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Gallbladder Cancer - Introduction

Approved by the Cancer.Net Editorial Board, 08/2023

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. Use the menu to see other pages. Think of that menu as a roadmap for this entire guide.

Gallbladder cancer occurs when healthy cells in the gallbladder change and grow out of control, forming a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

This section is about primary gallbladder cancer. Primary gallbladder cancer is cancer that starts in the gallbladder. This is different than when cancer 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. It is part of the body's biliary tract, along with the liver and bile ducts. The gallbladder stores bile, a fluid made by the liver that helps to digest fats. Bile travels through the liver to the gallbladder through the intrahepatic bile ducts for storage. It is released from the gallbladder through a tube called the common bile duct as food is broken down in the stomach and small intestine.

The gallbladder’s wall is made up of 3 main layers of tissue:

  • Mucosa: The innermost layer of tissue that covers the wall of the gallbladder.

  • Muscularis: The middle layer of smooth muscle.

  • Serosa: The outer layer of tissue.

Primary gallbladder cancer begins in the inner layer and spreads into the outer layers as it grows.

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The next section in this guide is Statistics. It helps explain the number of people who are diagnosed with gallbladder cancer and general survival rates. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - Statistics

Approved by the Cancer.Net Editorial Board, 08/2023

ON THIS PAGE: You will find information about the estimated number of people who will be diagnosed with gallbladder cancer each year. You will also read general information on surviving the disease. Remember, survival rates depend on several factors, and no 2 people with cancer are the same. Use the menu to see other pages.

Every person is different, with different factors influencing their risk of being diagnosed with this cancer and the chance of recovery after a diagnosis. It is important to talk with your doctor about any questions you have around the general statistics provided below and what they may mean for you individually. The original sources for these statistics are provided at the bottom of this page.

How many people are diagnosed with gallbladder cancer?

In 2023, an estimated 12,220 adults (5,750 men and 6,470 women) in the United States will be diagnosed with gallbladder and other biliary cancers. About 4 out of 10 are specifically gallbladder cancers. Worldwide, an estimated 115,949 people were diagnosed with gallbladder cancer in 2020.

It is estimated that 4,510 deaths (1,900 men and 2,610 women) from gallbladder and other biliary cancers will occur in the United States in 2023. In 2020, an estimated 84,695 people worldwide died from gallbladder cancer.

What is the survival rate for gallbladder cancer?

There are different types of statistics that can help doctors evaluate a person’s chance of recovery from gallbladder cancer. These are called survival statistics. A specific type of survival statistic is called the relative survival rate. It is often used to predict how having cancer may affect life expectancy. Relative survival rate looks at how likely people with gallbladder cancer are to survive for a certain amount of time after their initial diagnosis or start of treatment compared to the expected survival of similar people without this cancer.

Example: Here is an example to help explain what a relative survival rate means. Please note this is only an example and not specific to this type of cancer. Let’s assume that the 5-year relative survival rate for a specific type of cancer is 90%. “Percent” means how many out of 100. Imagine there are 1,000 people without cancer, and based on their age and other characteristics, you expect 900 of the 1,000 to be alive in 5 years. Also imagine there are another 1,000 people similar in age and other characteristics as the first 1,000, but they all have the specific type of cancer that has a 5-year survival rate of 90%. This means it is expected that 810 of the people with the specific cancer (90% of 900) will be alive in 5 years.

It is important to remember that statistics on the survival rates for people with gallbladder cancer are only an estimate. They cannot tell an individual person if cancer will or will not shorten their life. Instead, these statistics describe trends in groups of people previously diagnosed with the same disease, including specific stages of the disease.

The 5-year relative survival rate for gallbladder cancer in the United States is 19%.

The survival rates for gallbladder cancer vary based on several factors. These include the stage of cancer, a person’s age and general health, and how well the treatment plan works.

If the cancer is diagnosed and treated before it has spread outside the gallbladder, the 5-year relative survival rate is 66%. About 1 out of 5 gallbladder cancers are diagnosed at this localized stage. This is mainly because there is not an effective screening method for this disease, and it often grows without causing symptoms.

If the cancer has spread to surrounding tissues or organs and/or the regional lymph nodes, the 5-year relative survival rate is 28%. If the cancer has spread to a distant part of the body, the 5-year relative survival rate is 2%.

