ON THIS PAGE: You will learn about the different types of treatments doctors use for people with gallbladder cancer. Use the menu to see other pages.
This section explains the types of treatments that are the standard of care for gallbladder cancer. “Standard of care” means the best treatments known. When making treatment plan decisions, you are encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Clinical trials are an option to consider for treatment and care for all stages of cancer. Your doctor can help you consider all your treatment options. To learn more, see the About Clinical Trials and Latest Research sections.
In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. For gallbladder cancer, the team of doctors may include a gastroenterologist, a surgeon, a medical oncologist, and a radiation oncologist. Cancer care teams include a variety of other health care professionals, such as physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.
Descriptions of common types of treatments used for gallbladder cancer are listed below. Your care plan also includes treatment for symptoms and side effects, an important part of cancer care. Gallbladder cancer may be treated with 1 or more treatments, including surgery, chemotherapy, or radiation therapy. If detected at an early stage, gallbladder cancer has a much higher chance of being successfully treated.
Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health. Take time to learn about all of your treatment options. Be sure to ask questions about things that are unclear. Talk with your doctor about the goals of each treatment and what you can expect while receiving the treatment. Learn more about making treatment decisions.
Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. This can be done by a general surgeon, surgical oncologist, or hepatobiliary surgeon. A surgical oncologist is a doctor who specializes in treating cancer using surgery. A hepatobiliary surgeon specializes in surgery of the liver, gallbladder, and bile ducts.
The following are types of surgery used in the treatment of gallbladder cancer:
Cholecystectomy. Also called a simple cholecystectomy, this procedure involves the removal of the gallbladder. An extended cholecystectomy is the removal of the gallbladder, 1 inch or more of liver tissue located next to the gallbladder, and all of the lymph nodes in the region.
Radical gallbladder resection. This procedure involves the removal of the gallbladder, a wedge-shaped section of the liver near the gallbladder, the common bile duct, part or all of the ligaments between the liver and intestines, and the lymph nodes around the pancreas and nearby blood vessels. This surgery may be recommended even if a simple cholecystectomy was already done.
Palliative surgery. Surgery may sometimes help relieve symptoms caused by gallbladder cancer, even if the tumor cannot be removed completely. For example, surgery may relieve a blockage of the bile ducts or intestines, or relieve bleeding.
The side effects will depend on the specific type of surgery. Before surgery, talk with your health care team about the possible side effects from the specific surgery you will have. Learn more about the basics of cancer surgery.
Radiation therapy (updated 03/2019)
Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment for gallbladder cancer is called external-beam radiation therapy, which is radiation therapy given from a machine outside the body. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time.
Radiation therapy may be used before surgery to shrink the size of the tumor or after surgery to destroy any remaining cancer cells. In some cases, radiation therapy is given during surgery to directly target the area of the tumor and protect healthy organs from the effects of traditional radiation therapy. This procedure is called intra-operative radiation therapy, or IORT.
Radiation therapy may also be combined with chemotherapy, a treatment called chemoradiotherapy. Chemoradiotherapy may sometimes be given after surgery and chemotherapy to destroy remaining cancer cells when there is a positive margin that can be seen with a microscope. A positive margin means that there are cancer cells around the area where the tumor was removed. Learn more about ASCO's recommendations on chemoradiotherapy for gallbladder cancer.
Radiation therapy is not always used for gallbladder cancer, so your doctor may or may not recommend it. Side effects of radiation therapy may include fatigue, mild skin reactions, upset stomach, loose bowel movements, and damage to nearby structures such as the liver or intestines. Most side effects go away soon after treatment is finished. Learn more about the basics of radiation therapy.
Therapies using medication
Systemic therapy is the use of medication to destroy cancer cells. This type of medication is given through the bloodstream to reach cancer cells throughout the body. Systemic therapies are generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication.
Common ways to give systemic therapies include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).
The type of systemic therapy used for gallbladder cancer is chemotherapy. This is discussed below in more detail. A person may receive only 1 type of systemic therapy at a time or a combination of systemic therapies given at the same time. They can also be given as part of a treatment plan that includes surgery and/or radiation therapy.
The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptionsc by using searchable drug databases.
Chemotherapy is the use of drugs to destroy cancer cells, usually by ending the cancer cells’ ability to grow and divide. A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or a combination of different drugs given at the same time.
Chemotherapy should be given after surgery to help prevent a recurrence. ASCO recommends capecitabine (Xeloda) for 6 months after surgery. People with hilar cholangiocarcinoma and extrahepatic cholangiocarcinoma may receive chemoradiotherapy after surgery and capecitabine to destroy remaining cancer cells when there is a positive margin that can be seen with a microscope. A positive margin means that there are cancer cells around the area where the tumor was removed (see Radiation Therapy, above, for more on the ASCO recommendations).
Other drugs commonly used to treat gallbladder cancer include gemcitabine (Gemzar), fluorouracil (5-FU), cisplatin (Platinol), and oxaliplatin (Eloxatin). The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment is finished.
Chemotherapy is usually used as a palliative care treatment for gallbladder cancer. It may be recommended after the tumor has been removed surgically. Chemotherapy used before surgery is called neoadjuvant therapy. And chemotherapy used as an additional therapy after surgery is called adjuvant chemotherapy.
Learn more about the basics of chemotherapy.
Care for symptoms and side effects
Cancer and its treatment often cause side effects. In addition to treatments intended to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.
Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any person, regardless of age or type and stage of cancer, may receive palliative care. It works best when palliative care is started as early as needed in the cancer treatment process. People often receive treatment for the cancer and treatment at the same time that they receive treatment for the related side effects. In fact, people who receive both at the same time often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional support and other therapies. You may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy, surgery, or radiation therapy. Talk with your doctor about the goals of each treatment in your treatment plan.
Before treatment begins, talk with your health care team about the possible side effects of the specific treatment plan and palliative care options. During and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it can be addressed as quickly as possible. Learn more about palliative care.
Metastatic gallbladder cancer
If cancer spreads to another part in the body from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it, given that this is an uncommon cancer. Doctors can have different opinions about the best standard treatment plan. Clinical trials might also be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.
Your treatment plan may include a combination of surgery, chemotherapy, or radiation therapy. Palliative care will also be important to help relieve symptoms and side effects.
For most people, a diagnosis of metastatic cancer is very stressful and, at times, difficult to bear. You and your family are encouraged to talk about how you feel with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.
Remission and the chance of recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED.
A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
If the cancer does return after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence. After this testing is done, you and your doctor will talk about the treatment options. Often the treatment plan will include the treatments described above such as surgery, chemotherapy, and radiation therapy but they may be used in a different combination or given at a different pace. Your doctor may suggest clinical trials that are studying new ways to treat this type of recurrent cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.
People with recurrent cancer often experience emotions such as disbelief or fear. You are encouraged to talk with the health care team about these feelings and ask about support services to help you cope. Learn more about dealing with cancer recurrence.
If treatment does not work
Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.
This diagnosis is stressful, and for many people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.
People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.
After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.
The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. Use the menu to choose a different section to read in this guide.