Gallbladder and bile duct cancer treatment

Gallbladder and bile duct cancers are rare, so you may want to talk to your doctor about being referred to a specialist treatment centre with a multidisciplinary team (MDT) that regularly manages this cancer.

The MDT will work out the best treatment, depending on:

• the type and location of the cancer
• if the cancer has spread
• your health
• your own preferences.

You may also want to get a second opinion from another specialist team to confirm or explain the treatment options.

Surgery, radiation therapy and chemotherapy are the main treatments for gallbladder cancer and bile duct cancer. Immunotherapy and targeted therapy are also used to treat these cancers. You might have one or more of these treatments – either on their own or combined.

Surgery is the most common treatment for gallbladder cancer and bile duct cancer. For people with early-stage disease, the gallbladder can be completely removed and the bile duct openings in the liver can be attached directly to the bowel.

Sometimes a stent (small tube made of plastic or metal) will be inserted into the bile duct to help the bile flow past a blockage into the small bowel. 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.

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

Also called radiotherapy, radiation therapy uses a controlled dose of radiation to kill or damage cancer cells. External beam radiation therapy (EBRT) uses radiation from a large machine called a linear accelerator. The radiation is usually from x-ray beams.

You lie on a table and the machine delivers radiation to the targeted area. Each radiation session takes 10–20 minutes and is painless. A typical treatment plan might involve a session of radiation therapy every weekday for 4–6 weeks. In some instances, radiation therapy is given over a much shorter time period. The dose and duration of radiation therapy is decided by your radiation oncologist.

Selective internal radiation therapy (SIRT) is sometimes used for bile duct cancer. In SIRT, tiny radioactive beads (microspheres) made of resin or glass are inserted into your body, and target the tumour through the bloodstream.

Chemotherapy uses 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 the 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. Chemotherapy is commonly given in cycles which may be daily, weekly or monthly. For example, a cycle may last 3 weeks – 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 drugs being given.

Learn more about chemotherapy or call Cancer Council 13 11 20.

Immunotherapy is a drug treatment that uses the body’s own immune system to fight cancer. There are several different types of immunotherapy.

Targeted therapy is a type of drug treatment. It attacks specific cancer cell features, known as molecular targets, to stop the cancer growing and spreading. Targeted therapy is not suitable for everyone. Your doctors may test the cancer to see if the cells contain a particular molecular target.

Your doctor may suggest you take part in a clinical trial. Clinical trials 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’ll 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. 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).