Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas of the body. To learn more about how cancers start and spread, see What Is Cancer?

Gallbladder cancer is a cancer that starts in the gallbladder. To understand this cancer, it helps to know about the gallbladder and what it does.

About the gallbladder

The gallbladder is a small, pear-shaped organ under the liver. Both the liver and the gallbladder are behind the right lower ribs. In adults, the gallbladder is usually about 3 to 4 inches long and normally no wider than an inch.

Survival rates are often used by doctors as a standard way of discussing a person’s prognosis (outlook). Some people may want to know the survival statistics for people in similar situations, while others may not find the numbers helpful, or may even not want to know them. If you decide you don’t want to know them, stop reading here and skip to the next section.

When discussing cancer survival statistics, doctors often use a number called the 5-year survival rate. The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. Of course, many of these people live much longer than 5 years, and some people with gallbladder cancer may die from other causes. These survival rates do not take other causes of death into account.

To get 5-year survival rates, doctors have to look at people who were treated at least 5 years ago. Although the numbers below are among the most current we have available, improvements in treatment since then may result in a better outlook for people now being diagnosed with gallbladder cancer.

The rates below are based on the stage of the cancer at the time of diagnosis. When looking at survival rates, it’s important to understand that the statistics may be different for cancers that have come back or progressed during treatment. Still, the stage of a cancer does not change over time, even if the cancer progresses. A cancer that comes back or spreads is still referred to by the stage it was given when it was first found and diagnosed, but more information is added to explain the current extent of the cancer. (And of course, the treatment plan is adjusted based on the change in cancer status.)

The numbers below come from the American College of Surgeons/American Cancer Society National Cancer Data Base as published in the AJCC Cancer Staging Manual in 2010 and are based on more than 10,000 patients diagnosed with gallbladder cancer from 1989 to 1996.

Survival rates are often based on previous outcomes of large numbers of people who had the disease, but they can’t predict what will happen with any particular person. Many other factors can also affect a person’s outlook, such as their age and overall health, and how well the cancer responds to treatment. Even when taking these other factors into account, survival rates are at best rough estimates. Your doctor can tell you how the numbers above apply to you, as he or she knows your situation best.

Research into the causes, diagnosis, and treatment of gallbladder cancer is under way in many medical centers throughout the world.

Chemotherapy and radiation therapy

Researchers are looking at new ways of increasing the effectiveness of radiation therapy. With newer techniques such as 3-dimensional conformal radiation therapy (3D-CRT), intensity modulated radiation therapy (IMRT), and proton beam radiation therapy, doctors can better aim radiation to affect only the tumor and to spare nearby normal tissues. Doctors have also found that giving certain chemotherapy drugs just before radiation therapy may make it more effective.

In general, chemotherapy (chemo) has been found to be of limited use against gallbladder cancer, but newer drugs and combinations of drugs are now being tested.

Targeted therapy

Newer drugs are being developed that work in different ways from standard chemo drugs. These drugs target specific parts of cancer cells or their surrounding environments. Many of these newer drugs target cells with specific gene changes. As noted in “ Do we know what causes gallbladder cancer?”, researchers now know some of the gene changes commonly found in gallbladder cancer cells. Knowing which genes are abnormal could help doctors determine which of these new drugs might be effective.

One target of several newer drugs is tumor blood vessels. Gallbladder tumors need new blood vessels to grow beyond a certain size. Bevacizumab (Avastin^®) and pazopanib (Votrient^®) are examples of drugs that target blood vessel growth and are being studied against gallbladder cancer.

Other new drugs have different targets. For example, EGFR is a protein found in high amounts on some cancer cells that helps them grow. Drugs that target EGFR have shown some benefit against several types of cancer. Some of these, such as cetuximab (Erbitux^®) and lapatinib (Tykerb^®), are now being studied for use in people with gallbladder cancer, usually in combination with chemotherapy or other targeted drugs.

Drugs known as MEK inhibitors, such as trametinib (Mekinist^®) and selumetinib, are also being studied for use against gallbladder cancer.

Gallbladder cancer does not usually cause signs or symptoms until later in the course of the disease, but sometimes symptoms can appear sooner and lead to an early diagnosis. If the cancer is found at an earlier stage, treatment might be more effective.

Some of the more common symptoms of gallbladder cancer are:

Abdominal (belly) pain

Most people with gallbladder cancer will have abdominal pain. Most often this is in the upper right part of the belly.

Nausea and/or vomiting

People with gallbladder cancer sometimes have vomiting as a symptom.