Experts measure relative survival rate statistics for gallbladder cancer every 5 years. This means the estimate may not reflect the results of advancements in how gallbladder cancer is diagnosed or treated from the last 5 years. Talk with your doctor if you have any questions about this information. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society's (ACS) publication, Cancer Facts & Figures 2023; the ACS website; and the International Agency for Research on Cancer website. (All sources accessed February 2023.)

The next section in this guide is Medical Illustrations. It offers drawings of the gallbladder and biliary tract. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - Medical Illustrations

Approved by the Cancer.Net Editorial Board, 08/2023

ON THIS PAGE: You will find drawings of the gallbladder and biliary tract. Use the menu to see other pages.

This illustration shows the location and anatomy of the gallbladder and bile ducts. The gallbladder is a small pear-shaped organ, located under the liver. The right and left hepatic ducts branch out to connect to the liver, and come together to form the common hepatic duct, which connects to the gallbladder via the cystic duct. The common hepatic duct connects to the common bile duct, which continues to the distal common bile duct. The common bile duct branches out to connect to the pancreas, located in the curve of the duodenum under and behind the stomach. Copyright 2005-2011 American Society of Clinical Oncology (ASCO). Robert Morreale/Visual Explanations, LLC.

The next section in this guide is Risk Factors. It describes the factors that may increase the chance of developing gallbladder cancer. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - Risk Factors

Approved by the Cancer.Net Editorial Board, 08/2023

ON THIS PAGE: You will find out more about the factors that increase the chance of gallbladder cancer. Use the menu to see other pages.

What are the risk factors for gallbladder cancer?

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. 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. Between 75% and 90% of people with gallbladder cancer have a history of gallstones. However, less than 1% of people with gallstones develop gallbladder cancer. It is unknown why some people develop cancer while most with gallstone disease do not.

  • 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 1 centimeter because these are more likely to be cancerous.

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

  • Sex. 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.

The next section in this guide is Symptoms and Signs. It explains what changes or medical problems gallbladder cancer can cause. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - Symptoms and Signs

Approved by the Cancer.Net Editorial Board, 08/2023

ON THIS PAGE: You will find out more about the changes and medical problems that can be a sign of gallbladder cancer. Use the menu to see other pages.

What are the symptoms and signs of gallbladder cancer?

People with gallbladder cancer may experience one or more of the following symptoms or signs. Symptoms are changes that you can feel in your body. Signs are changes in something measured, like taking your blood pressure or doing a lab test. Together, symptoms and signs can help describe a medical problem. Sometimes, people with gallbladder cancer do not have any of the symptoms and signs described below. Or, the cause of a symptom or sign may be 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. Often, there may be no symptoms at all. 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 or infection of the gallbladder. When symptoms do occur, they include the following:

  • Jaundice (yellowing of the skin, including the gums and inner lips, and yellowing of the whites of the eyes)

  • Abdominal pain and cramping

  • Nausea and vomiting

  • Bloating

  • A lump in the abdomen

  • Fever

  • Itchy skin

If you are concerned about any changes you experience, please talk with your doctor. Your doctor will try to understand what is causing your symptom(s). They may do an exam and order tests to understand the cause of the problem, which is called a diagnosis.

If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. Managing symptoms may also be called "palliative and supportive care," which is not the same as hospice care given at the end of life. This type of care focuses on managing symptoms and supporting people who face serious illnesses, such as cancer. You can receive palliative and supportive care at any time during cancer treatment. Learn more in this guide’s section on Coping with Treatment.

Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - Diagnosis

Approved by the Cancer.Net Editorial Board, 08/2023

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, cancer. They also do tests to learn if cancer has spread to another part of the body from where it started. If the cancer has spread, it is called metastasis. Doctors may also do tests to learn which treatments could work best.

For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.

How gallbladder cancer is diagnosed

There are different tests used for diagnosing gallbladder cancer. Not all tests described here will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of cancer suspected

  • Your signs and symptoms

  • Your age and general health

  • The results of earlier medical tests

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

  • Biopsy. A biopsy is the only way to make a definite diagnosis, even if other tests can suggest that cancer is present. During biopsy, a small amount of tissue is removed for examination under a microscope. A pathologist analyzes the sample(s). 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 1 of several ways:

    • During a surgery

    • With a minimally invasive surgical technique known as laparoscopy (see below)

    • With a fine needle or thick needle aspiration (a core biopsy), using a computed tomography (CT or CAT) scan or ultrasound (see both below) to guide the needle placement

    • In some cases, a biopsy is done by passing an endoscope (a thin, flexible tube with a powerful light) 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). An ERCP 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 bile duct cancer than to find gallbladder cancer, but it may also be used if the gallbladder cancer spreads and blocks the bile ducts.

