What Are Gallbladder Cancer Symptoms and Is It Easy to Detect?

It’s difficult to discern gallbladder cancer symptoms, especially when cancer is in the early stages and easier to treat. 

Why? 

First, the location of this small pear-shaped organ is deep in the abdomen, tucked under your liver, where it produces and stores bile. 

Bile aids in the digestion of fats in the small intestine. When you eat a meal, particularly one that's high in fat, the gallbladder releases bile into the small intestine through a series of small ducts.

Second, in early stage gallbladder cancer, symptoms are often vague and attributed to other less serious gallbladder disease. Furthermore, gallbladder cancer tends to spread quickly. Unlike other cancers, there’s no standard or routine screening for gallbladder cancer. But that doesn’t mean there’s nothing you can do.

Here, we’ll discuss gallbladder cancer symptoms and how gallbladder cancer is detected. We’ll also identify the top 10 risk factors for developing this disease, and explain why routinely screening for multiple cancer types can help in early detection.

Most Common Gallbladder Cancer Symptoms

Gallbladder cancer symptoms can be difficult to recognize. That’s because in its early stages, gallbladder cancer may not cause many specific symptoms. However, as the cancer progresses, the following are often experienced:

• Abdominal discomfort: This occurs particularly in the upper right side of the abdomen, near the gallbladder.
• Jaundice: Caused by a buildup of bilirubin (a byproduct of red blood cells breaking down), jaundice is a yellowing of the skin and the whites of the eyes. In gallbladder cancer, jaundice can occur if a tumor blocks the bile duct, preventing bile (which contains bilirubin) from reaching the intestines where it's normally processed. Jaundice can also occur in other illnesses related to the liver. 
• Bloating of the abdomen: Swelling or enlargement of the abdomen is often accompanied by discomfort or pain. 
• Nausea and vomiting: In cases of bile duct obstruction, bile can't flow into the intestines as usual. Bile plays an important role in digestion, including breaking down fats in the food we consume. If bile is unable to reach the intestines, it can lead to digestive problems, including feelings of fullness, discomfort, or nausea, especially after meals.
• Unintended weight loss: Unexplained weight loss over a short period can signal gallbladder cancer or other types of cancers. 
• Appetite loss: Loss of appetite is when you don’t want to eat or don’t experience the same hunger cues despite eating less than usual.
• Itchy skin: When bilirubin and other toxins build up in the skin, it can cause severe itching.

How Do You Detect Gallbladder Cancer?

Diagnosing gallbladder cancer involves several steps. It typically begins when a patient has symptoms like jaundice, abdominal pain, or weight loss. The following procedures may help reach a diagnosis of gallbladder cancer.

History and Physical Examination

This step involves providing a detailed account of your medical information. Your medical history may include information, such as allergies, illnesses, surgeries, and immunizations. Your medical history will also include information about your family’s health and any genetic links to illnesses.

A physical exam allows your healthcare provider to check your overall health, including vital signs like heart rate, respiratory rate, and body temperature. They’ll also take a look at your general appearance, which includes your skin appearance, neurological well-being, and an abdominal examination that checks for tenderness and pain.

Laboratory Testing

Blood tests to evaluate for gallbladder cancer will include a liver function panel to measure the levels of substances released by the liver. An abnormal liver function test may indicate liver disease or other illnesses like cancer of the gallbladder. Other pertinent blood tests may look for signs of inflammation, infection, or anemia.

Tumor marker testing may be requested by your oncology doctor before or after a diagnosis of gallbladder cancer is reached. According to the American Cancer Society, tumor markers measure byproducts of tumor formation sometimes found in the blood. 

Tumor markers for gallbladder cancer may include carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9). However, it’s important to know that other types of cancer and other illnesses may also cause an elevation of these markers.

Imaging Tests

Imaging is crucial for detecting gallbladder cancer, determining the cancer’s extent (staging), and planning appropriate treatment. Here are some of the imaging tests and how they help detect gallbladder cancer. 

