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Although signs and symptoms are usually not present until the later stages of gallbladder cancer, in some cases they may lead to an early diagnosis. If you have any of the following problems, see a doctor right away:

Abdominal pain: More than half of all people with gallbladder cancer have abdominal (stomach area) pain at the time of diagnosis. Most often this is in the upper right part of the abdomen.

Nausea and/or vomiting: At the time of their diagnosis, more than half of all people with gallbladder cancer report vomiting as a symptom.

Jaundice: Jaundice is a condition that gives a yellowish color to the skin, the white part of the eyes, and tissues of the body. One fourth to one half of all patients with gallbladder cancer have jaundice when they are diagnosed.

Gallbladder enlargement: Sometimes bile duct blockage causes bile to accumulate in the gallbladder, causing it to become larger than usual. This enlargement can sometimes be felt by the doctor during a physical exam and can also be detected by imaging studies such as ultrasound.

Other symptoms: Less common symptoms include loss of appetite, weight loss, abdominal swelling, severe itching, and black, tarry stools.

Although these are symptoms and signs of gallbladder cancer, it is important to remember that they may also be caused by non-cancerous diseases. In fact, hepatitis (infection of the liver by a virus) is a much more common cause of jaundice and there are many causes of abdominal pain that are far more common than gallbladder cancer. Nonetheless, people with these signs and symptoms should check with their doctor so that any health problems can be diagnosed as soon as possible, when treatment is likely to be most successful.

History and physical exam: To begin, a complete medical history (medical interview) will be taken to check for risk factors and symptoms. A physical exam is done to provide other information about signs of gallbladder cancer and other health problems.

If gallbladder cancer is suspected, the physical exam will focus mostly on the abdomen to check for any masses or fluid accumulation. The skin and the white part of the eyes will be checked for jaundice (yellow discoloration). Sometimes, cancer of the gallbladder spreads to lymph nodes, producing an enlargement that can be felt beneath the skin surface. Lymph nodes above the collarbone and lymph nodes in several other locations will be examined carefully to look for swelling that might indicate the spread of cancer.

Blood tests: Doctors may order lab tests to determine how much bilirubin is in the blood. Bilirubin is what gives the bile its color, and too much bilirubin in the blood is what is responsible for the yellow color of skin and the whites of the eyes when jaundice occurs. A high bilirubin count tells the doctor that there may be either gallbladder or liver problems.

The medical team may also order tests for levels of two enzymes, alkaline phosphatase and aspartate aminotransferase, that can also be an indication of gallbladder disease. Other tests are CEA and CA 19-9. These are tumor markers (proteins that circulate in the blood when certain cancers are present). Usually the blood levels of these markers are high only when the cancer is in an advanced stage.

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