Gall bladder cancer: what treatment is available?

Gall bladder cancer is fairly uncommon type of cancer and your chances of recovering from it are good as long as it is caught early. Surgery is the first line of treatment for most gall bladder cancers and this aims to remove all the cancerous tissue with a healthy margin around it to prevent the cancer coming back. Follow up treatments are used to kill any cancerous cells that may have started to escape to other parts of the body.

Unfortunately, there are usually no initial signs and symptoms of gall bladder cancer, which means that it’s not often detected until the later stages. If gall bladder cancer has already spread to other sites in the body, follow up treatment may involve tackling secondary cancers, preventing further spread and controlling any symptoms and complications that may arise.

This article on gall bladder cancer treatment is by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.  

Diagnosing gall bladder cancer

There are several identifiable stages of gall bladder cancer; the stage of your cancer at diagnosis will be used as a starting point to make treatment decisions:

• Stage 1: The cancer is confined to within the walls of your gall bladder and has not spread

• Stage 2: The gall bladder cancer has penetrated the walls of your gall bladder, but has not spread to any other organs or lymph nodes

• Stage 3: The cancer has spread to your lymph nodes or has invaded other nearby organs

• Stage 4: The gall bladder cancer has invaded deeply into adjacent tissues, or has spread to distant lymph nodes or organs.

If you have been diagnosed with gall bladder cancer, the right treatment for you will depend on:

• The stage of your gall bladder cancer

• The position and size of the tumour in your gall bladder

• Whether the gall bladder cancer has spread to other parts of your body

• Your medical history

• Your general health

• Your personal preferences 

Gall bladder cancer treatment options: surgery

If your gall bladder cancer is in an early stage, your doctor may decide to remove your gall bladder completely to give you a good chance of a complete recovery. This operation is called a cholecystectomy and sometimes also involves removing your bile ducts and a portion of your liver. Surgery to remove the gall bladder can have significant side effects and it may take quite a while to recover. In general, the severity of the risks and side effects depend on how much tissue is removed, as well as on your general health before surgery.

Gall bladder cancer treatment options: chemotherapy

This involves taking anti-cancer drugs to destroy cancer cells in your body. Although chemotherapy is not usually effective for the primary gall bladder cancer, it can help to kill cancerous cells elsewhere in your body to delay or stop the spread of the disease. Chemotherapy therefore tends to be used if your gall bladder cancer is more advanced.

Chemotherapy is usually given in cycles of around three to four weeks, with a rest period after each treatment to allow your body time to recover.  This is necessary because although chemotherapy drugs attack the gall bladder cancer cells, they also affect other rapidly dividing cells in your body. This cell damage can lead to treatment side effects including:

• Hair loss

• Mouth sores

• Nausea and vomiting

• Fatigue

• An increased chance of infection

• Increased bruising and bleeding

Gall bladder cancer treatment options: radiotherapy

Radiotherapy is also used as a treatment for gall bladder cancer after you have had surgery to remove as much of the tumour as possible. High-energy beams are used to kill any cancer cells that remain while having as little effect as possible on other cells and tissues. There are three main ways in which radiation therapy is given for gall bladder cancer:

• External-beam radiation therapy (EBRT): The most common type of radiation therapy, this is when an external machine is used to deliver the radiation to your body.

• Internal Radiation therapy: Also known as brachytherapy; small pellets of radioactive material are inserted into the body tissue, near to the site of the original cancer.

• Three-dimensional conformal radiation therapy (3D-CRT): This technique uses computers to map the tumour in your body, and then radiation beams are aimed at it from several directions. This type of gall bladder cancer treatment is less likely to damage your body’s healthy tissue.  

Gall bladder cancer treatment options: palliative therapy

Some gall bladder cancers are so advanced when they are detected that they cannot be treated using surgery. Other people may respond well to treatment, only to have the cancer return at a later date. Treatment in these cases is therefore more about easing symptoms and retaining as much quality of life as possible, rather than concentrating on trying to cure the cancer.

If you have advanced gall bladder cancer that has caused a blockage in your bile duct, your doctor may insert a stent to relieve this and to allow bile to flow freely again. A stent is a hollow metal tube that, when placed inside your bile duct, creates a hollow passage through your bile duct so that the bile can drain away. If you have a stent inserted, it will usually need to be replaced every couple of months so that it doesn’t become blocked.

Chemotherapy and radiotherapy can also be used as palliative treatments to reduce the size of the original gall bladder cancer and of any other secondary tumours. This can relieve pain and symptoms.

Profile of the author

Dr Kathryn Senior is an acclaimed medical journalist who has written over 500 feature articles for leading international journals within The Lancet group. As Senior Writer at Freelance Copy she produces high quality scientific and medical content for websites and printed publications for companies and organisations in the health, medical and pharmaceutical sectors.

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