  • 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 the patient’s 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. Carbohydrate antigen 19-9 (CA19-9) is a tumor marker that may also be checked with this type of cancer. A tumor marker is a substance produced by a tumor that may be found at higher levels if cancer is present and can be measured in the blood.

  • Computed tomography (CT or CAT) scan. A CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, 3-dimensional image that shows any abnormalities or tumors. A CT scan can 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 or liquid to swallow.

  • Magnetic resonance imaging (MRI). An MRI produces detailed images of the inside of the body using magnetic fields, not x-rays. It 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 or liquid to swallow.

    A specialized MRI used for the gallbladder is called MRI cholangiopancreatography (MRCP). A contrast medium may be given before the MRI to create a clearer picture.

  • Ultrasound. An ultrasound creates a picture of the internal organs using sound waves. Tumors generate different echoes of the sound waves than normal tissue. This means that when the waves are bounced back to a computer and create images, the doctor can locate a mass inside the body.

  • Endoscopic ultrasonography. A special endoscope, which is a long, flexible scope, is inserted through the mouth after sedation. It can reach the stomach and some of the intestine. It has an ultrasound probe at the end that can be used to look for tumors and guide a biopsy with a small needle.

  • Positron emission tomography (PET) or PET-CT scan. A PET scan creates pictures of organs and tissues inside the body. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. However, you may hear your doctor refer to this procedure just as a PET scan. 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. However, the amount of radiation in the substance is too low to be harmful. A scanner then detects this substance to produce images of the inside of the body. These tests can sometimes be difficult to read because healthy and active tissues also use energy actively.

After diagnostic tests are done, your doctor will review 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 in this guide is Stages. It explains the system doctors use to describe the extent of the disease. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - Stages

Approved by the Cancer.Net Editorial Board, 08/2023

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. Use the menu to see other pages.

READ MORE BELOW:

What is cancer staging?

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 recommend the best kind of treatment, and it can help predict a patient's prognosis, which is the chance of recovery or average life expectancy. There are different stage descriptions for different types of cancer.

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TNM staging system

One tool that doctors use to describe the stage is the TNM system. Doctors use the results from diagnostic tests and scans to answer these questions:

  • Tumor (T): How large is the primary tumor? Where is it located?

  • Node (N): Has the tumor spread to the lymph nodes? If so, where and how many?

  • Metastasis (M): Has the cancer spread to other parts of the body? If so, where and how much?

The results are combined to determine the stage of gallbladder cancer for each person. There are 5 stages: stage 0 (zero) and stages I through IV (1 through 4). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

Staging can be "clinical" or "pathological." Clinical staging is based on the results of tests done before surgery, which may include physical examinations and imaging tests. Pathological staging is based on what is found during surgery, including during a biopsy. In general, pathological staging provides the most complete information to determine a patient’s prognosis.

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

Tumor (T)

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. Tumor size is measured in centimeters (cm).

Stages may also be 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 (T zero): 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.

  • T2a: The tumor has invaded the perimuscular connective tissue on the peritoneal side.

  • T2b: The tumor has invaded the perimuscular connective tissue on the side of the liver but has not spread to the liver.

T3: The tumor extends beyond the gallbladder and/or has invaded the liver and/or 1 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 1 organ or structure beyond the liver.

Node (N)

The “N” in the TNM staging system stands for lymph nodes. These small, bean-shaped organs 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 zero): There is no regional lymph node metastasis, or spread.

N1: There is regional lymph node metastasis.

N2: There is distant lymph node metastasis.

Metastasis (M)

The “M” in the TNM system describes whether the cancer has spread to other parts of the body, called metastasis.

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

M1: There is metastasis to 1 or more other parts of the body.

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Stage groups for gallbladder cancer

Doctors assign the stage of the cancer by combining the T, N, and M classifications (see above).

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. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis. Most recurrent disease is stage IV.

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Used with permission of the American College of Surgeons, Chicago, Illinois. The original and primary source for this information is the AJCC Cancer Staging Manual, Eighth Edition (2017), published by Springer International Publishing.

Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - Types of Treatment

Approved by the Cancer.Net Editorial Board, 08/2023

ON THIS PAGE: You will learn about the different types of treatments doctors use for people with gallbladder cancer. Use the menu to see other pages.

This section explains the types of treatments, also known as therapies, that are the standard of care for gallbladder cancer. “Standard of care” means the best treatments known. Information in this section is based on medical standards of care for gallbladder cancer in the United States. Treatment options can vary from one place to another.

When making treatment plan decisions, you are encouraged to discuss with your doctor whether clinical trials offer additional treatment options to consider. A clinical trial is a research study that tests a new approach to treatment. Doctors learn through clinical trials whether a new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Clinical trials are an option for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.

How gallbladder cancer is treated

In cancer care, different types of doctors who specialize in cancer, called oncologists, 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. Cancer care teams include other health care professionals, such as physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, physical therapists, occupational therapists, and others. Learn more about the clinicians who provide cancer care.

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. Take time to learn about all of your treatment options. Be sure to ask questions about things that are unclear. Talk with your doctor about the goals of each treatment and what you can expect while receiving the treatment. These types of conversations are called “shared decision-making.” Shared decision-making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision-making is important for gallbladder cancer because there are different treatment options. Learn more about making treatment decisions.

The common types of treatments used for gallbladder cancer are described below. Your care plan also includes treatment for symptoms and side effects, an important part of cancer care. Gallbladder cancer may be treated with 1 or more treatments, including surgery, chemotherapy, or radiation therapy. If found at an early stage, gallbladder cancer has a much higher chance of being successfully treated.

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Surgery

Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. This can be done by a general surgeon, surgical oncologist, or hepatobiliary surgeon. A surgical oncologist is a doctor who specializes in treating cancer using surgery. A hepatobiliary surgeon specializes in surgery of the liver, gallbladder, and bile ducts.

The following types of surgery are 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, 1 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. This surgery may be recommended even if a simple cholecystectomy was already done for a more complete resection to remove potentially cancerous cells.

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

The side effects you may experience will depend on the specific type of surgery you receive. Before surgery, talk with your health care team about the possible side effects from the specific surgery you will have. Learn more about the basics of cancer surgery.

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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, or 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.

Radiation therapy may also be combined with chemotherapy, a treatment called chemoradiotherapy. Chemoradiotherapy may sometimes be given after surgery and chemotherapy to destroy remaining cancer cells when there is a positive margin that can be seen with a microscope. A positive margin means that there are cancer cells on the edge of the tissue removed during surgery, which may be a sign that there are still very small amounts of cancer cells remaining in the patient's body that can possibly continue to grow. Learn more about the American Society of Clinical Oncology's (ASCO's) recommendations on chemoradiotherapy for gallbladder cancer.

Radiation therapy is not always used for gallbladder cancer, so your doctor may or may not recommend it. 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 the basics of radiation therapy.

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Therapies using medication

The treatment plan may include medications to destroy cancer cells. Medication may be given through the bloodstream to reach cancer cells throughout the body. When a drug is given this way, it is called systemic therapy. Medication may also be given locally, which is when the medication is applied directly to the cancer or kept in a single part of the body.

This treatment is generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication.

Medications are often given through an intravenous (IV) tube placed into a vein using a needle or as a pill or capsule that is swallowed (orally). If you are given oral medications to take at home, be sure to ask your health care team about how to safely store and handle them.

The primary type of medication used for gallbladder cancer is chemotherapy. In some cases, immunotherapy may be offered. This is discussed below in more detail. A person may receive 1 type of medication at a time or a combination of medications given at the same time. They can also be given as part of a treatment plan that includes surgery and/or radiation therapy.

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. It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with cancer medications, causing unwanted side effects or reduced effectiveness. Learn more about your prescriptions by using searchable drug databases.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells.

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or a combination of different drugs given at the same time.

Chemotherapy should be given after surgery to help prevent a recurrence. ASCO recommends capecitabine (Xeloda) for 6 months after surgery. People with hilar cholangiocarcinoma and extrahepatic cholangiocarcinoma may receive chemoradiotherapy after surgery and capecitabine to destroy remaining cancer cells when there is a positive margin that can be seen with a microscope (see "Radiation therapy," above, for more on the ASCO recommendations).