Jaundice

Jaundice is a yellowing of the skin and the white part of the eyes. If the cancer grows large enough to block the bile ducts, bile from the liver can’t drain into the intestines. This can cause bilirubin (a chemical in bile that gives it a yellow color) to build up in the blood and settle in different parts of the body. This can often be seen in the skin and eyes.

Lumps in the belly

If the cancer blocks the bile ducts, the gallbladder can swell to larger than normal. Gallbladder cancer can also spread to nearby parts of the liver. These can sometimes be felt by the doctor as lumps on the right side of the belly. They can also be detected by imaging tests such as an ultrasound.

Other symptoms

Less common symptoms of gallbladder cancer include:

• Loss of appetite
• Weight loss
• Swelling in the abdomen (belly)
• Fever
• Itchy skin
• Dark urine
• Light-colored or greasy stools

Gallbladder cancer is not common, and these symptoms and signs are more likely to be caused by something other than gallbladder cancer. For example, people with gallstones also have many of these symptoms. There are many far more common causes of abdominal pain than gallbladder cancer. And viral hepatitis (infection of the liver) is a much more common cause of jaundice. Still, if you have any of these problems, it’s important to see your doctor right away so the cause can be found and treated, if needed.

The American Cancer Society’s estimates for cancer of the gallbladder and nearby large bile ducts in the United States for 2018 are:

• About 12,190 new cases diagnosed: 5,450 in men and 6,740 in women
• About 3,790 deaths from these cancers: 1,530 in men and 2,260 in women

Of these new cases, a little less than 4 in 10 will be gallbladder cancers.

Gallbladder cancer is not usually found until it has become advanced and causes symptoms. Only about 1 of 5 gallbladder cancers is found in the early stages, when the cancer has not yet spread beyond the gallbladder.

The chances of survival for patients with gallbladder cancer depend to a large extent on how advanced it is when it is found. For statistics on survival rates, see Survival statistics for gallbladder cancer by stage.

Visit the American Cancer Society’s Cancer Statistics Center for more key statistics.

A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed.

But having a risk factor, or even several risk factors, does not mean that a person will get the disease. And many people who get the disease may have few or no known risk factors.

Scientists have found several risk factors that make a person more likely to develop gallbladder cancer. Many of these are related in some way to chronic inflammation (irritation and swelling) in the gallbladder.

Gallstones

Gallstones are the most common risk factor for gallbladder cancer. Gallstones are pebble-like collections of cholesterol and other substances that form in the gallbladder and can cause chronic inflammation. At least 3 out of 4 people with gallbladder cancer have gallstones when they are diagnosed. But gallstones are very common, and gallbladder cancer is quite rare, especially in the United States. Most people with gallstones never develop gallbladder cancer.

Porcelain gallbladder

Porcelain gallbladder is a condition in which the wall of the gallbladder becomes covered with calcium deposits. It sometimes occurs after long-term inflammation of the gallbladder (cholecystitis), which can be caused by gallstones. People with this condition have a higher risk of developing gallbladder cancer (possibly because both conditions can be related to inflammation).

Female gender

In the United States, gallbladder cancer occurs more than twice as often in women. Gallstones and gallbladder inflammation are important risk factors for gallbladder cancer and are also much more common in women than men.

Obesity

Patients with gallbladder cancer are more often overweight or obese than people without this disease. Obesity is also a risk factor for gallstones, which might help explain this link.

Older age

Gallbladder cancer is seen mainly in older people, but younger people can develop it as well. The average age of people when they are diagnosed is 72. More than 2 out of 3 people with gallbladder cancer are 65 or older when it is found.

Ethnicity and geography

In the United States, the risk of developing gallbladder cancer is highest among Mexican Americans and Native Americans. They are also more likely to have gallstones than members of other ethnic and racial groups. The risk is lowest among African Americans. Worldwide, gallbladder cancer is much more common in India, Pakistan, and Central European and South American countries than it is in the United States.

Choledochal cysts

Choledochal cysts are bile-filled sacs that are connected to the common bile duct, the tube that carries bile from the liver and gallbladder to the small intestine. (Choledochal means having to do with the common bile duct.) The cysts can grow large over time and may contain as much as 1 to 2 quarts of bile. The cells lining the sac often have areas of pre-cancerous changes, which increase a person’s risk for gallbladder cancer.

Abnormalities of the bile ducts

The pancreas is another organ that releases fluids through a duct into the small intestine to help digestion. This duct normally meets up with the common bile duct just as it enters the small intestine. Some people have an abnormality where these ducts meet that lets juice from the pancreas reflux (flow backward) into the bile ducts. This backward flow also prevents the bile from being emptied through the bile ducts as quickly as normal. People with these abnormalities are at higher risk of gallbladder cancer. Scientists are not sure if the increased risk is due to the action of the pancreatic juice or is possibly due to the ducts being exposed longer to damaging substances in the bile itself.