Ultrasound: This is the first test done if gallbladder cancer is suspected. An ultrasound uses sound waves to create images of internal organs. Ultrasounds are non-invasive and can reveal abnormalities like tumors in the gallbladder or nearby tissues. Endoscopic ultrasound (EUS) is a more invasive method that uses an endoscope passed down the esophagus to create even more detailed images of the gallbladder and nearby tissues.

Computed tomography (CT) scan: CT scans use X-rays to make detailed cross sectional images of internal organs and body parts. CTs can show the gallbladder, liver, and other organs as well as lymph nodes and blood vessels. CTs may also be useful in staging the cancer after diagnosis and determining if the cancer has spread.

Magnetic resonance imaging (MRI): An MRI uses radio waves and strong magnets instead of radiation to produce detailed images of internal organs like the gallbladder. Certain types of MRI technology may be helpful to visualize inside the gallbladder and into the bile ducts. This test can also be useful to determine the extent of the cancer when staging and can factor into choosing the best treatment options.

Cholangiography: This procedure uses dye to highlight the bile ducts on X-ray images. It may show whether the ducts are narrow or blocked by a tumor. There are different types of cholangiography including endoscopic retrograde cholangiopancreatography (ERCP). ERCP is a somewhat invasive procedure that uses endoscopy and X-ray imaging to diagnose and treat conditions of the bile ducts, pancreatic ducts, and related structures.

Biopsy Procedure and Pathology Testing

A biopsy procedure will be performed by an oncologist or surgeon to verify the diagnosis of cancer. Biopsies involve removing a tissue sample from the area that is suspicious for cancer. 

The samples are then examined under a microscope by a pathologist who specializes in diagnosing diseases from biopsies. When it comes to diagnosing gallbladder cancer, biopsies can be performed in a number of ways. 

Fine needle aspiration biopsy: A thin hollow needle attached to a syringe is inserted through the skin into the gallbladder. The needle extracts a small amount of fluid that contains the cells to be examined.

Core needle biopsy: This is similar to a fine needle aspiration but uses a larger needle to remove a small cylinder of tissue. It provides a larger sample and may be more useful if the ordering healthcare provider suspects sarcoma (the name given to cancer originating in connective tissue), which can be better diagnosed through a core biopsy.

Laparoscopic biopsy: During this procedure, a surgeon makes a small incision into the abdomen and inserts a laparoscope (a thin tube with a camera lens and a light) for viewing. Other instruments may be inserted to remove any tissues that look suspicious or abnormal.

Surgical biopsy: In some cases, the surgeon may plan to remove the gallbladder completely and will take a surgical biopsy during the cholecystectomy–gallbladder removal. In this case, a pathologist will look at the samples or the entire gallbladder for evidence of cancer. 

Your doctor may recommend running further tests to identify specific genes, proteins, and other factors. This information can help guide treatment options. 

What Are the Early Stages of Gallbladder Cancer?

The early stages of gallbladder cancer are often silent, meaning they do not exhibit noticeable symptoms. The stages of cancer are defined by how large the cancer is or how much it has spread. Gallbladder cancer stages range from stage 0 to IVB, according to the American Joint Committee on Cancer TMN (tumor, node, metastasis) system. The early stages are described as follows:

• Stage 0: At this stage, the cancer is only in the innermost layer of the gallbladder wall and hasn’t spread to other organs.
• Stage IA: The cancer has spread beyond the innermost layer into the connective tissue or to the muscle layer of the gallbladder wall.
• Stage IB: Cancer has spread to connective tissue and the muscle layer of the gallbladder wall.
• Stage IIA: Cancer has spread beyond the muscle layer but it hasn't spread to nearby lymph nodes or distant sites.
• Stage IIB: Cancer has spread to nearby structures, like the liver or pancreas, a nearby blood vessel, or the biliary or common bile duct. It may have spread to nearby lymph nodes but hasn’t spread to distant sites.