Other drugs commonly used to treat gallbladder cancer include gemcitabine (Gemzar), fluorouracil (5-FU), cisplatin (Platinol), oxaliplatin (Eloxatin), and nab-paclitaxel (Abraxane). 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, diarrhea, neuropathy, and swelling. These side effects usually go away after treatment is finished.

Chemotherapy is usually used as a palliative care treatment for gallbladder cancer. It may be recommended after the tumor has been removed surgically. Chemotherapy used before surgery is called neoadjuvant chemotherapy. Chemotherapy used as an additional therapy after surgery is called adjuvant chemotherapy.

Learn more about the basics of chemotherapy.

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Immunotherapy

Immunotherapy uses the body's natural defenses to fight cancer by improving your immune system’s ability to attack cancer cells.

In 2022, the FDA approved durvalumab (Imfinzi) in combination with the chemotherapy drugs gemcitabine and cisplatin for people with locally advanced or metastatic biliary tract cancer, including those with bile duct cancer and gallbladder cancer. Durvalumab is a type of immunotherapy called an immune checkpoint inhibitor. An immune checkpoint is a protein that can stop the body’s immune system from responding to cancer cells. Durvalumab works by targeting and blocking the immune checkpoint PD-1, which then allows the immune system to find and attack cancer cells.

Pembrolizumab (Keytruda) and nivolumab (Opdivo) are 2 immunotherapy drugs approved for all microsatellite instability-high (MSI-H) tumors, including for MSI-H gallbladder tumors. MSI is a genomic marker that indicates a flaw in a cell’s ability to repair damaged DNA, which can lead to an increase in genetic changes, or mutations. These mutations produce abnormal proteins on the tumor cells that allow immune cells to find and attack the tumor more easily.

Different types of immunotherapy can cause different side effects. Common side effects include skin reactions, flu-like symptoms, diarrhea, and weight changes. Talk with your doctor about possible side effects for the immunotherapy recommended for you. Learn more about the basics of immunotherapy.

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Physical, emotional, social, and financial effects of cancer

Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative and supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative and supportive care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with medical and non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative and supportive care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments, such as chemotherapy, surgery, or radiation therapy, to improve symptoms.

Before treatment begins, talk with your doctor about the goals of each treatment in the recommended treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative and supportive care options. Many patients also benefit from talking with a social worker and participating in support groups. Ask your doctor about these resources, too.

Cancer care is often expensive, and navigating health insurance can be difficult. Ask your doctor or another member of your health care team about talking with a financial navigator or counselor who may be able to help with your financial concerns.

During treatment, your health care team may ask you to answer questions about your symptoms and side effects and to describe each problem. Be sure to tell the health care team if you are experiencing a problem. This helps the health care team treat any symptoms and side effects as quickly as possible. It can also help prevent more serious problems in the future.

Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative and supportive care in a separate section of this website.

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Metastatic gallbladder cancer

If cancer spreads to another part in the body from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it, especially since this is an uncommon cancer. Doctors can have different opinions about the best standard treatment plan. Clinical trials might also be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.

Your treatment plan may include a combination of surgery, medications, or radiation therapy. Palliative and supportive care will also be important to help relieve symptoms and side effects.

For many people, a diagnosis of metastatic cancer is very stressful and difficult. You and your family are encouraged to talk about how you feel with doctors, advanced practice providers, nurses, social workers, or other members of your health care team. It may also be helpful to talk with other patients, such as through a support group or other peer support program.

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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 having “no evidence of disease” or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your 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 returns 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).

If a recurrence happens, a new cycle of testing will begin to learn as much as possible about it. After this testing is done, you and your doctor will talk about the treatment options. Often the treatment plan will include the treatments 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 suggest clinical trials that are studying new ways to treat recurrent gallbladder cancer. Whichever treatment plan you choose, palliative and supportive care will be important for relieving symptoms and side effects.

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

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If treatment does not work

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

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

Planning for your future care and putting your wishes in writing is important, especially at this stage of disease. Then, your health care team and loved ones will know what you want, even if you are unable to make these decisions. Learn more about putting your health care wishes in writing.

People who have advanced cancer and who are expected to live less than 6 months may want to consider 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 talk with a member of your palliative care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option 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.

