Gall bladder treatment

Below we look at the common treatment options for gall bladder cancer.

Learn more about:

Making treatment decisions
Your healthcare team
Surgery
External beam radiation therapy
Chemotherapy
Clinical trials
Complementary therapies

Making treatment decisions

It can be difficult to know which treatment is best for you. Your doctors may discuss your situation at a specialist multi-disciplinary meeting prior to giving you treatment recommendations. It is important that you speak with the specialist team before making your decision. Ask them to give you a clear plan of your treatment options, including written information about side effects.

Some people prefer to seek several opinions before feeling confident to go ahead with the treatment. There is no need to feel awkward about seeking a second opinion and specialists will not be offended if you do so. If you are confused or want to check anything, ask your specialist questions. This will ensure you have all the information you need to make decisions about treatment and your future that you are comfortable with.

You may have to attend many appointments. It’s difficult to remember everything your specialist is saying to you so it’s a good idea to take someone with you. They will be able to listen, ask questions and remember what the doctor says. It may help to take a list of questions with you, take notes (especially about anything you are unfamiliar with) or ask the doctor if you can record the discussion (many mobile phones have a recording function or you can use the CAN.recall app. Here are some suggestions for questions you could ask.

Your healthcare team

You will be cared for by a multi-disciplinary team (MDT) of health professionals during your treatment for gall bladder cancer.

The team may include a:

surgeon
pathologist (to interpret the results of blood tests and biopsies)
radiologist
radiation oncologist (to prescribe and coordinate a course of radiation therapy)
medical oncologist (to prescribe and coordinate a course of systemic therapy which includes chemotherapy)
gastroenterologist (to treat disorders of the digestive system)
nurse and allied health professionals such as a dietitian
social worker, psychologist or counsellor
physiotherapist and occupational therapist.

Discussion with your doctor will help you decide on the best treatment for your cancer depending on:

the type of cancer you have
whether or not the cancer has spread (stage of disease)
your age, fitness and general health
your preferences.

The main treatments for gall bladder cancer include surgery, radiation therapy and chemotherapy. These can be given alone or in combination. This is called multi-modality treatment.

Surgery

Surgery is the main treatment for gall bladder cancer, especially for people with early-stage disease where the gall bladder can be completely removed.

Surgery to remove the gall bladder is called a cholecystectomy. Often surrounding tissue including lymph nodes, adjacent bile ducts and part of the liver will also be removed if gall bladder cancer is suspected. Surgery may be performed as either open surgery or keyhole (laparoscopic) surgery.

If the tumour has been found after the gall bladder has been removed for another reason, further surgery may be required.

If the cancer has spread and the tumour is pressing on, or blocking, the bile duct, you may need a stent (small tube made of either plastic or metal). This holds the bile duct open and allows bile to flow into the small bowel again. Stents are placed under x-ray guidance or during an endoscopic retrograde cholangiopancreatography (ERCP).

The extent of the surgery depends on the location and stage of the tumour. Your surgeon will discuss the type of operation you may need and the side effects and risks of surgery.

For more on this, see our general section on Surgery or call Cancer Council 13 11 20.

External beam radiation therapy

Radiation therapy (also known as radiotherapy) uses high energy rays to destroy cancer cells, where the radiation comes from a machine outside the body.

It is often given with chemotherapy in a treatment known as chemoradiation. It may be used for gall bladder cancer:

after surgery, to destroy any remaining cancer cells and stop the cancer coming back
if the cancer can’t be removed with surgery
if the cancer has spread to other parts of the body (e.g. palliative radiation for the management of symptoms such as pain).

A course of radiation therapy needs to be carefully planned. During your first consultation session you will meet with a radiation oncologist who will take a detailed medical history and arrange a planning session. At the planning session (known as CT planning or simulation) you will need to lie still on an examination table and have a CT scan. You will be placed in the same position you will be placed in for treatment.

The information from the planning session will be used by your specialist to work out the treatment area and how to deliver the right dose of radiation. Radiation therapists will then deliver the course of radiation therapy as set out in the treatment plan.

Radiation therapy does not hurt and is usually given in small doses over a period of time to minimise side effects. Each treatment only takes a few minutes but the set-up time can take longer.

For more on this, see our general section on Radiation therapy or call Cancer Council 13 11 20.

Chemotherapy

Chemotherapy (sometimes just called “chemo”) is the use of drugs to kill or slow the growth of cancer cells. You may have one chemotherapy drug, or be given a combination of drugs. This is because different drugs can destroy or shrink cancer cells in different ways. Your treatment will depend on your situation and the stage of your tumour. Your medical oncologist will discuss your options with you.

Chemotherapy is usually given through a drip into a vein (intravenously) or as a tablet that is swallowed. Your medical oncologist will discuss your options with you.

Chemotherapy is commonly given in treatment cycles which may be daily, weekly or monthly. For example, one cycle may last three weeks where you have the drug over a few hours, followed by a rest period, before starting another cycle. The length of the cycle and number of cycles depends on the chemotherapy drugs being given.

For more on this, see our general section on Chemotherapy or call Cancer Council 13 11 20.

Clinical trials

Your doctor or nurse may suggest you take part in a clinical trial. Doctors run clinical trials to test new or modified treatments and ways of diagnosing disease to see if they are better than current methods. For example, if you join a randomised trial for a new treatment, you will be chosen at random to receive either the best existing treatment or the modified new treatment. Over the years, trials have improved treatments and led to better outcomes for people diagnosed with cancer.

You may find it helpful to talk to your specialist, clinical trials nurse or GP, or to get a second opinion. If you decide to take part in a clinical trial, you can withdraw at any time.

For more information, see Clinical trials and research. To find current clinical trials near you, visit Cancer Institute NSW or Australian Cancer Trials.

You can also contact the Australasian Gastro-Intestinal Trials Group (AGITG).

Complementary therapies

Complementary therapies are designed to be used alongside conventional medical treatments (such as surgery, chemotherapy and radiation therapy) and can increase your sense of control, decrease stress and anxiety, and improve your mood.

Some Australian cancer centres have developed “integrative oncology” services where evidence-based complementary therapies are combined with conventional treatments to create patient-centred cancer care that aims to improve both wellbeing and clinical outcomes.

Let your doctor know about any therapies you are using or thinking about trying, as some may not be safe or evidence-based.

For more on this, see our general section on Complementary therapies, listen to our meditation and relaxation podcasts or call 13 11 20.

Alternative therapies are therapies used instead of conventional medical treatments. These are unlikely to be scientifically tested and may prevent successful treatment of the cancer. Cancer Council does not recommend the use of alternative therapies as a cancer treatment.