Gallbladder Cancer (cont.)
Treatment Option Overview
There are different types of treatment for patients with gallbladder cancer.
Different types of treatments are available for patients with gallbladder
cancer. Some treatments are standard (the currently used treatment), and some
are being tested in clinical trials. Before starting treatment, patients may
want to think about taking part in a clinical trial. A treatment clinical trial
is a research study meant to help improve current treatments or obtain
information on new treatments for patients with cancer. When clinical trials
show that a new treatment is better than the standard treatment, the new
treatment may become the standard treatment.
Clinical trials are taking place in many parts of the country. Information
about ongoing clinical trials is available from the NCI Web site. Choosing the
most appropriate cancer treatment is a decision that ideally involves the
patient, family, and health care team.
Three types of standard treatment are used:
Surgery
Gallbladder cancer may be treated with a cholecystectomy, surgery to remove
the gallbladder and some of the tissues around it. Nearby lymph nodes may be
removed. A laparoscope is sometimes used to guide gallbladder surgery. The
laparoscope is attached to a video camera and inserted through an incision
(port) in the abdomen. Surgical instruments are inserted through other ports to
perform the surgery. Because there is a risk that gallbladder cancer cells may
spread to these ports, tissue surrounding the port sites may also be removed.
If the cancer has spread and cannot be removed, the following types of
palliative surgery may relieve symptoms:
- Surgical biliary bypass: If the tumor is blocking the small intestine and
bile is building up in the gallbladder, a biliary bypass may be done. During
this operation, the gallbladder or bile duct will be cut and sewn to the small
intestine to create a new pathway around the blocked area.
- Endoscopic stent placement: If the tumor is blocking the bile duct, surgery
may be done to put in a stent (a thin, flexible tube) to drain bile that has
built up in the area. The stent may be placed through a catheter that drains to
the outside of the body or the stent may go around the blocked area and drain
the bile into the small intestine.
- Percutaneous transhepatic biliary drainage: A procedure done to drain bile
when there is a blockage and endoscopic stent placement is not possible. An
x-ray of the liver and bile ducts is done to locate the blockage. Images made by
ultrasound are used to guide placement of a stent, which is left in the liver to
drain bile into the small intestine or a collection bag outside the body. This
procedure may be done to relieve jaundice before surgery.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other
types of radiation to kill cancer cells. There are two types of radiation
therapy. External radiation therapy uses a machine outside the body to send
radiation toward the cancer. Internal radiation therapy uses a radioactive
substance sealed in needles, seeds, wires, or catheters that are placed directly
into or near the cancer. The way the radiation therapy is given depends on the
type and stage of the cancer being treated.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of
cancer cells, either by killing the cells or by stopping the cells from
dividing. When chemotherapy is taken by mouth or injected into a vein or muscle,
the drugs enter the bloodstream and can reach cancer cells throughout the body
(systemic chemotherapy). When chemotherapy is placed directly into the spinal
column, an organ, or a body cavity such as the abdomen, the drugs mainly affect
cancer cells in those areas (regional chemotherapy). The way the chemotherapy is
given depends on the type and stage of the cancer being treated.
New types of treatment are being tested in clinical trials. These include the
following:
Radiosensitizers
Radiosensitizers are drugs that make tumor cells more sensitive to radiation
therapy. Combining radiation therapy with radiosensitizers may kill more tumor
cells.
This summary section refers to specific treatments under study in clinical
trials, but it may not mention every new treatment being studied. Information
about ongoing clinical trials is available from the NCI Web site.
Treatment Options for Gallbladder Cancer
Localized Gallbladder Cancer
Treatment of localized gallbladder cancer may include the following:
- Surgery to remove the gallbladder and some of the tissue around it. The liver
and nearby lymph nodes may also be removed. Radiation therapy with or without
chemotherapy may follow surgery.
- Radiation therapy with or without chemotherapy.
- A clinical trial of radiation therapy with radiosensitizers.
This summary
section refers to specific treatments under study in clinical trials, but it may
not mention every new treatment being studied. Information about ongoing
clinical trials is available from the NCI Web site.
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that
are now accepting patients with localized gallbladder cancer.
Unresectable Gallbladder Cancer
Treatment of unresectable gallbladder cancer
may include the following:
- Radiation therapy as palliative treatment, with or without surgery or the
placement of stents, to relieve symptoms caused by blocked bile ducts.
- Surgery as palliative treatment to relieve symptoms caused by blocked bile ducts.
- Chemotherapy as palliative treatment to relieve symptoms caused by the cancer.
- A clinical trial of internal radiation therapy or radiosensitizers.
- A clinical trial of chemotherapy.
This summary section refers to specific treatments under
study in clinical trials, but it may not mention every new treatment being
studied. Information about ongoing clinical trials is available from the NCI Web
site.
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that
are now accepting patients with unresectable gallbladder cancer.
Recurrent Gallbladder Cancer
Treatment of recurrent gallbladder cancer is
usually done in a clinical trial.
Information about ongoing clinical trials is available from the NCI Web site.
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that
are now accepting patients with recurrent gallbladder cancer.
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