Gallbladder polyps

A gallbladder polyp is a growth that bulges from the surface of the inner gallbladder wall. Some polyps are formed by cholesterol deposits in the gallbladder wall. Others may be small tumors (either cancerous or benign) or may be caused by inflammation. Polyps larger than 1 centimeter (almost a half inch) are more likely to be cancer, so doctors often recommend removing the gallbladder in patients with gallbladder polyps that size or larger.

Primary sclerosing cholangitis

In primary sclerosing cholangitis (PSC), there is inflammation and scarring of the bile ducts. People with this disease have an increased risk of cancer of the gallbladder and bile ducts. Many people with PSC also have ulcerative colitis, a type of inflammatory bowel disease.

Industrial and environmental chemicals

It is not clear if exposure to certain chemicals in the workplace or the environment increases the risk of gallbladder cancer. This is hard to study because this cancer is not common. Some studies in lab animals have suggested that chemical compounds called nitrosamines may increase the risk of gallbladder cancer. Other studies have found that gallbladder cancer might occur more in workers in the rubber and textile industries than in the general public. More research is needed in this area to confirm or refute these possible links.

Typhoid

People chronically infected with salmonella (the bacterium that causes typhoid) and those who are carriers of the disease are more likely to get gallbladder cancer than those not infected. This is probably because the infection can cause gallbladder inflammation. But typhoid is rare in the United States.

Family history

Most gallbladder cancers are not found in people with a family history of the disease. A history of gallbladder cancer in the family seems to increase a person’s chances of developing this cancer, but the risk is still low because this is a rare disease.

If cancer keeps growing or comes back after one kind of treatment, it may be possible to try another treatment plan that might still cure the cancer, or at least keep it under control enough to help you live longer and feel better. Clinical trials also might offer chances to try newer treatments that could be helpful. But when a person has tried many different treatments and the cancer is still growing, even newer treatments might no longer be helpful. If this happens, it’s important to weigh the possible limited benefits of a new treatment against the possible downsides, including treatment side effects. Everyone has their own way of looking at this.

This is likely to be the hardest part of your battle with cancer – when you have been through many treatments and nothing’s working anymore. Your doctor might offer you new options, but at some point you may need to consider that treatment is not likely to improve your health or change your outcome or survival.

If you want to continue to get treatment for as long as you can, you need to think about the odds of treatment having any benefit and how this compares to the possible risks and side effects. Your doctor can estimate how likely it is the cancer will respond to treatment you’re considering. For instance, the doctor may say that more treatment might have about a 1 in 100 chance of working. Some people are still tempted to try this. But it’s important to have realistic expectations if you do choose this plan.

Palliative care

No matter what you decide to do, it’s important that you feel as good as you can. Make sure you are asking for and getting treatment for any symptoms you might have, such as nausea or pain. This type of treatment is called palliative care or supportive care.

Palliative care helps relieve symptoms, but is not expected to cure the disease. It can be given along with cancer treatment, or can even be cancer treatment. The difference is its purpose – the main goal of palliative care is to improve the quality of your life, or help you feel as good as you can for as long as you can. Sometimes this means using drugs to help with symptoms like pain or nausea. Sometimes, though, the treatments used to control your symptoms are the same as those used to treat cancer. For instance, radiation might be used to help relieve pain caused by cancer that has spread. Or a stent might be placed in a bile duct to keep it from being blocked by the cancer. But this is not the same as treatment to try to cure the cancer. Some of the treatments that might be used are discussed in “Palliative therapy for gallbladder cancer.”

Hospice care

At some point, you may benefit from hospice care. This is special care that treats the person rather than the disease; it focuses on quality rather than length of life. Most of the time, it is given at home. Your cancer may be causing problems that need to be managed, and hospice focuses on your comfort. You should know that while getting hospice care often means the end of treatments such as chemo and radiation, it doesn’t mean you can’t have treatment for the problems caused by the cancer or other health conditions. In hospice, the focus of your care is on living life as fully as possible and feeling as well as you can at this difficult time. See Hospice Care for more information.

Staying hopeful is important, too. Your hope for a cure may not be as bright, but there’s still hope for good times with family and friends – times that are filled with happiness and meaning. Pausing at this time in your cancer treatment gives you a chance to refocus on the most important things in your life. Now is the time to do some things you’ve always wanted to do and to stop doing the things you no longer want to do. Though the cancer may be beyond your control, there are still choices you can make.

To learn more

You can learn more about the changes that occur when treatment stops working, and about planning ahead for yourself and your family, in Advance Directives and Nearing the End of Life.

