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Gallbladder Cancer - Overview

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Gallbladder Cancer. To see other pages, use the menu on the side of your screen. Think of that menu as a roadmap to this full guide.

Gallbladder cancer occurs when normal cells in the gallbladder change and grow uncontrollably, forming a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can spread to other parts of the body. A benign tumor means the tumor will not spread. This section is about primary gallbladder cancer. Primary gallbladder cancer is cancer that starts in the gallbladder, as opposed to cancer that begins somewhere else in the body and spreads to the gallbladder.

About the gallbladder

The gallbladder is a pear-shaped organ located just under the liver. The gallbladder stores bile, a fluid made by the liver that helps to digest fats. Bile is released from the gallbladder through a tube, called the common bile duct, as food is broken down in the stomach and intestines.

The gallbladder’s wall is made up of three main layers of tissue: the mucosa, which is the innermost layer and covers the wall of the gallbladder; the muscularis, the middle layer of smooth muscle; and the serosa, the outer layer. Primary gallbladder cancer begins in the inner layer and spreads into the outer layers as it grows.

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Gallbladder Cancer - Statistics

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find information about how many people learn they have this type of cancer each year and some general survival information. Remember, survival rates depend on several factors. To see other pages, use the menu on the side of your screen.

This year, an estimated 10,650 adults (4,960 men and 5,690 women) in the United States will be diagnosed with gallbladder and other biliary cancers. It is estimated that 3,630 deaths (1,610 men and 2,020 women) from these diseases will occur this year.

The five-year survival rate is the percentage of people who survive at least five years after the cancer is detected, excluding those who die from other diseases. The five-year survival rate for people with gallbladder cancer depends on several factors, including the extent of cancer at the time of diagnosis (called the stage). Cancer survival statistics should be interpreted with caution. Estimates are based on data from thousands of people with this type of cancer in the United States each year, but the actual risk for a particular individual may differ. It is not possible to tell a person how long he or she will live with gallbladder cancer. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society's publication, Cancer Facts & Figures 2014.

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Gallbladder Cancer - Medical Illustrations

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find a basic drawing about the common body parts affected by this disease. To see other pages, use the menu on the side of your screen.

Gallbladder Anatomy

Larger image

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Gallbladder Cancer - Risk Factors

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find out more about the factors that increase the chance of this type of cancer. To see other pages, use the menu on the side of your screen.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. However, knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The following factors can raise a person's risk of developing gallbladder cancer:

Gallstones. Gallstones are the most common risk factor for gallbladder cancer. These are rock-like formations of cholesterol and bile salts that can occur in the gallbladder or bile duct. Gallstones are the most common digestive disease in the United States, and between 75% and 90% of people with gallbladder cancer have a history of gallstones. However, only a small proportion of people with gallstones develop gallbladder cancer.

Gallbladder polyps. This type of polyp is a growth that sometimes forms when small gallstones get embedded in the gallbladder wall. Gallbladder polyps bulge inward from the inner gallbladder wall. Some polyps may also be caused by inflammation. Doctors often recommend gallbladder removal for people who have polyps larger than one centimeter because these are more likely to be cancerous.

Age. Most people diagnosed with gallbladder cancer are older than 70.

Gender. Women are about twice as likely to develop gallbladder cancer as men.

Ethnicity. Mexican Americans and Native Americans, particularly in the southwestern United States, are more likely to develop gallbladder cancer than the general population.

Smoking. Tobacco use may increase the risk of gallbladder cancer.

Family history. A family history of gallbladder cancer slightly increases a person’s risk of developing gallbladder cancer.

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Gallbladder Cancer - Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. To see other pages, use the menu on the side of your screen.

People with gallbladder cancer may experience the following symptoms or signs. Sometimes, people with gallbladder cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer, such as a stomach virus.

Gallbladder cancer is usually not found at an early stage because the gallbladder is located deep inside the body. Therefore, gallbladder cancer can be difficult to detect during routine physical examinations. Sometimes, gallbladder cancer is found unexpectedly after removal of the gallbladder for another reason, such as gallstones. When symptoms do occur, they include the following:

  • Jaundice (yellowing of the skin and whites of the eyes)
  • Abdominal pain
  • Nausea and vomiting
  • Bloating
  • Lumps in the abdomen
  • Fever

If you are concerned about one or more of the symptoms or signs on this list, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.

