Gallbladder cancer vs. cholangiocarcinoma: How do they differ?

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Gallbladder cancer is a rare cancer that occurs when cancerous cells start to grow in the pear-shaped organ that stores and secretes bile. The gallbladder has four layers:

• an inner layer of moist, mucosal tissue
• a layer of muscle
• a layer of connective tissue
• an outer layer

Gallbladder cancer typically starts in the inner layer and grows and spreads toward the outer layers. According to the American Cancer Society (ACS), this cancer accounts for around 4 in every 10 biliary tract cancers.

A 2019 report confirms that gallbladder cancer is the most common biliary tract cancer. Around 1.2% of cancer diagnoses worldwide are gallbladder cancers, but they cause 1.7% of cancer deaths. Almost every gallbladder cancer is an adenocarcinoma, meaning that it affects fluid-secreting cells.

Learn more about gallbladder cancer.

Cholangiocarcinoma is a cancer of the bile ducts. This network of tubes transports bile from the liver to the gallbladder and out to the gut, supporting the role of bile in digesting fats.

Three types different types of cholangiocarcinoma can develop:

• Extrahepatic cholangiocarcinoma: This type of bile duct cancer occurs where liver and gallbladder ducts meet, forming the common bile duct. Doctors also refer to this as distal cholangiocarcinoma.
• Perihilar cholangiocarcinoma: This also develops outside the liver, in the region where the right and left bile ducts leave the liver.
• Intrahepatic cholangiocarcinoma: This rare form of cholangiocarcinoma grows in bile ducts inside the liver.

According to the ACS, around 8,000 people a year in the United States receive a cholangiocarcinoma diagnosis.

Learn more about bile duct cancer.

According to the National Health Service (NHS) in the United Kingdom, symptoms of both gallbladder and bile duct cancers can be challenging for doctors to identify or may not develop at all.

Symptoms more commonly occur due to other health problems and may not be an immediate cause for concern. However, if these symptoms do not improve or worsen, a healthcare professional can help rule out or identify these cancers.

Gallbladder cancer often does not cause symptoms until it reaches an advanced stage. The ACS estimates that doctors only find 1 in 5 gallbladder cancers before they spread outside of the gallbladder.

Symptoms of gallbladder and bile duct cancer include:

• jaundice or yellowing of the eyes and skin
• itchy skin
• darker urine
• pale stool
• fever
• weakness
• shivering
• a lump in the stomach area
• digestive symptoms, including nausea and vomiting
• appetite loss
• unintended or unexpected weight loss
• sharp or aching belly pain
• a swollen belly that does not link to meal times

Jaundice may not be as visible in people with darker skin tones.

The NHS states that cholangiocarcinoma can cause the same symptoms as bile duct cancer.

Learn about the symptoms of bile duct cancer.

Cancer occurs due to faulty DNA that causes cells to copy themselves too much. The direct causes of both cancers are still unclear. Many risk factors for gallbladder cancer have links to chronic inflammation of the gallbladder. This might occur due to physical defects, defects in the ducts, or gallstones.

Gallbladder cancer

The main risk factors for gallbladder might include:

• Gallstones: Around 4 in 5 people who have gallbladder cancer have gallstones at the time of diagnosis.
• Porcelain gallbladder: A condition that causes calcium deposits to cover the wall of the gallbladder.
• Gender: Gallbladder cancer occurs in three to four times more often in females than males in the United States.
• Obesity: Gallbladder cancer is more common in people who have overweight or obesity.
• Age: Gallbladder cancer occurs most often in older people. The average age of diagnosis is 72.

It is important to note that most people with gallstones will never develop gallbladder cancer.

Cholangiocarcinoma

Often, bile duct cancers do not have a direct cause. However, certain conditions or environmental factors can increase a person’s risk, including:

• being over 65 years of age
• having primary sclerosing cholangitis (PSC)
• choledochal cysts or rare growths within the bile duct
• a parasite called a liver fluke that invades the bile duct, although this is far more common in Asia
• bile duct stones
• previous exposure to a discontinued medical dye called Thorotrast
• having physical problems with the bile ducts, which can sometimes cause inflammation
• gallbladder polyps
• having typhoid

The main treatments for gallbladder and bile duct cancers are surgery, radiation therapy, and chemotherapy. However, these vary depending on the spread, type of the cancer, and where it has developed.

Gallbladder cancer

Doctors may use the following to treat gallbladder cancer:

• surgery to remove the gallbladder, surrounding tissue, or nearby lymph nodes
• radiation therapy
• chemotherapy

However, doctors rarely identify gallbladder cancer at an early stage. For cancer that has spread, a doctor may attempt to address blockages and reduce symptoms, clear blockage, and drain buildup using various types of surgery.

Learn more about treatment for gallbladder cancer.

Cholangiocarcinoma

Depending on the location of the cancer, surgery for cholangiocarcinoma might include removal of:

• the bile duct
• part of the liver
• the bile duct, head of the pancreas, gallbladder, and part of the stomach and small intestine, in a procedure called the Whipple procedure

People with perihilar cholangiocarcinoma may need a liver transplant.

A doctor may follow these procedures with radiation therapy or chemotherapy to destroy any remaining cancer cells. After the Whipple procedure, enough of the pancreas remains to keep making insulin.

Learn more about treatment and remission rates.

Gallbladder and cholangiocarcinoma are both rare and cause similar symptoms, including jaundice, belly pain, sickness, and fever.

Gallstones are a common risk factor for gallbladder cancer. However, other risk factors, such as being over age 65, choledochal cysts, and primary sclerosing cholangitis, may increase a person’s risk of either cancer.

Treatment for both may include surgery, radiation therapy, and chemotherapy. Some surgical procedures, including liver or gallbladder stents and biliary bypass, may help relieve symptoms. Surgery is more common for cholangiocarcinoma, whereas people with late-stage gallbladder cancer may start with radiation or chemotherapy.