Diagnosing gallbladder and bile duct cancers 

Hearing you have gallbladder or bile duct cancer is never easy. But getting the right diagnosis helps us create the best treatment plan.

A diagnosis isn’t just a statement that says you have gallbladder or bile duct cancer. It will also describe what type and even subtype of cancer you have, and how far the cancer has spread.  

What is the first step in a gallbladder or bile duct cancer diagnosis?

In many cases, patients learn they have gallbladder cancer after having their gallbladder taken out for another reason. 

What are the symptoms of gallbladder and bile duct cancers?

Gallbladder and bile duct cancers don’t usually cause symptoms right away. When they do cause symptoms, patients might mistake them for another condition, such as a virus or indigestion.

If you notice one or more of the following symptoms and don’t see any improvement over several weeks, make an appointment with your doctor:

• Fever 
• Nausea and vomiting 
• Upper belly pain 
• Bloating 
• Itching 
• Yellowing of the skin and whites of the eyes (jaundice)  

Jaundice is one symptom that should never be ignored. Call your doctor right away if you notice this.

Why Choose Siteman for Your Cancer Diagnosis?

At Siteman, we will make sure your diagnosis is correct the first time. Our WashU Medicine physicians have seen many cases of gallbladder and bile duct cancers. They will carefully study your tumor and see how far it has spread in your body. They will look at the cells of the tumor to see how they behave and how they can be targeted.

When your team is finished gathering information, they will make your treatment plan. 

What to expect during a diagnosis

If you suspect you may have gallbladder or bile duct cancer, you will want to schedule an appointment with your doctor. They will examine you and do tests to learn more about what is going on.

After doing tests, your doctor might refer you to Siteman. Or, you can make an appointment with us yourself. Many patients come to Siteman for a second opinion. You don’t need a referral to come see us.

At Siteman, we will do more tests to confirm that your diagnosis is right.

We understand that medical tests make many people anxious. Your comfort is our priority – we want you to feel safe when you’re in our care. Please don’t hesitate to ask questions or to request accommodations.

Your Siteman care team will likely recommend one or more of the following tests:

• Blood tests: Blood tests are an important tool for detecting gallbladder and bile duct cancer. They can show whether gallbladder and bile duct cancer might be present in your body. They will check how well your liver is working and look for substances released by cancer cells.  
• X-rays of the liver, gallbladder, and bile ducts: X-rays can show whether you have a blockage anywhere in your bile ducts. You’ll have them in an operating room while you’re asleep. Your doctors may inject a special dye that will help them see where the blockages are. If you do have a blockage, your care team can place a tube called a stent to unblock it.  
• Biopsy: During a biopsy, your doctors will remove a sample of tissue from your bile ducts or gallbladder. Doctors called pathologists will check the samples under a microscope for signs of cancer. You’ll be asleep during the procedure. If you’re already having surgery to remove your gallbladder, your surgeon will collect a tissue sample after the surgery is done. 
• Imaging tests: Imaging tests take pictures of the inside of the body. They can show how big your tumor is and how far it has spread. You might have an ultrasound, which uses sound waves to make a picture, or a CT-scan.  
• Laparoscopy: While you are asleep, your doctors will make several small incisions in your belly (abdomen). They will place a tube with a camera called a laparoscope through the incisions. Using the laparoscope, they will look to see if cancer has spread. They might be able to remove your gallbladder at this time. They might also collect (biopsy) other samples of tissue. A laparoscopy is a minimally-invasive surgery.  

Staging Gallbladder and Bile Duct Cancers

If you have gallbladder or bile duct cancer, it’s important to find out how far the cancer has spread in your body. Doctors call this “staging” the cancer. Your treatment plan will depend on what stage the cancer is.

Like most cancers, gallbladder and bile duct cancers are given stages from 0 to 4 (IV). Stage 0 cancers have not spread beyond the original tumor.

Tumors at Stage 1 (I) have grown larger. Tumors at Stages 2 (II) and 3 (III) have grown deeper into the tissues of the gallbladder and bile ducts and may have spread to other organs in the belly such as the liver.

Stage 4 (IV) cancers have spread outside of the belly to other parts of the body. This means that the cancer has “metastasized.”