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The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - About Clinical Trials

Approved by the Cancer.Net Editorial Board, 08/2023

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are studied to see how well they work. Use the menu to see other pages.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for people with gallbladder cancer. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. Every drug that is now approved by the U.S. Food and Drug Administration (FDA) was tested in clinical trials.

Clinical trials are used for all types and stages of gallbladder cancer. Many focus on new treatments to learn if a new treatment is safe, effective, and possibly better than the existing treatments. These types of studies evaluate new drugs, different combinations of treatments, new approaches to radiation therapy or surgery, and new methods of treatment.

People who participate in clinical trials can be some of the first to get a treatment before it is available to the public. However, there are some risks with a clinical trial, including possible side effects and the chance that the new treatment may not work. People are encouraged to talk with their health care team about the pros and cons of joining a specific study.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects.

Deciding to join a clinical trial

People decide to participate in clinical trials for many reasons. For some, 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. Others volunteer for clinical trials because they know that these studies are a way to contribute to the progress in treating gallbladder cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future people with gallbladder cancer.

Insurance coverage and the costs of clinical trials differ by location and by study. In some programs, some of the expenses from participating in the clinical trial are reimbursed. In others, they are not. It is important to talk with the research team and your insurance company first to learn if and how your treatment in a clinical trial will be covered. Learn more about health insurance coverage of clinical trials.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” When used, placebos are usually combined with standard treatment in most cancer clinical trials. Study participants will always be told when a placebo is used in a study. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, people must participate in a process known as informed consent. During informed consent, the doctor should:

  • Describe all of the treatment options so that the person understands how the new treatment differs from the standard treatment.

  • List all of the risks of the new treatment, which may or may not be different from the risks of standard treatment. The risks of the treatment may be updated as the study goes on, and patients should expect to be updated as well.

  • Explain what will be required of each person in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

  • Describe the purposes of the clinical trial and what researchers are trying to learn.

Clinical trials also have certain rules called “eligibility criteria” that help structure the research and keep patients safe. You and the research team will carefully review these criteria together. You will need to meet all of the eligibility criteria in order to participate in a clinical trial. Learn more about eligibility criteria in clinical trials.

People who participate in a clinical trial may stop participating at any time for personal or medical reasons. This may include that the new treatment is not working, that there are serious side effects, or that the number of visits required for treatment are too much. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that people 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 they choose to leave the clinical trial before it ends.

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for gallbladder cancer, learn more in the Latest Research section.

Cancer.Net offers more information about cancer clinical trials in other areas of the website, including a complete section on clinical trials.

There are many resources and services to help you search for clinical trials for gallbladder cancer, including the following services. Please note that these links will take you to separate, independent websites:

  • ClinicalTrials.gov. This U.S. government database lists publicly and privately supported clinical trials.

  • World Health Organization (WHO) International Clinical Trials Registry Platform. The WHO coordinates health matters within the United Nations. This search portal gathers clinical trial information from many countries’ registries.

Read more about the basics of clinical trials matching services.

PRE-ACT, Preparatory Education About Clinical TrialsIn addition, you can find a free video-based educational program about cancer clinical trials located in another section of this website.

The next section in this guide is Latest Research. It explains areas of scientific research for gallbladder cancer. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - Latest Research

Approved by the Cancer.Net Editorial Board, 08/2023

ON THIS PAGE: You will read about the scientific research being done to learn more about gallbladder cancer and how to treat it. Use the menu to see other pages.

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 best diagnostic and treatment options for you.

  • Immunotherapy. As explained in the Types of Treatment section of this guide, immunotherapy is designed to boost the body’s natural defenses to fight the cancer. Current clinical trials are testing different immunotherapy drugs as a way to treat gallbladder cancer. Learn more about immunotherapy.

  • Treatment 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. Drugs that target features specific to an individual cancer, such as certain genes or proteins, are called targeted therapies. The side effects of these drugs often differ from chemotherapy drugs.

  • Palliative and supportive care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current gallbladder cancer treatments to improve comfort and quality of life for patients.

Looking for More About the Latest Research?

If you would like more information about the latest areas of research in gallbladder cancer, explore these related items that take you outside of this guide:

The next section in this guide is Coping with Treatment. It offers some guidance on how to cope with the physical, emotional, social, and financial changes that cancer and its treatment can bring. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - Coping with Treatment

Approved by the Cancer.Net Editorial Board, 08/2023

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of cancer and its treatment. Use the menu to see other pages.