There is no known way to prevent most gallbladder cancers. Many of the known risk factors for gallbladder cancer, such as age, gender, ethnicity, and bile duct abnormalities, are beyond our control. But there are things you can do that might lower your risk.

Getting to and staying a healthy weight is one important way a person may reduce their risk of gallbladder cancer, as well as several other cancers. The American Cancer Society recommends that people try to stay at a healthy weight throughout life by being active and eating a healthy diet, with mostly plant foods. This includes at least 2½ cups of vegetables and fruits every day. Choose whole-grain breads, pastas, and cereals instead of refined grains. Eat fish, poultry, or beans and limit how much processed meat and red meat you eat. To learn more, see the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention.

Since gallstones are a major risk factor, removing the gallbladders of all people with gallstones would prevent many of these cancers. But gallstones are very common, and gallbladder cancer is quite rare, even in people with gallstones. Most doctors don’t recommend people with gallstones have their gallbladder removed unless the stones are causing symptoms or other problems. This is because the possible risks and complications of surgery probably don’t outweigh the possible benefit. Some doctors might advise removing the gallbladder if long-standing gallstone disease has resulted in a porcelain gallbladder.

Gallbladder cancer is hard to find early. The gallbladder is deep inside the body, so early tumors can’t be seen or felt during routine physical exams. There are no blood tests or other tests that can reliably detect gallbladder cancers early enough to be useful as screening tests. (Screening is testing for cancer in people without any symptoms.) Because of this, most gallbladder cancers are found only after the cancer has grown enough to cause signs or symptoms.

Still, some gallbladder cancers are found before they have spread to other tissues and organs. Many of these early cancers are found unexpectedly when a person’s gallbladder is removed because of gallstones. When the gallbladder is looked at in the lab after it is removed, small cancers or pre-cancers that did not cause any symptoms are sometimes found.

For some people with gallbladder cancer, treatment can remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer growing or coming back. (When cancer comes back after treatment, it is called recurrence.) This is a very common concern in people who have had cancer.

It may take a while before your fears lessen. But it may help to know that many cancer survivors have learned to live with this uncertainty and are living full lives. See Living With Uncertainty: The Fear of Cancer Recurrence for more about this.

For other people, the cancer may never go away completely. These people may get regular treatments with chemotherapy, radiation therapy, or other therapies to try to help keep the cancer under control and help relieve symptoms from it. Learning to live with cancer that does not go away can be difficult and very stressful. It has its own type of uncertainty. See When Cancer Doesn’t Go Away for more about this.

Follow-up care

If you have completed treatment, your doctors will still want to watch you closely. It’s very important to go to all follow-up appointments. During these visits, your doctors will ask about symptoms, do physical exams, and may order blood tests or imaging tests such as CT scans.

If you have had surgery and have no signs of cancer remaining, many doctors recommend follow-up with imaging tests about every 6 months for at least the first 2 years, but not all doctors may follow this same schedule. Follow-up is needed to check for cancer recurrence or spread, as well as possible side effects of certain treatments.

This is the time for you to ask your healthcare team any questions you need answered and to discuss any concerns you might have.

Almost any cancer treatment can have side effects. Some may last for a few weeks to months, but others can last the rest of your life. Don’t hesitate to tell your cancer care team about any symptoms or side effects bothering you so they can help you manage them.

Even if your cancer treatment is finished, you will probably still need to see your cancer doctor for many years. Ask what kind of follow-up schedule you can expect.

It’s also very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.

If cancer does recur, further treatment will depend on where the cancer is, what treatments you’ve had before, and your health. For more information on how recurrent cancer is treated, see “Treatment options based on the extent of gallbladder cancer.” For more general information on dealing with a recurrence, you may also want to see When Your Cancer Comes Back: Cancer Recurrence.

Seeing a new doctor

At some point after your treatment, you may be seeing a new doctor who doesn’t know anything about your medical history. It’s important to able to give your new doctor the details of your diagnosis and treatment. Gathering these details soon after treatment may be easier than trying to get them at some point in the future. Make sure you have this information handy (and always keep copies for yourself):

• A copy of your pathology report(s) from any biopsies or surgeries
• Copies of imaging tests (CT or MRI scans, etc.), which can usually be stored digitally (on a DVD, etc.)
• If you had surgery, a copy of your operative report(s)
• If you stayed in the hospital, a copy of the discharge summary that the doctor wrote when you were sent home
• If you had radiation therapy, a copy of the treatment summary
• If you had chemotherapy, a list of your drugs, drug doses, and when you took them
• The names and contact information of the doctors who treated your cancer