, to learn how far cancer may have spread, and to help determine if treatment is working.
    • Endoscopic retrograde cholangiopancreatography (ERCP). ERCP combines endoscopy and fluoroscopy to diagnose gallbladder cancer.
    • Endoscopic ultrasound (EUS).  This procedure combines endoscopy and ultrasound to provide images of the gallbladder and surrounding structures, and may also be used for tissue acquisition.
    • Computed tomography (CT). A CT scan creates a 3-D X-ray of the inside of the body. A computer combines the images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (dye) is used to provide better detail.
    • Magnetic resonance imaging (MRI). Magnetic fields are used to create detailed images of the body. A contrast medium may be injected into a vein to create a clearer picture.
    • Magnetic resonance cholangiopancreatography (MRCP). MRCP is a non-invasive imaging test that uses magnetic resonance imaging to view biliary and pancreatic ducts.
    • Percutaneous transhepatic cholangiography (PTC). A thin needle is inserted via the liver into the bile ducts and dye is injected before an X-ray is taken. A stent may be left to drain bile if a blockage is found.
    • Angiography. A catheter is threaded along the blood vessels leading to the liver. Contrast is injected into the blood vessels and X-rays are taken that can show tumors.
  • Biopsy. A sample of the suspicious area is removed and viewed under a microscope when other tests find a change that is possibly cancer. A biopsy is the only way to tell if cancer is really present.
    • Needle biopsy. A thin needle is used to remove a small sample of the gallbladder or surrounding tissue.
    • Fine-needle aspiration biopsy. Fine-needle aspiration (FNA) is the least invasive method of biopsy and it usually leaves no scar. An injection of local anesthesia numbs the area before the surgeon or radiologist uses a thin needle with a hollow center to remove a sample of cells from the suspicious area. Imaging studies such as ultrasound are used to guide the needle to the right location.

Staging Gallbladder Cancer

Staging is a way of describing a cancer, such as where it is located, if or where it has spread, and if it is affecting the functions of other organs in the body. Doctors use diagnostic tests to determine the cancer's stage, so staging may not be complete until all the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's chance of recovery.

  • Stage 0. Abnormal cells are found only in the innermost layer of tissue lining the gallbladder; also called carcinoma in situ.
  • Stage IA: Cancer has spread through the innermost layer of the gallbladder and to the connective or muscle tissue.
  • Stage IB: Cancer has spread beyond the muscle to the connective tissue around the muscle.
  • Stage IIA: Cancer has spread to the tissue that covers the gallbladder, and/or to the liver and/or to one nearby organ.
  • Stage IIB: Cancer has spread and one of the following:      
    • Beyond innermost layer to connective tissue and lymph nodes
    • To the muscle layer and nearby lymph nodes
    • Beyond the muscle layer to the connective tissue around the muscle and lymph nodes
    • Through the outermost tissue and/or to the liver and/or to one nearby organ and to lymph nodes.
  • Stage III. Cancer has spread to a main blood vessel in the liver or nearby organs, and may be in nearby lymph nodes.
  • Stage IV. Cancer has spread to nearby lymph nodes and/or organs far away from gallbladder.

Gallbladder cancer is also classified as to how the cancer may be treated.

  • Localized: Cancer is found in the wall of the gallbladder and can be completely removed by surgery.
  • Unresectable: Cancer has spread and, except in patients whose cancer has spread only to lymph nodes, cannot be surgically removed.

Gallbladder Cancer Treatment

Following the diagnosis and staging of gallbladder cancer, cancer specialists at Penn Medicine's Abramson Cancer Center develop a personalized treatment plan. Penn's treatment options for gallbladder cancer include:

  • Surgery
    • Cholecystectomy (gallbladder removal)
    • Partial hepectomy
    • Surgical biliary bypass
    • Percutaneous transhepatic biliary drainage
    • Endoscopic stent placement
  • Radiation therapy
    • 3-D conformal radiation therapy
    • Intensity-modulated radiation therapy (IMRT)
    • Volumetric-modulated arc therapy
    • Proton therapy
    • Photdynamic therapy (PDT)
    • Brachytherapy
  • Chemotherapy and biologic therapies
    • Chemotherapy
    • Chemoradiotherapy
    • Liver-directed biologic therapies
  • Clinical trials
  • Other treatments

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right physician.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN.

Read more Gallbladder Cancer Treatment

Gallbladder Cancer Survivorship

Survivorship programs at Penn Medicine are a distinct phase of gallbladder cancer care and are designed to help patients' transition from their gallbladder cancer treatment routine to a post-cancer care lifestyle. There are more than 12 million cancer survivors living and thriving today as a result of advances in cancer treatment. However, cancer treatments can result in physical, emotional and financial complications long after the therapy is complete.

Read more Gallbladder Cancer Survivorship

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