Every cancer treatment can cause side effects or changes to your body and how you feel. For many reasons, people do not experience the same side effects even when they are given the same treatment for the same type of cancer. This can make it hard to predict how you will feel during treatment.

READ MORE BELOW:

As you prepare to start cancer treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. This part of cancer treatment is called palliative and supportive care. It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for gallbladder cancer are described in the Types of Treatment section. Learn more about side effects of cancer and its treatment, along with ways to prevent or control them. Changes to your physical health depend on several factors, including the cancer’s stage, the length and dose of treatment, and your general health.

Talk with your health care team regularly about how you are feeling. It is important to let them know about any new side effects or changes in existing side effects. If they know how you are feeling, they can find ways to relieve or manage your side effects to help you feel more comfortable and potentially keep any side effects from worsening.

You may find it helpful to keep track of your side effects so it is easier to talk about any changes with your health care team. Learn more about why tracking side effects is helpful.

Sometimes, side effects can last after treatment ends. Doctors call these long-term side effects. Side effects that occur months or years after treatment are called late effects. Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-Up Care section of this guide or talking with your doctor.

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Coping with emotional and social effects

You can have emotional and social effects after a cancer diagnosis. This may include dealing with a variety of emotions, such as sadness, anxiety, fear, guilt, or anger, or managing stress. Sometimes, people find it difficult to express how they feel to their loved ones. Some have found that talking to an oncology social worker, counselor, or member of the clergy can help them develop more effective ways of coping and talking about cancer.

You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

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Coping with the costs of cancer care

Cancer treatment can be expensive. It may be a source of stress and anxiety for people with cancer and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost of medical care stops them from following or completing their cancer treatment plan. This can put their health at risk and may lead to higher costs in the future. Patients and their families are encouraged to talk about financial concerns with a member of their health care team. Learn more about managing financial considerations in a separate part of this website.

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Coping with barriers to care

Some groups of people experience different rates of new cancer cases and experience different outcomes from their cancer diagnosis. These differences are called “cancer disparities.” Disparities are caused in part by real-world barriers to quality medical care and social determinants of health, such as where a person lives and whether they have access to food and health care. Cancer disparities more often negatively affect racial and ethnic minorities, people with fewer financial resources, sexual and gender minorities (LGBTQ+), adolescent and young adult populations, adults older than 65, and people who live in rural areas or other underserved communities.

If you are having difficulty getting the care you need, talk with a member of your health care team or explore other resources that help support medically underserved people.

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Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they likely to happen?

  • What can we do to prevent or relieve them?

  • When and who should I call about side effects?

Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you do not think the side effects are serious. This discussion should include physical, emotional, social, and financial effects of cancer.

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Caring for a loved one with gallbladder cancer

Family members and friends often play an important role in taking care of a person with gallbladder cancer. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away. Being a caregiver can also be stressful and emotionally challenging. One of the most important tasks for caregivers is caring for themselves.

Caregivers may have a range of responsibilities on a daily or as-needed basis, including:

  • Providing support and encouragement

  • Talking with the health care team

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to and from appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

A caregiving plan can help caregivers stay organized and help identify opportunities to delegate tasks to others. It may be helpful to ask the health care team how much care will be needed at home and with daily tasks during and after treatment. Use this 1-page fact sheet to help make a caregiving action plan. This free fact sheet is available as a PDF, so it is easy to print.

Learn more about caregiving or read the ASCO Answers Guide to Caring for a Loved One With Cancer in English or Spanish.

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Looking for More on How to Track Side Effects?

Cancer.Net offers several resources to help you keep track of your symptoms and side effects. Please note that these links will take you to other sections of Cancer.Net:

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The next section in this guide is Follow-Up Care. It explains the importance of checkups after you finish cancer treatment. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - Follow-Up Care

Approved by the Cancer.Net Editorial Board, 08/2023

ON THIS PAGE: You will read about your medical care after cancer treatment is completed and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with gallbladder cancer does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead. In addition to physical examinations, blood tests and imaging tests, such as computed tomography (CT) scans, may be done.

Cancer rehabilitation may be recommended, and this could mean any of a wide range of services, such as physical therapy, occupational therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent as possible. Learn more about cancer rehabilitation.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of cancer first diagnosed and the types of treatment given.