If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.

The next section helps explain what tests and scans may be needed to learn more about the cause of the symptoms. Use the menu on the side of your screen to select Diagnosis, or you can select another section, to continue reading this guide.  

Gallbladder Cancer - Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find a list of the common tests, procedures, and scans that doctors can use to find out what’s wrong and identify the cause of the problem. To see other pages, use the menu on the side of your screen.

Doctors use many tests to diagnose cancer and find out if it has spread to another part of the body, called metastasis. Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has spread. This list describes options for diagnosing this type of cancer, and not all tests listed will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • Age and medical condition
  • Type of cancer suspected
  • Signs and symptoms
  • Previous test results

In addition to a physical examination, the following tests may be used to diagnose gallbladder cancer:

Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The sample removed during the biopsy is analyzed by a pathologist. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.

The sample of tissue can be taken one of several ways: during a surgery; with a minimally invasive surgical technique known as laparoscopy (see below); or with a fine needle or thick needle aspiration (a core biopsy), using a computed tomography (CT or CAT) scan or ultrasound to guide the needle placement. In some cases, a biopsy is done by passing an endoscope (a thin, lighted, flexible tube) through the mouth, past the stomach, and into the first part of the intestine. A tool can be passed from the endoscope through the intestinal wall to remove a sample of tissue.

Endoscopic retrograde cholangiopancreatography (ERCP). This test allows the doctor to see inside the body. The person is lightly sedated, and the doctor inserts an endoscope through the mouth, down the esophagus, and into the stomach and small bowel. A smaller tube or catheter is passed through the endoscope and into the bile ducts. Dye is injected into the ducts, and the doctor takes x-rays that can show whether a tumor is present in the area around the bile ducts. A plastic or metal stent can be placed across an obstructed bile duct during ERCP to help relieve jaundice if it is present. An experienced gastroenterologist should perform this procedure. A gastroenterologist is a doctor who specializes in the function and disorders of the gastrointestinal tract. This procedure is used more commonly to find cancer of the bile duct than to find gallbladder cancer, but it may also be used if the gallbladder cancer spreads and blocks the bile ducts.

X-ray. An x-ray is a way to create a picture of the structures inside of the body using a small amount of radiation. The patient may be asked to swallow barium, which coats the digestive tract, to enhance the image on the x-ray. This is called a barium swallow.

Percutaneous cholangiography. In this procedure, a thin needle is inserted through the skin and into the gallbladder area. A dye is injected through the needle so that a clear image will show up on x-rays. By looking at the x-rays, the doctor may be able to see whether there is a tumor in the gallbladder. More commonly, a cholangiography provides images of the bile ducts, and it may not show a tumor in the gallbladder. However, the procedure is excellent in detecting the site of a blocked bile duct.

Laparoscopy. Laparoscopy uses an endoscope to look at the gallbladder and other internal organs. The tube is inserted through a small incision in the abdomen.

Blood tests. The doctor may take samples of blood to check for abnormal levels of bilirubin and other substances. Bilirubin is a chemical that may reach high levels in people with gallbladder cancer due to blockage of the common bile duct by a tumor.

Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan can also be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill to swallow.

Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body and can be used to find out whether the cancer has spread outside the gallbladder. MRI can also be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow.

Ultrasound. An ultrasound uses sound waves to create a picture of the internal organs. Tumors generate different echoes of the sound waves than normal tissue; thus, when the waves are bounced back to a computer, creating images, the doctor can locate a mass inside the body.

Positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. A scanner then detects this substance to produce images of the inside of the body.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer; this is called staging.

The next section helps explain the different stages for this type of cancer. Use the menu on the side of your screen to select Stages, or you can select another section, to continue reading this guide.  

Gallbladder Cancer - Stages

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. To see other pages, use the menu on the side of your screen.

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Doctors use diagnostic tests to find out 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 prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.

One tool that doctors use to describe the stage is the TNM system. TNM is an abbreviation for tumor (T), node (N), and metastasis (M). Doctors look at these three factors to determine the stage of cancer:

  • How large is the primary tumor and where is it located? (Tumor, T)
  • Has the tumor spread to the lymph nodes? (Node, N)
  • Has the cancer metastasized to other parts of the body? (Metastasis, M)

The results are combined to determine the stage of cancer for each person. There are five stages: stage 0 (zero) and stages I through IV (one through four). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

Here are more details on each part of the TNM system for gallbladder cancer:

Tumor. Using the TNM system, the "T" plus a letter or number (0 to 4) is used to describe the amount of cancer found in the gallbladder. Some stages are also divided into smaller groups that help describe the tumor in even more detail. This helps the doctor develop the best treatment plan for each patient. Specific tumor stage information is listed below.

