Chemotherapy is treatment with anticancer 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 in some cancers that have spread or metastasized to organs beyond the gallbladder. Unfortunately, gallbladder cancer seems to be resistant to chemotherapy, and for that reason it is not widely or consistently used against this disease.

Chemotherapy alone cannot cure gallbladder cancer, and there is no chemotherapy regimen known to consistently prolong survival in people with gallbladder cancer if used without surgery or radiation therapy. For those reasons, chemotherapy is used as an adjuvant therapy (used in addition with a main therapy, usually surgery, to boost its effectiveness).

Some studies have found that chemotherapy drugs, such as mitomycin or a combination of 5-fluorouracil (5-FU), doxorubicin, and mitomycin can shrink gallbladder cancers. Unfortunately, the percentage of patients whose tumors are reduced by 50% or more in response to the drugs has been small. As a result, most doctors do not recommend chemotherapy to be used with surgery. Recently, doctors have reported some success with a new combination of chemotherapy drugs that used gemcitabine and cisplatin as well as another drug called capecitabine.

Some doctors feel that chemotherapy has more effect on gallbladder cancer when used in combination with radiation therapy. That combination has shown some ability to control gallbladder cancer for short periods of time when used either with or without surgery. More studies are planned with these and similar combination therapies.

Direct hepatic arterial infusion (injection of the drugs directly into the artery that brings blood to the liver) with a combination of drugs has been shown to allow some people whose cancer was not removable by surgery to live longer.

Chemotherapy drugs kill cancer cells but also damage some normal cells, causing side effects. Side effects that might occur depend on the type of drugs used, the amount taken, and the length of treatment. Temporary side effects might include nausea and vomiting, loss of appetite, loss of hair, and mouth sores. Because chemotherapy can damage the blood-producing cells of the bone marrow, patients may have low blood cell counts. This can increase the chance of infection (due to a shortage of white blood cells), bleeding or bruising after minor cuts or injuries (due to a shortage of blood platelets), and fatigue (due to a shortage of red blood cells).

Careful attention is given to using the right amount of drug to treat the cancer while causing the least amount of side effects possible. Most side effects disappear once treatment is stopped. There are remedies for many of the temporary side effects of chemotherapy. For example, anti-emetic drugs can be given to prevent or reduce nausea and vomiting. Last Revised: 08/06/2006