Therapy is based on primarily on whether the cancer can be surgically removed. However, it's also critical to know the stage of disease. Staging occurs during diagnosis, and ranges from early-stage cancer to stage IV gallbladder cancer, which means the cancer cells have already spread to distant sites in the body.
Some patients' cases are discussed at a multidisciplinary tumor board a conference attended by many doctors with different specialties that might be required for your care.
Four main types of treatment are used for gallbladder cancer: surgery, radiation, chemotherapy, and palliative care.
This is the most common treatment used for gallbladder cancer and offers the best chance for a cure. Only some of these cancers are completely removable, though. Surgical options include removal of the gallbladder (a cholecystectomy), which can be done with a small incision and laparoscope, or by a traditional, open surgery with a larger incision. Most gallbladder cancers require a more extensive surgery, called an extended or radical cholecystectomy. Doctors remove the gallbladder, some liver tissue next to the gallbladder, and all lymph nodes in the region. Depending on the case, surgeons might also remove a larger section of the liver, the pancreas, the bile duct, and additional lymph nodes. Palliative surgery also can be done to relieve symptoms.
Radiation therapy uses energy from radiation beams, radioisotopes, or charged particles to target tumors and eradicate cancer cells. Radiation is used after surgery to kill remnants of the cancer, and as a primary treatment in combination with chemotherapy. Palliative radiation can be used if the cancer is advanced to relieve symptoms and shrink tumors that are blocking bile passageways or pressing on nerves.
Chemotherapy uses drugs or combinations of drugs — given intravenously or as pills — to destroy cancer cells. Chemo for gallbladder cancer is usually given after surgery to ensure that the cancer does not return or as palliative therapy to relieve symptoms.
This type of therapy can ease symptoms caused by advanced cancer. Sometimes doctors insert a small stent or catheter into the gall bladder or bile duct to drain fluid. Another option is to use surgery — a biliary bypass — to create a new way for bile to move past a blockage in the ducts caused by cancer. Pain medicines and alcohol injections that deaden the nerves in the intestinal area can also help.
Many cancer treatments cause side effects such as hair loss or fatigue, but not everyone experiences side effects the same way.
The American Cancer Society also offers a free online class to help patients manage the side effects of their illness.