TX: The primary tumor cannot be evaluated.

T0: No evidence of cancer was found in the gallbladder.

Tis: This refers to carcinoma (cancer) in situ, which means that the tumor remains in a pre-invasive state and its spread, if any, is very confined.

T1: The tumor is only in the gallbladder and has only invaded the lamina propria (a type of connective tissue found under the thin layer of tissue covering a mucous membrane) or muscle layer.

T1a: The tumor has invaded the lamina propria.

T1b: The tumor has invaded the muscle layer.

T2: The tumor has invaded the perimuscular connective tissue (the layer between the muscle layer and the serosa) but has not extended beyond the serosa (the outer layer) or into the liver.

T3: The tumor extends beyond the gallbladder and/or has invaded the liver and/or one other adjacent organ or structure, such as the stomach, duodenum (part of the small bowel), colon, or pancreas.

T4: The tumor has invaded the main portal vein or hepatic artery or has invaded more than one organ or structure beyond the liver.

Node. The “N” in the TNM staging system stands for lymph nodes, the tiny, bean-shaped organs that help fight infection. Lymph nodes near the gallbladder are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes.

NX: The regional lymph nodes cannot be evaluated.

N0 (N plus zero): There is no regional lymph node metastasis.

N1: There is regional lymph node metastasis.

N2: There is distant lymph node metastasis.

Distant metastasis. The “M” in the TNM system indicates whether the cancer has spread to other parts of the body.

M0 (M plus zero): There is no distant metastasis.

M1: There is metastasis to one or more other parts of the body.

Cancer stage grouping

Doctors assign the stage of the cancer by combining the T, N, and M classifications.

Stage 0: Describes cancer in situ (Tis, N0, M0).

Stage I: A tumor is only in the gallbladder and has not spread (T1, N0, M0).

Stage II: A tumor has extended to the perimuscular connective tissue but has not spread elsewhere (T2, N0, M0).

Stage IIIA: A tumor has spread beyond the gallbladder but not to nearby arteries or veins. It has not spread to any lymph nodes or other parts of the body (T3, N0, M0).

Stage IIIB: A tumor of any size has spread to nearby lymph nodes but not to nearby arteries and/or veins or to other parts of the body (T1, T2, T3; N1; M0).

Stage IVA: A tumor has spread to nearby arteries, veins, and/or nearby lymph nodes, but it has not spread to other parts of the body (T4, N0 or N1, M0).

Stage IVB: Describes any tumor that has spread to other parts of the body (any T, any N, M1) or any tumor that has distant lymph node spread, even if it has not spread to distant organs (any T, N2, M0).

Recurrent: Recurrent gallbladder cancer is cancer that has come back after treatment. If there is a recurrence, the cancer may need to be staged again (called re-staging) using the system above.

Used with permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Seventh Edition (2010) published by Springer-Verlag New York, www.cancerstaging.net

Information about the cancer’s stage will help the doctor recommend a treatment plan.  The next section helps explain the treatment options for this type of cancer. Use the menu on the side of your screen to select Treatment Options, or you can select another section, to continue reading this guide.  

Gallbladder Cancer - Treatment Options

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will learn about the different ways doctors use to treat people with this type of cancer. To see other pages, use the menu on the side of your screen.

This section outlines treatments that are the standard of care (the best proven treatments available) for this specific type of cancer. When making treatment plan decisions, patients are also encouraged to consider clinical trials as an option. A clinical trial is a research study to test a new approach to treatment to evaluate whether it is safe, effective, and possibly better than the standard treatment. Clinical trials may test such approaches as a new drug, a new combination of standard treatments, or new doses of current therapies. Your doctor can help you review all treatment options. For more information, see the Clinical Trials and Latest Research sections.

Treatment overview

In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. For gallbladder cancer, the team of doctors may include a gastroenterologist, a surgeon, a medical oncologist, and a radiation oncologist.

