Chemotherapy for Gallbladder Cancer
Chemotherapy (chemo) is treatment with anti-cancer drugs that are usually given into a vein or taken by mouth. These drugs enter the bloodstream and reach all areas of the body, making this treatment useful for cancers that have spread beyond where they started. Chemo can help some people with gallbladder cancer, but so far its effects against this type of cancer has been found to be limited.
For resectable gallbladder cancers, chemo may be used after surgery (often along with radiation therapy) to try to lower the risk that the cancer will return. This is called adjuvant treatment. Doctors aren’t yet sure how useful it is in treating gallbladder cancer.
Chemo can also be used (with or without radiation therapy) for more advanced cancers. Chemo does not cure these cancers, but it might shrink or slow the growth of tumors for a time. This can help relieve symptoms from the cancer, and may help people live longer.
Doctors give chemo in cycles, with each period of treatment followed by a rest period to allow the body time to recover. Chemo cycles generally last about 3 to 4 weeks. Chemo is often not recommended for patients in poor health, but advanced age by itself is not a barrier to getting chemotherapy.
Hepatic artery infusion (HAI): Because giving chemo into a vein is not always helpful for gallbladder cancer, doctors have studied giving it a different way – directly into the main artery going into the liver, called the hepatic artery. Since the hepatic artery also supplies most gallbladder tumors, more chemo goes to the tumor. The healthy liver then removes most of the remaining drug before it can reach the rest of the body. This can lessen the chemo side effects. HAI may help some people whose cancer couldn’t be removed by surgery live longer, but more research is needed. This technique may not be useful in some patients because it often requires surgery to insert a catheter into the hepatic artery, an operation that many gallbladder cancer patients may not tolerate well.
Drugs used to treat gallbladder cancer
The chemo drugs most often used for gallbladder cancer include:
- Gemcitabine (Gemzar®)
- Cisplatin (Platinol®)
- 5-fluorouracil (5-FU)
- Capecitabine (Xeloda®)
- Oxaliplatin (Eloxatin®)
In some cases, 2 of these drugs are combined to try to make them more effective. For example, combining gemcitabine and cisplatin may help people live longer than getting just gemcitabine alone. When chemo is given with radiation, most often 5-FU or capecitabine is used.
Possible side effects
Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow (where new blood cells are made), the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells can also be affected by chemo, which can lead to side effects.
The side effects of chemo depend on the type and dose of drugs given and the length of time they are taken. Side effects can include:
- Hair loss
- Mouth sores
- Loss of appetite
- Nausea and vomiting
- Increased chance of infections (from having too few white blood cells)
- Easy bruising or bleeding (from having too few blood platelets)
- Fatigue (from having too few red blood cells)
These side effects are usually short-term and go away after treatment is finished. There are often ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting. Be sure to ask your doctor or nurse about medicines to help reduce side effects.
Along with the possible side effects above, some drugs can have their own specific side effects. For example, cisplatin and oxaliplatin can damage nerves (called neuropathy). This can cause numbness, tingling, weakness, and sensitivity to cold or heat, especially in the hands and feet. This goes away in most patients after treatment stops, but in some cases the effects can be long lasting. For more information, see Peripheral Neuropathy Caused by Chemotherapy.
Report any side effects you notice while getting chemo to your medical team so that they can be treated promptly. In some cases, the doses of the chemo drugs may need to be reduced or treatment might need to be delayed or stopped to prevent the effects from getting worse.
Last Medical Review: October 29, 2014 Last Revised: February 5, 2016