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Chemotherapy (chemo) is treatment with anti-cancer drugs that
are 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.
Unfortunately, chemotherapy has not been found to be very effective
against, gallbladder cancer, which is why it's not often used against
this disease.
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. Chemotherapy may also be
used (with or without radiation therapy) for more advanced cancers.
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 of the poor response to regular
chemotherapy, doctors have studied giving it a different way -- by
hepatic artery infusion (HAI). In this technique the chemotherapy is
given not into a vein, but directly into the hepatic artery. 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 allow some people whose cancer was not removable by
surgery live longer, but more research is needed. This technique may
not be useful in all 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. In some
cases, 2 or more of these drugs may be combined to try to make them
more effective. The drugs most often used for gallbladder cancer
include:
- 5-fluorouracil (5-FU)
- gemcitabine
- mitomycin C
- doxorubicin (Adriamycin®)
- cisplatin
- capecitabine (Xeloda®)
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 (due to low white
blood cell counts)
- easy bruising or bleeding (due to low blood
platelet counts)
- fatigue (due to 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, there are drugs that 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, and tell them when you do
have side effects so they can be managed effectively.
For more general information about chemotherapy, please see
our document, Understanding Chemotherapy: A
Guide for Patients and
Families.
Last Medical Review: 11/02/2009
Last Revised: 11/02/2009
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