Descriptions of the most common treatment options for gallbladder cancer are listed below. Gallbladder cancer may be treated with one or more treatments, including surgery, chemotherapy, or radiation therapy. If detected at an early stage, gallbladder cancer has a much higher chance of being successfully treated.

Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Learn more about making treatment decisions.

Surgery

Surgery is the removal of the tumor and surrounding tissue during an operation.

A surgical oncologist is a doctor who specializes in treating cancer using surgery. The following are types of surgery used in the treatment of gallbladder cancer:

Cholecystectomy. Also called a simple cholecystectomy, this procedure involves the removal of the gallbladder. An extended cholecystectomy is the removal of the gallbladder, one inch or more of liver tissue located next to the gallbladder, and all of the lymph nodes in the region.

Radical gallbladder resection. This procedure involves the removal of the gallbladder, a wedge-shaped section of the liver near the gallbladder, the common bile duct, part or all of the ligaments between the liver and intestines, and the lymph nodes around the pancreas and nearby blood vessels.

Palliative surgery. Surgery may sometimes help relieve symptoms caused by gallbladder cancer, even if the tumor cannot be removed. For example, surgery may relieve a blockage of the bile ducts or intestines.

The side effects will depend on the specific type of surgery. Patients are encouraged to talk with their health care team before the operation about what to expect in their recovery following surgery. Learn more about cancer surgery.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment for gallbladder cancer is called external-beam radiation therapy, which is radiation therapy given from a machine outside the body. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time.

Radiation therapy may be used before surgery to shrink the size of the tumor or after surgery to destroy any remaining cancer cells. In some cases, radiation therapy is given during surgery to directly target the area of the tumor and protect healthy organs from the effects of traditional radiation therapy. This procedure is called intra-operative radiation therapy, or IORT.

Side effects of radiation therapy may include fatigue, mild skin reactions, upset stomach, loose bowel movements, and damage to nearby structures such as the liver or intestines. Most side effects go away soon after treatment is finished. Learn more about radiation therapy.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication. A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time.

Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally). Chemotherapy may be given before surgery to shrink the tumor or after surgery to destroy any remaining cancer cells. It also may be combined with radiation therapy. Chemotherapy can be given by mouth or injection. The drugs that are commonly recommended include gemcitabine (Gemzar), fluorouracil (5-FU), and cisplatin (Platinol). The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

Learn more about chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Getting care for symptoms and side effects

Cancer and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care can help a person at any stage of illness. People often receive treatment for the cancer and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy, surgery, and radiation therapy. Talk with your doctor about the goals of each treatment in your treatment plan.

Before treatment begins, talk with your health care team about the possible side effects of your specific treatment plan and supportive care options. And during and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it is addressed as quickly as possible. Learn more about palliative care

Metastatic gallbladder cancer

If cancer has spread to another location in the body, it is called metastatic cancer. Patients with this diagnosis are encouraged to talk with doctors who are experienced in treating this stage of cancer, because there can be different opinions about the best treatment plan. Learn more about seeking a second opinion before starting treatment, so you are comfortable with the treatment plan chosen. This discussion may include clinical trials.

Your health care team may recommend a treatment plan that includes a combination of surgery, chemotherapy, or radiation therapy. Supportive care will also be important to help relieve symptoms and side effects.

For most patients, a diagnosis of metastatic cancer is very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.

Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called “no evidence of disease” or NED. 

A remission can be temporary or permanent. This uncertainty leads to many survivors feeling worried or anxious that the cancer will come back. While many remissions are permanent, it’s important to talk with your doctor about the possibility of the cancer returning. Understanding the risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

If the cancer does return after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

When this occurs, a cycle of testing will begin again to learn as much as possible about the recurrence, including whether the cancer’s stage has changed. After testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the therapies described above such as surgery, chemotherapy, and radiation therapy but they may be used in a different combination or given at a different pace. Your doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent cancer.

People with recurrent cancer often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with cancer recurrence.

If treatment fails

Recovery from cancer is not always possible. If treatment is not successful, the disease may be called advanced or terminal cancer.

This diagnosis is stressful, and this is difficult to discuss for many people. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.

Patients who have advanced cancer and who are expected to live less than six months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to think about where you would be most comfortable: at home, in the hospital, or in a hospice environment. Nursing care and special equipment can make staying at home a workable alternative for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

The next section helps explain clinical trials, which are research studies. Use the menu on the side of your screen to select About Clinical Trials, or you can select another section, to continue reading this guide.  