The anticipation before having a follow-up test or waiting for test results may add stress to you or a family member. This is sometimes called “scanxiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to have side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years after treatment has ended. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on your diagnosis, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. The American Society of Clinical Oncology (ASCO) offers forms to keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed.

This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their primary care doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, treatments received, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with them and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - Survivorship

Approved by the Cancer.Net Editorial Board, 08/2023

ON THIS PAGE: You will read about how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to see other pages.

What is survivorship?

The word “survivorship” is complicated because it means different things to different people. Common definitions include:

  • Having no signs of cancer after finishing treatment.

  • Living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and continues during treatment and through the rest of a person’s life.

For some, the term “survivorship” itself does not feel right, and they may prefer to use different language to describe and define their experience. Sometimes long-term treatment will be used for months or years to manage or control cancer. Living with cancer indefinitely is not easy, and the health care team can help you manage the challenges that come with it. Everyone has to find their own path to name and navigate the changes and challenges that are the results of their cancer diagnosis and treatment.

Survivors may experience a mixture of feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain about coping with everyday life. Feelings of fear and anxiety may still occur as time passes, but these emotions should not be a constant part of your daily life. If they persist, be sure to talk with a member of your health care team.

Survivors may feel some stress when their frequent visits to the health care team end after completing treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true when new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexual health and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing

  • Thinking through solutions

  • Asking for and allowing the support of others

  • Feeling comfortable with the course of action you choose

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the place where you received treatment.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make lifestyle changes.

People recovering from gallbladder cancer are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, exercising regularly, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

It is important to have recommended medical checkups and tests (see Follow-Up Care) to take care of your health.

Talk with your health care team to develop a survivorship care plan that is best for your needs.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Guide to Cancer Survivorship: Get this 48-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The free booklet is available as a PDF, so it is easy to print.

  • Survivorship Resources: Cancer.Net offers information and resources to help survivors cope, including specific sections for children, teens and young adults, and people over age 65. There is also a main section on survivorship for people of all ages.

The next section offers Questions to Ask the Health Care Team to help start conversations with your cancer care team. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - Questions to Ask the Health Care Team

Approved by the Cancer.Net Editorial Board, 08/2023

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

Talking often with the health care team 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. It may also be helpful to ask a family member or friend to come with you to appointments to help take notes.

Questions to ask after getting a diagnosis

  • What type of gallbladder 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?

Questions to ask about choosing a treatment and managing side effects

  • What are my treatment options?

  • What types of research are being done for gallbladder cancer in clinical trials? Do clinical trials offer additional treatment options for me?

  • 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 leading my overall treatment?

  • 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 of cancer care, who can help me?

  • What support services are available to me? To my family?

  • If I have questions or problems, who should I call?

Questions to ask about having surgery

  • What is the purpose of the surgery? Can you describe the surgery to me?

  • How long will the operation take? 

  • What are the side effects of the surgery I’m having? How will these be managed?

  • Who should I contact about any side effects I experience? And how soon? 

  • Will I need to stay in the hospital for this surgery? If so, for how long?

  • How long will recovery from the surgery take?

  • How experienced is the surgeon? What types of surgery do they typically perform?

  • What are the possible long-term effects of having this surgery?

Questions to ask about having 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?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term effects of having this treatment? 

Questions to ask about having chemotherapy or immunotherapy

  • What type of medication is recommended?

  • What is the purpose of each drug?

  • How long will each treatment be?

  • How often will I need these treatments?

  • Will I receive this treatment at a hospital or clinic? Or will I take it at home? 

  • What side effects can I expect from this treatment?

  • What can be done to help prevent or relieve the side effects?

  • Who should I contact about any side effects I experience? And how soon? 

  • What are the possible long-term or late effects of having this treatment?

Questions to ask about planning follow-up care

  • What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

  • What long-term side effects or late effects are possible based on the cancer treatment I received?

  • What follow-up tests will I need, and how often will those tests be needed?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • When should I return to my primary care doctor for regular medical care?

  • Who will be leading my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources. It offers more resources on this website that may be helpful to you. Use the menu to choose a different section to read in this guide.

Gallbladder Cancer - Additional Resources

Approved by the Cancer.Net Editorial Board, 08/2023

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. Use the menu to go back and see other pages.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer, 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 links to help you explore other parts of Cancer.Net:

This is the end of the Cancer.Net’s Guide to Gallbladder Cancer. Use the menu to choose a different section to read in this guide.