Gallbladder cancer often shows no symptoms in its early stages. As the disease progresses, symptoms associated with bile obstruction often develop. These include:
- Abdominal pain
- Pain in the upper back (called referred pain)
- Jaundice (yellowing of the “whites” of the eyes, the skin, under the tongue)
Other symptoms may include:
- Nausea and/or vomiting
- Loss of appetite
- Weight loss
- Liver and spleen enlargement
- Increased abdominal girth
Gallbladder cancer is often hard to diagnose because:
- The disease often shows no early symptoms.
- The symptoms often mimic those of other gallbladder conditions (such as gallstones).
- The gallbladder is hidden by other organs in the abdomen.
Gallbladder cancer is sometimes discovered during abdominal surgery for another reason.
The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:
- Blood tests—testing to check levels of bilirubin (part of the bile) and liver enzymes
- Ultrasound —a test that uses sound waves to examine internal organs, in this case, the gallbladder and bile ducts. The radiologist will examine the gallbladder with the ultrasound probe and may see stones inside; stones often can mask the presence of cancer.
- CT scan —a type of x-ray that uses a computer to make pictures of the inside of the body, in this case, the liver, gallbladder, bile ducts, and surrounding tissue. The CT scan can help determine if the gallbladder is calcified or surrounded by a lining of calcium. This condition is called a porcelain gallbladder and can be caused by the growth of cancer cells. The CT scan is also helpful to determine if the cancer has spread to the lymph nodes or liver (the two most common places for gallbladder cancer to spread).
- Cholangiography—an invasive test that uses x-rays and a large needle inserted into the liver to examine the gallbladder and bile ducts. This can be done to collect cells from the bile ducts to help diagnosis cancer.
- ERCP test —a test that combines x-rays and an endoscope, which is a long, flexible, lighted tube inserted down the throat. This is done to examine the duodenum (first part of the small intestine), bile ducts, and pancreatic ducts. It can also be used to collect cells to help diagnose cancer.
A biopsy , which is the removal of a sample of tissue for testing, must be done to definitively diagnose gallbladder cancer. This often requires open surgery. Many times gallbladder cancer is found by accident. The patient is often taken to surgery because of a gallbladder "attack." At surgery, the surgeon may find cancer or it may only be found once the pathologist has sliced the entire gallbladder into very small slices.