Gallbladder Cancer - About Clinical Trials

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. To see other pages, use the menu on the side of your screen.

Doctors and scientists are always looking for better ways to treat patients with gallbladder cancer. To make scientific advances, doctors create research studies involving volunteers, called clinical trials.

Many clinical trials are focused on new treatments, evaluating whether a new treatment is safe, effective, and possibly better than the current (standard) treatment. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials are often among the first to receive new treatments before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.

There are also clinical trials that study new ways to ease symptoms and side effects during treatment and managing the late effects that may occur after treatment. Talk with your doctor about clinical trials regarding side effects. In addition, there are ongoing studies about ways to prevent the disease.

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that these studies are the only way to make progress in treating gallbladder cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with gallbladder cancer.

Sometimes people have concerns that, by participating in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” The use of placebos in cancer clinical trials is rare. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

To join a clinical trial, patients must participate in a process known as informed consent. During informed consent, the doctor should list all of the patient’s options so that the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different than the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

For specific topics being studied for gallbladder cancer, learn more in the Latest Research section.

Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if the patient chooses to leave the clinical trial before it ends. 

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

The next section helps explain the areas of research going on today about this type of cancer. Use the menu on the side of your screen to select Latest Research, or you can select another section, to continue reading this guide.  

Gallbladder Cancer - Latest Research

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will read about the scientific research being done now to learn more about this type of cancer and how to treat it. To see other pages, use the menu on the side of your screen.

Doctors are working to learn more about gallbladder cancer, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the diagnostic and treatment options best for you.

Immunotherapy. Immunotherapy, also called biologic therapy, is designed to boost the body’s natural defenses to fight the cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function. Current clinical trials are testing immunotherapy as a way to treat gallbladder cancer. Learn more about immunotherapy.

Gene therapy. Gene therapy is an experimental treatment that involves introducing genetic material into a person’s cells to treat cancer. Gene therapy is being studied in clinical trials for many different types of cancer and for other diseases.

Chemotherapy and radiation therapy improvements. Currently, the effectiveness of chemotherapy and radiation therapy for the treatment of gallbladder cancer is limited. Clinical trials are evaluating new drugs for gallbladder cancer and trying to increase the effectiveness of radiation therapy.

Supportive care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current gallbladder cancer treatments in order to improve patients’ comfort and quality of life.

To find clinical trials specific to your diagnosis, talk with your doctor or search online clinical trial databases now.

The next section addresses how to cope with the symptoms of the disease or the side effects of its treatment. Use the menu on the side of your screen to select Coping with Side Effects, or you can select another section, to continue reading this guide.  

Gallbladder Cancer - Coping with Side Effects

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find out more about steps to take to help cope with physical, social, and emotional side effects. This page includes several links outside of this guide to other sections of this website. To see other pages, use the menu on the side of your screen.

Fear of treatment side effects is common after a diagnosis of cancer, but it may help to know that preventing and controlling side effects is a major focus of your health care team. This is called palliative or supportive care, and it is an important part of the overall treatment plan, regardless of the stage of disease.

Common side effects from each treatment option for gallbladder cancer are described in detail within the Treatment Options section. Learn more about the most common side effects of cancer and different treatments, along with ways to prevent or control them. Side effects depend on a variety of factors, including the cancer’s stage, the length and dosage of treatment(s), and your overall health.

Before treatment begins, talk with your doctor about possible side effects of each type of treatment you will be receiving. Ask which side effects are most likely to happen, when they are likely to occur, and what can be done to prevent or relieve them. And, ask about the level of caregiving you may need during treatment and recovery, as family members and friends often play an important role in the care of a person with gallbladder cancer. Learn more about caregiving.

In addition to physical side effects, there may be emotional and social effects as well. Patients and their families are encouraged to share their feelings with a member of their health care team who can help with coping strategies, including concerns about managing the cost of your cancer care

During and after treatment, be sure to tell the health care team about the side effects you experience, even if you feel they are not serious. Sometimes, side effects can last beyond the treatment period, called a long-term side effect. A side effect that occurs months or years after treatment is called a late effect. Treatment of both types of effects is an important part of survivorship care. Learn more by reading the After Treatment section or talking with your doctor.