10 Risk Factors for Gallbladder Cancer

The exact cause of developing gallbladder cancer is unknown. However, several factors are known to increase your risk for developing this disease, including:

1. Age and gender: The risk for developing gallbladder cancer increases with age and is more common in women than in men. 
2. Previous gallbladder disease: Gallstones are hard particles that accumulate inside the gallbladder. Most people with gallstones don’t develop gallbladder cancer. However, having previous episodes of gallstones is one of the most common risk factors. Most types of gallbladder cancer are adenocarcinomas that start in the lining, making long-term gallbladder inflammation a main risk factor.
3. Gallbladder polyps: These growths in the gallbladder protrude from the inner lining. Most polyps do not cause gallbladder cancer symptoms, but a small percentage (around 5%) become cancer.
4. Porcelain gallbladder: This condition occurs when the gallbladder becomes coated with calcium. The inner walls of the gallbladder become brittle, hard, and appear bluish. This condition may also be called calcified gallbladder, calcifying cholecystitis, and chronic cholecystopathy. Porcelain gallbladder is very rare and carries only a slight risk of malignancy.
5. Obesity: Being overweight can increase the chances of developing gallstones and inflammation, thereby increasing the risk of gallbladder cancer. 
6. Family history: A history of gallbladder cancer in your family may increase your risk due to genetic factors.
7. Ethnicity and geography: According to the American Cancer Society, in the United States, individuals of Mexican, Latin American, and Native American descent face the highest risk of developing gallbladder cancer, accompanied by a greater prevalence of gallstones. The risk appears to be lowest among African Americans. Conversely, on a global scale, countries such as India, Pakistan, Central European nations, and South American countries have significantly higher incidences of gallbladder cancer compared to the U.S. The reasons for this is largely unknown. However, 2019 research published in Chinese Clinical Oncology found that it may be due to differences in regional prevalence of environmental risk factors, particularly those causing prolonged inflammation. 
8. Primary Sclerosing Cholangitis: This rare disease causes inflammation and scarring of the bile ducts; it’s also linked to a higher risk of gallbladder cancer. 
9. Choledochal cysts: These are bile-filled sacs that become attached to the bile ducts. People with these cysts have an increased risk of gallbladder cancer. 
10. Chemical exposure: According to reports published in Environmental Pollution, exposure to chemicals used in organic chemical facilities may cause an increased risk for developing gallbladder cancer. 

It’s important to keep in mind that having a risk factor doesn’t mean you’ll develop gallbladder cancer. However, if you have one or more of these, you should discuss them with your healthcare provider. Regular monitoring or screenings may be warranted. 

How to Be More Proactive in Your Health Journey

Ezra’s Full Body MRI is a cutting-edge tool designed to detect potential health issues before you even have gallbladder cancer symptoms. Here’s how to incorporate it into your proactive health routine.

Understand the benefits: Before you book an appointment for an MRI, learn about its benefits. Unlike other screening tools, Ezra’s Full Body is designed to scan your entire body (13 organs). It allows for the detection of potential issues across numerous systems and organs.

Schedule your scan: Once you decide to move forward, you can schedule your MRI online. Ezra’s Full Body is a straightforward procedure that typically takes about an hour. It’s non-invasive and doesn’t expose you to ionizing radiation.

Review your results with an Ezra provider: If you choose to, you can schedule a telehealth call to discuss your results with an Ezra provider. This will help you discuss the findings, including any signs or symptoms of gallbladder cancer. 

Schedule regular follow-ups: Proactive health is an ongoing process. Depending on your results and any risk factors, you may wish to schedule regular follow-ups with an Ezra Full Body Scan or Full Body Plus (14 organs). 

Incorporate other proactive measures: The Ezra Full Body Scan is a powerful tool for empowering health and peace of mind. But it’s only one aspect of proactive cancer detection. Include a healthy lifestyle, get regular physical activity, and eat a balanced diet of whole foods for a comprehensive approach to prevention. 

Gallbladder Cancer Symptoms Are Evasive—Be Proactive

Gallbladder cancer can be elusive and risk factors are wide-ranging. Given the typical lack of gallbladder cancer symptoms in the early stages, the importance of proactive screening becomes more evident.

Screening MRI scans are designed to help identify potential issues across numerous systems and organs. Ezra offers you access to cutting-edge technology and expert analysis that will empower you in your health journey. 

The Ezra Full Body Scan is comprehensive, non-invasive, and takes only an hour of your time. Furthermore, it can serve as an early warning system alerting you to potential health issues before any symptoms arise. Book your scan online today.