Tests for gallbladder cancer
You usually have a number of tests to diagnose gallbladder cancer and find out how far it has grown. The tests you might have include:
- blood tests
- different types of scans
- taking samples of cells (biopsy)
Tests your GP might do
Most people start by seeing their GP. Your GP will examine you. They can do some tests to help them decide whether you need a referral to a specialist. Your GP might send you for blood tests and an ultrasound scan.
Blood tests
A blood test can check your general health, including how well your liver and kidneys are working. The doctors will also check numbers of 
.
You might also have a blood test to check for . People with gallbladder cancer might have high blood levels of the markers called CEA and CA 19-9.
Ultrasound scan
Ultrasound scans use high frequency sound waves to create a picture of a part of the body. You might have an ultrasound scan of your tummy (abdomen). The scan looks at your gallbladder.
A radiologist or a specialist called a sonographer puts some gel over your tummy. This can sometimes feel cold. They then use an ultrasound probe to slide over the skin and give a clear picture on a screen.
Tests your specialist might do
Depending on the results of your tests, your GP might refer you to a specialist. You usually see a , who may do more tests. These can include:
- CT scan
- cholangiography
- biopsy
- ERCP (endoscopic retrograde cholangio pancreatography)
- laparoscopy
- Percutaneous transhepatic cholangiography (PTC)
- endoscopic ultrasound
- MRCP and MRI scan
- PET scan
CT scan
A CT scan is a test that uses x-rays and a computer to create detailed pictures of the inside of your body. It takes pictures from different angles. The computer puts them together to make a 3 dimensional (3D) image.
You might have a CT scan to find out how big the cancer is, and whether it has spread.
Cholangiography
Cholangiography (or a cholangiogram) is a test that puts a dye into the bile ducts and gallbladder to show them up clearly on x-ray.
It can help to find the size of a gallbladder cancer and whether it has spread. It looks at the bile ducts to see if they are blocked, narrowed, or dilated (widened). This can help show if a cancer is blocking a duct. It can also be used to help plan surgery.
Biopsy
A biopsy means taking a sample of tissue and sending it to the laboratory so it can be looked at under a microscope. You might have cells taken from the gallbladder, the liver, or enlarged lymph nodes. There are different ways of taking biopsies to check for gallbladder cancer. The tests used to take a biopsy include:
- ultrasound or CT guided biopsy or fine needle aspiration (FNA)
- ERCP
- using a tube put through the skin of your tummy (laparoscopy)
- endoscopic ultrasound
The type of biopsy you have will depend on your individual situation.
Ultrasound or CT guided biopsy or fine needle aspiration (FNA)
A fine needle aspiration is a way of taking a sample of cells from the gallbladder.
First your doctor does an ultrasound scan or CT scan of your gallbladder. This finds the right place to take the sample. Then they gently put a small needle into your gallbladder and take a sample of fluid and cells. You will feel some pressure but it shouldn’t be too painful. Let your doctor know if it’s painful for you.
After taking the sample your doctor removes the needle. Following a gallbladder biopsy or fine needle aspiration, you have to stay in hospital for a few hours or overnight. This is because there is a risk of bleeding afterwards.
Biopsy during an ERCP
ERCP stands for endoscopic retrograde cholangio pancreatography.
Your doctor might do an ERCP to check whether there is a growth or any abnormal looking area in your gallbladder. They can also look at the inside of your small bowel (duodenum) and take tissue samples (biopsies).
This test can also show if there is a narrowing or blockage of the bile duct or pancreatic duct. This can help with planning surgery.
Biopsy during an operation on your tummy (laparoscopy)
A laparoscopy is a small operation to look inside your tummy (abdomen). Your surgeon can look for any signs of cancer and whether it has spread. You might have it to help your doctor decide if surgery to remove the cancer is possible.
You have the operation while you are asleep (under general anaesthetic). Your surgeon can take samples of tissue and fluid to send to the laboratory. The samples are checked for cancer cells.
Percutaneous transhepatic cholangiography (PTC)
A percutaneous transhepatic cholangiography is a way of looking at your bile ducts using x-rays. This test is also called PTC.
Your doctor puts a long thin needle through the skin and into your liver and bile ducts.
PTC is not used to diagnose gallbladder cancer but can take x-rays of the pancreas, gallbladder and bile ducts. If tests show that you have a blockage in your bile ducts, you might have treatment during a PTC to help relieve the blockage.
Endoscopic ultrasound
This test combines an ultrasound and endoscopy.
An endoscopy is a test to look inside your body. Your doctor uses a long flexible tube (endoscope) with a tiny camera and light on the end. The endoscope also has an ultrasound probe at its tip.
An ultrasound scan uses high frequency sound waves to create a picture of the inside of your body.
Your doctor can take biopsies of your lymph nodes using this test. This helps them to work out the stage of the cancer. It also helps to show if the cancer has grown into the wall of the gallbladder or spread to the liver. This helps to plan for surgery.
MRCP and MRI scan
MRCP stands for magnetic resonance cholangio pancreatography. An MRCP scan is a type of MRI scan that you have in an MRI scanner.
MRI stands for magnetic resonance imaging. An MRI scan produces pictures from angles all around the body and shows up soft tissues very clearly.
You might have an MRI scan to show whether a tumour is only in the gallbladder, or if it has also spread to the liver. MRI used with cholangiography can be better than some other tests at showing whether a cancer is blocking the flow of bile. It can also show whether the cancer has grown around the portal vein (the vein bringing blood to the liver from the stomach and intestines).
PET scan
PET scans are a type of test that create 3 dimensional (3D) pictures of the inside of your body. PET stands for positron emission tomography. It uses a mildly radioactive drug to show up areas of your body where cells are more active than others.
It is not a routine test for gallbladder cancer but you might have it to check if the cancer has spread to other parts of the body.
Treatment
The tests you have help to diagnose gallbladder cancer and find out how far it has grown. This is the stage of the cancer. This is important because doctors recommend your treatment according to the stage of the cancer.
