Gallbladder Cancer: An Overview from Diagnosis to Treatment

Educating yourself about gallbladder cancer is a vital step in navigating your care. This guide provides a clinical overview of the disease, diagnostic procedures, and current treatment standards.

Overview

Gallbladder cancer is a rare and often aggressive malignancy that develops in the tissues of the gallbladder — a small, pear-shaped organ located beneath the liver. The gallbladder stores bile, a fluid produced by the liver that aids in the digestion of fats.

Because the gallbladder is located deep within the abdomen and early-stage tumors rarely cause symptoms, the disease is frequently diagnosed at advanced stages. It is often discovered incidentally during surgery for gallstones or other routine gallbladder issues.

Diagnosis and Staging

Diagnosis typically begins with blood tests to evaluate liver function and check for tumor markers like CEA orCA 19-9. However, imaging is the primary tool for confirming a diagnosis.

• Imaging: Ultrasounds are often the first step, followed by CT scans or MRIs to determine the tumor's size and whether it has spread.
• ERCP: This specialized X-ray procedure uses an endoscope to examine the bile ducts for blockages.
• Staging (TNM System): Doctors use the TNM system to categorize the cancer:
• Stage 1: Cancer is confined to the inner layers of the gallbladder wall.
• Stage 2: Cancer has grown into the outer layers.
• Stage 3: Cancer has spread to nearby lymph nodes or organs like the liver or stomach.
• Stage 4: The most advanced stage, where cancer has spread to distant organs or major blood vessels.

Treatment Options

Your treatment plan is highly individualized and depends on whether the cancer is resectable (can be removed with surgery) or unresectable.

Surgery

Surgery is the only potential cure for gallbladder cancer.

• Simple Cholecystectomy: Removal of the gallbladder only; typically for very early (Stage T1a) cases.
• Radical (Extended) Cholecystectomy: Removal of the gallbladder, a portion of the liver and nearby lymph nodes to ensure no cancer remains.

Systemic Therapy (Chemotherapy and Immunotherapy)

For 2026, the standard of care for advanced or metastatic gallbladder cancer involves a combination of chemotherapy and immunotherapy.

• Standard Combination: Gemcitabine and cisplatin (chemotherapy) combined with Imfinzi (durvalumab) or Keytruda (pembrolizumab) (immunotherapy).
• Targeted Therapy: If your tumor has specific genetic mutations, doctors may use drugs like Pemazyre (pemigatinib) (for FGFR2 changes) or Tibsovo (ivosidenib) (for IDH1 mutations).

Radiation Therapy

This uses high-energy beams to kill cancer cells. It is often used after surgery (adjuvant therapy) or to relieve symptoms like pain in advanced cases (palliative care).

Side Effects

Managing side effects is a collaborative effort between you and your care team.

• Surgery: Pain, infection, bile leakage and digestive changes.
• Chemotherapy: Fatigue, nausea, hair loss and increased risk of infection.
• Immunotherapy: Skin rashes, fatigue and potential inflammation of organs (e.g., colitis).
• Targeted therapy: Changes in taste, dry skin, mouth sores and nail changes.
• Radiation: Sunburn-like skin changes, fatigue and stomach upset.

Conclusion

A diagnosis of gallbladder cancer is complex, but advances in immunotherapy and targeted treatments have expanded the options available to patients. Open communication with your oncology team is essential for managing the physical and emotional challenges of this journey.

Next Steps for Your Consultation

To help drive the conversation with your oncologist, you may want to ask:

• "What is the specific TNM stage of my cancer?"
• "Is my tumor eligible for biomarker testing to see if I qualify for targeted therapy?"
• "What is the primary goal of our treatment: curative or palliative?"

Editor's note: This article is for informational purposes only and is not a substitute for professional medical advice, as your own experience will be unique. Use this article to guide discussions with your oncologist. Content was generated with AI, reviewed by a human editor, but not independently verified by a medical professional.

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.