The next section helps explain medical tests and check-ups needed after finishing cancer treatment. Use the menu on the side of your screen to select After Treatment, or you can select another section, to continue reading this guide.  

Gallbladder Cancer - After Treatment

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will read about your medical care after cancer treatment is finished and why this follow-up care is important. To see other pages, use the menu on the side of your screen.

After treatment for gallbladder cancer ends, talk with your doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years. It is necessary to have regular checkups following treatment for gallbladder cancer to watch for possible recurrence. In addition to physical examinations, blood tests and imaging tests (such as CT scans) may be done.

ASCO offers cancer treatment summary forms to help keep track of the cancer treatment you received and develop a survivorship care plan once treatment is completed.

People recovering from gallbladder cancer are encouraged to follow established guidelines for good health, such as maintaining a healthy weight, not smoking, eating a balanced diet, and having recommended cancer screening tests. Talk with your doctor to develop a plan that is best for your needs. Moderate physical activity can help rebuild your strength and energy level. Your doctor can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about the next steps to take in survivorship, including making positive lifestyle changes.

The next section offers a list of questions you may want to ask. Use the menu on the side of your screen to select Questions to Ask the Doctor, or you can select another section, to continue reading this guide.  

Gallbladder Cancer - Questions to Ask the Doctor

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health care team, to help you better understand your diagnosis, treatment plan, and overall care. To see other pages, use the menu on the side of your screen.

Talking often with the doctor is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for an e-list and other interactive tools to manage your care.

General questions:

  • What type of cancer do I have?
  • What is the stage of the cancer? What does this mean?
  • Can you explain my pathology (laboratory test results) report to me?
  • Are other tests needed to confirm this diagnosis?
  • What are my treatment options?
  • What clinical trials are open to me? Where are they located, and how do I find out more about them?
  • What treatment plan do you recommend? Why?
  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?
  • Who will be part of my health care team, and what does each member do?
  • Who will be coordinating my overall treatment and follow-up care?
  • How experienced is the gastroenterologist?
  • What are the possible side effects of each treatment, both in the short term and the long term?
  • How will this treatment affect my daily life? Will I be able to work, exercise, or perform my usual activities?
  • Could this treatment affect my sex life? If so, how and for how long?
  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?
  • If I’m worried about managing the costs related to my cancer care, who can help me with these concerns?
  • What support services are available to me? To my family?
  • Whom should I call for questions or problems?

Questions to ask before surgery:

  • What is the purpose of the surgery?
  • What are the side effects of the surgery I’m having? How will these be managed?
  • Will I need to stay in the hospital for this surgery? If so, for how long?
  • How long will recovery from the surgery take?

Questions to ask before radiation therapy:

  • What type of radiation therapy is recommended?
  • What is the purpose of the radiation therapy?
  • How long will each treatment be? How often will I need these treatments?
  • What side effects can I expect from this treatment?
  • What can be done to help relieve the side effects?

For patients who need chemotherapy:

  • What type of chemotherapy is recommended?
  • What is the purpose of the chemotherapy?
  • How long will each chemotherapy treatment be? How often will I need these treatments?
  • What side effects can I expect from this treatment?
  • What can be done to help relieve the side effects?

After treatment:

  • What are the chances that the cancer will return?
  • What follow-up tests do I need, and how often do I need them?

The next section offers some more resources that may be helpful to you. Use the menu on the side of your screen to select Additional Resources, or you can select another section, to continue reading this guide.  

Gallbladder Cancer - Additional Information Resources

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Gallbladder Cancer. To go back and review other pages, use the menu on the side of your screen.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer, both for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond. Here are a few sections that may get you started in exploring the rest of Cancer.Net:

- Search for a cancer specialist in your local area using this free database of doctors from the American Society of Clinical Oncology.

Review dictionary articles to help understand medical phrases and terms used in cancer care and treatment.

- Read more about the first steps to take when newly diagnosed with cancer.

- Find out more about clinical trials as a treatment option.

Learn more about coping with the emotions that cancer can bring, including those within a family or a relationship.

Find a national, not-for-profit advocacy organization that may offer additional information, services, and support for people with this type of cancer.

- Explore next steps a person can take after active treatment is complete.

This is the end of the Cancer.Net’s Guide to Gallbladder Cancer. Use the menu on the side of your screen to select another section to continue reading this guide.