Due to its aggressive nature, gallbladder cancer is often detected and diagnosed in later stages. Staging is determined by the size of the tumor and where in your body the cancer has spread.

Gallbladder cancer is a rare type of cancer that begins with a tumor in your gallbladder. Doctors stage gallbladder cancer based on:

  • the size of the tumor
  • whether it has spread beyond your gallbladder
  • whether cancer is found in other parts of your body

As is true for all types of cancer, someone who receives a diagnosis of gallbladder cancer in the early stages has a better treatment outlook. Gallbladder cancer is considered an aggressive cancer and is typically difficult to treat once it spreads.

How aggressive is gallbladder cancer (how fast does it spread)?

Gallbladder cancer is considered to be an aggressive form of cancer. The exact speed of cancer spread will depend on the person and on how they respond to treatment. But gallbladder cancer is often diagnosed in later stages when it’s harder to treat.

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You might undergo a few different tests to receive a confirmed diagnosis of gallbladder cancer. This will often start with blood tests to check how well your liver is functioning. These will likely be followed with tests such as:

  • Imaging tests: You might have X-rays, CT scans, ultrasounds, and MRIs to help doctors get a closer look at your gallbladder and bile ducts.
  • Laparoscopy: A laparoscopy is a test that uses a small tube called an endoscope with a camera and light on the end. This tube is inserted through a very small incision in your abdomen. The surgeon can use it to see your gallbladder and the surrounding tissues and organs. You might have a biopsy at the same time.
  • Magnetic resonance cholangiography: For this test, you’ll have a special dye injected. This dye will display the passage of substances through your body’s bile ducts.

What are the symptoms of gallbladder cancer?

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Gallbladder cancer is staged using the American Joint Committee on Cancer TNM system. The TMN system uses three factors to evaluate and stage gallbladder cancer:

  • T: This stands for tumor size. It measures how far the cancer has grown and spread.
  • N: This stands for nodes, the body’s lymph nodes. It’s a measure of how many, if any, lymph nodes have been affected.
  • M: This stands for metastasis. It’s a measure of total cancer spread.

Stage 0 | Tis, N0, M0

Stage 0 is the earliest stage of gallbladder cancer. Cancer hasn’t spread and hasn’t affected any lymph nodes. It’s still in the very outer layers of your gallbladder.

Stage 1 | T1, N0, M0

In stage 1, the tumor has grown in your gallbladder’s muscle layer, called the lamina propria. But it still hasn’t spread to the lymph nodes or anywhere else in the body.

Stage 2A | T2a, N0, M0

In stage 2A, the tumor has gotten larger. It has grown past the muscle layer into the fibrous tissue that lines the abdominal cavity. There’s still no spread to the lymph nodes or throughout your body.

Stage 2B | T2b, N0, M0

In stage 2B, cancer has grown and spread through the muscle layer and into fibrous tissue along the side of your liver. It hasn’t invaded your liver, nor has it spread to lymph nodes or throughout your body.

Stage 3A | T3, N0, M0

Stage 3 cancer is when it has grown through the outer most layer of your gallbladder, called the serosa, and has grown into your liver, or into at least one nearby structure such as your:

  • stomach
  • small intestine
  • colon
  • bile ducts
  • pancreas

Cancer in this stage hasn’t spread to the lymph nodes or throughout your body.

Stage 3B | T1–3, N1, M0

Stage 3B describes cancer with a tumor that might be in or outside your liver, but that hasn’t grown into your liver’s main blood vessels. Stage 3B cancer has also spread to no more than three lymph nodes. It hasn’t spread throughout your body.

Stage 4A | T4, N0 or N1, M0

In stage 4A, the tumor has reached your liver’s primary vessels or has grown into two of the organs around your liver, such as your stomach, pancreas, or small intestine. There’s no spread throughout your body, but at least three lymph nodes might be affected.

Stage 4B | Any T, N2, M0

In stage 4B, the tumor can be inside or outside of your gallbladder, but the cancer itself has spread and has affected four or more lymph nodes. There’s no spread throughout your body.

But stage 4B can also be used to describe a tumor of any size and cancer that has spread to any number of lymph nodes if the cancer has also spread throughout your body.

The outlook for people with gallbladder cancer depends on a number of factors, including:

  • stage at diagnosis
  • tumor size
  • response to treatment
  • age
  • overall health

According to the American Cancer Society, the overall 5-year relative survival rate for gallbladder cancer between 2012 and 2018 was 20%.

  • People who received a diagnosis in the early stages had a 5-year relative survival rate of 69%.
  • Once gallbladder cancer started to spread, the 5-year relative survival rate was 28%.
  • The 5-year relative survival rate for people in later stages of gallbladder cancer was 3%.

If you’ve received a diagnosis of gallbladder cancer, talk with a doctor. They can help you understand the stage of your cancer and your individual outlook.

What is a relative survival rate?

A relative survival rate gives you an idea of how long someone with a specific condition may live after receiving a diagnosis compared with someone without the condition. For example, a 5-year relative survival rate of 20% means that someone with that condition is 20% as likely to live for 5 years as someone without the condition.

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Gallbladder cancer is diagnosed and staged based on tumor size and growth and on the overall spread of cancer through your body.

Tumors that are contained to the gallbladder are early stage and are easiest to treat. Tumors that have grown into the liver and other nearby organs are later stage and are more difficult to treat.

Once your cancer is staged, a doctor can help plan the most appropriate cancer treatment for you.