- How is gallbladder cancer treated?
- Surgery for gallbladder cancer
- Radiation therapy for gallbladder cancer
- Chemotherapy for gallbladder cancer
- Palliative therapy for gallbladder cancer
- Clinical trials for gallbladder cancer
- Complementary and alternative therapies for gallbladder cancer
- Treatment options based on the extent of gallbladder cancer
- More treatment information about gallbladder cancer
Chemotherapy for gallbladder cancer
Chemotherapy (chemo) is treatment with anti-cancer drugs that are usually given into a vein or by mouth. These drugs enter the bloodstream and reach all areas of the body, making this treatment useful for cancers that have spread outside the organs where they started. Chemotherapy may help some people with gallbladder cancer, but most studies have found its effectiveness against this type of cancer is limited.
For gallbladder cancers that are resectable, chemotherapy 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 the treatment of gallbladder cancer.
Chemotherapy may also be used (with or without radiation therapy) for more advanced cancers. Chemotherapy does not cure these cancers, but it may help shrink or slow the growth of tumors for a time. This may help relieve symptoms from the cancer, and may help people live longer.
Doctors give chemotherapy in cycles, with each period of treatment followed by a rest period to allow the body time to recover. Chemotherapy cycles generally last about 3 to 4 weeks. Chemotherapy is often not recommended for patients in poor health, but advanced age by itself is not a barrier to getting chemotherapy.
Hepatic artery infusion: Because the chemotherapy given into a vein is not always helpful, doctors have studied giving it a different way – directly into the hepatic artery. This is called hepatic artery infusion or HAI. Since the hepatic artery 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 was not removable by surgery to 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
Several drugs can be used to treat gallbladder cancer. The 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 may be combined to try to make them more effective. For example, one study found that 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
Chemotherapy drugs work by attacking 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, the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are also likely to be affected by chemotherapy, which can lead to side effects.
The side effects of chemotherapy depend on the type and dose of drugs given and the length of time they are taken. These side effects can include:
- Hair loss
- Mouth sores
- Loss of appetite
- Nausea and vomiting
- Increased chance of infections (from low white blood cell counts)
- Easy bruising or bleeding (from low blood platelet counts)
- Fatigue (from low red blood cell counts)
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 may 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 our document, Peripheral Neuropathy Caused by Chemotherapy.
You should report any side effects you notice while getting chemotherapy to your medical team so that they can be treated promptly. In some cases, the doses of the chemotherapy drugs may need to be reduced or treatment might need to be delayed or stopped to prevent the effects from getting worse.
For more general information about chemotherapy, please see our document, Understanding Chemotherapy: A Guide for Patients and Families.
Last Medical Review: 04/30/2012
Last Revised: 01/18/2013