Gall bladder cancer

Body map diagram showing the position of the Gall Bladder

Facts and figures about gall bladder cancer

Gall bladder cancer is very rare; only around 800 new cases are diagnosed in the UK each year. It is the 5th most common gastrointestinal cancer. Higher incidence in women, male to female ratio is approximately 1:2. Age related, most common in those 70+ years.

Risks factors include smoking, obesity and possibly an unhealthy diet. Medical conditions such as gall stones, cholecystitis and diabetes increase the risk as does having a first degree relative diagnosed with gall bladder cancer. 80% of cases are adenocarcinomas arising from the lining of the gall bladder. Most tumours are detected at a late stage, often during surgery to remove gall stones.

Gall Bladder cancer symptoms

  • Abdominal pain/swelling.
  • Nausea.
  • Jaundice.
  • Weight loss.
  • Night sweats and/or fever.
  • Tiredness.

Diagnosis of gall bladder cancer

Investigations may include:

  • Physical examination.
  • Blood tests.
  • Ultrasound scan.
  • CT scan.
  • MRI scan.
  • Endoscopy - tissue samples may be taken for biopsy.
  • Angiogram (this is to assess any involvement of surrounding blood vessels).
  • Fine needle aspiration (FNA) - under CT scan or ultrasound a very fine needle is passed through the skin into the liver and gall bladder to enable tissue samples to be collected for biopsy.
  • Laparoscopy- tissue samples may be taken for biopsy.

Gall bladder cancer treatment

Depends on several factors:

  • The type of gall bladder cancer.
  • The stage of the cancer.
  • General health.

Surgery

In early disease, different operations may be required depending on position of the tumour and findings at surgery. The main option will be to remove the gall bladder (cholecystectomy).

During this procedure, lymph nodes from the surrounding tissue will be removed and sent for analysis. If they are found to contain cancer cells, a further operation may be required to remove lymph nodes and surrounding tissues. This helps reduce the risk of recurrence.

Radiotherapy

Radiotherapy is most likely to be given in combination with other treatments. It may be used after surgery with the intention of destroying any remaining cancer cells (adjuvant radiotherapy), but it is a rare cancer and it has been difficult to undertake large enough clinical trials to provide evidence that this reduces recurrence.

It may be used in advanced cases to shrink the tumour and relieve symptoms. If the disease has spread significantly outside of the gall bladder, surgery is very unlikely, therefore a combination of radiotherapy and/or chemotherapy may be used.

Chemotherapy

Chemotherapy may be prescribed if the disease has recurred after surgery or it has spread beyond the gall bladder. It may be used to relieve symptoms and try and slow the growth of the cancer cells.

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