After diagnosing gallbladder cancer, a doctor will categorize it into one of four stages. Each stage indicates how big the tumor is as well as whether and where any cancerous cells have spread in the body.

Gallbladder cancer is a rare form of cancer that is typically hard to detect due to a lack of symptoms in the early stages. When symptoms are present, they can include fever, pain in the abdomen, and jaundice, which is yellowing of the skin and whites of the eyes.

The gallbladder is a small organ in the upper right part of the abdomen, just underneath the liver. It stores bile, which is a liquid that the liver produces to help break down fatty foods.

This article discusses how the staging of gallbladder cancer works, what the different stages are, treatments for the conditions, and the possible outlook for people with the condition.

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When a person receives a diagnosis of gallbladder cancer, a doctor will also determine the stage of the cancer. This will help them understand whether and where the cancer has spread, how much cancer is in the body, and the appropriate form of treatment.

The system that doctors in the United States typically use to determine each stage of gallbladder cancer is the American Joint Committee on Cancer (AJCC) TNM system. It includes the following three elements:

  • T: the size of the tumor and whether the cancer has grown through the layers of the gallbladder into nearby organs, such as the liver
  • N: if the cancer has spread to the nearby lymph nodes
  • M: if the cancer has spread to organs in the body that are farther away from the gallbladder, such as the lungs

The stages of gallbladder cancer run from 0–4. The higher the number, the more difficult the cancer may be to treat.

A doctor may describe the stages as follows:

  • Stage 0: The earliest stage of gallbladder cancer, when the cancer cells are present inside the inner wall of the gallbladder only.
  • Stage 1: When a tumor has formed and has grown into the connective tissue or muscular layer of the gallbladder.
  • Stage 2: Occurs in two further stages:
    • 2A: When the cancer has grown through the muscle layers and into the lining of the abdominal cavity.
    • 2B: When the tumor has grown into the tissue at the side of the liver but has not yet affected the liver itself.
  • Stage 3: Occurs in two further stages:
    • 3A: When the cancer has grown through the outer wall of the gallbladder and possibly into one of the nearby organs, such as the liver, stomach, or pancreas.
    • 3B: When the tumor may have grown into one of the nearby organs and may be affecting up to three lymph nodes that are near the gallbladder.
  • Stage 4: The final stage of gallbladder cancer and the most serious. It occurs in two further stages:
    • 4A: When the cancer has grown into the main blood vessels that supply the liver or into at least two structures outside of the liver. It may have also spread to up to three lymph nodes near the gallbladder.
    • 4B: When the cancer has spread to at least four lymph nodes but not to any distant organs, or when it may not have spread to any lymph nodes but has spread to one of the distant organs such as the lungs.

Surgery is typically the most preferable option for people with gallbladder cancer. However, depending on the stage of gallbladder cancer, a person may need further treatment. For example:

  • Stage 1: A surgeon will typically remove the gallbladder. This should be the only treatment a person needs at this stage. However, if the cancer has grown through the muscular layer of the gallbladder, a surgeon may also remove parts of the liver, surrounding lymph nodes, and bile duct.
  • Stage 2: A surgeon will typically remove the gallbladder, parts of the liver, surrounding lymph nodes, and bile duct. According to Cancer Research UK, a person may also need further treatment, which may include chemotherapy or radiation therapy.
  • Stage 3: At this stage, a surgeon may still be able to remove most of the cancer through surgery of the gallbladder, surrounding lymph nodes, and organs. A person will typically need further treatment including chemotherapy and radiation therapy.
  • Stage 4: A surgeon would not typically recommend surgery at this stage. However, they may recommend chemotherapy or radiation therapy. Alternatively, a person may decide that palliative care to manage some of their cancer symptoms is right for them.

In some cases, a person may be able to take part in clinical trials for new treatments. However, people will need to speak with a healthcare professional for further information about whether they are eligible and which trials may be beneficial for them.

A doctor will typically determine the outlook of gallbladder cancer using information from the National Cancer Institute’s surveillance, epidemiology, and end results (SEER) database.

Instead of the numbered stages that doctors use to diagnose gallbladder cancer, the SEER database groups outlook into the following categories:

  • Localized: This is when there is no indication that the cancer has spread outside the gallbladder. The survival rate is 69%, according to the American Cancer Society.
  • Regional: This is when the gallbladder cancer has spread to the surrounding structures and lymph nodes. The survival rate is 28%.
  • Distant: This is when the gallbladder cancer has spread to parts of the body far from the gallbladder, like the lungs. The survival rate is 3%.

The percentages above are based on people who received a gallbladder cancer diagnosis between 2012 and 2018, so a person receiving a diagnosis now may have a better outlook than the percentages suggest. Additionally, the outlook varies between people depending on multiple factors, such as their overall health and age.

A person should speak with a doctor for more information about their individual outlook.

When a doctor diagnoses a person with gallbladder cancer, they will categorize the cancer into one of four stages. This will depend on how much cancer is in the body, as well as whether and where it has spread.

A doctor can recommend appropriate treatment based on the stage of someone’s gallbladder cancer. There are several treatments available for the different stages of gallbladder cancer including surgery, chemotherapy, radiation therapy, and palliative care.

Additionally, a healthcare professional can provide further information about a person’s outlook on an individual basis.