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Chemotherapy (chemo) is treatment with cancer-killing drugs that are usually given into a vein (IV) 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 it's not clear how useful it is for this type of cancer. Still, chemo might be used in these ways:
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 usually isn't recommended for patients in poor health, but advanced age by itself isn't a barrier to getting chemotherapy.
Because giving chemo into a vein (IV) isn't always helpful for gallbladder cancer, doctors have studied a different way to give it – right into the main artery going into the liver, called the hepatic artery. The hepatic artery also supplies most gallbladder tumors, so putting chemo into this artery means 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 often requires surgery to put a catheter into the hepatic artery, and many people with gallbladder are not well enough to have this surgery.
The chemo drugs most often used for gallbladder cancer include:
In some cases, 2 of these drugs are combined. 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.
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 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:
These side effects are usually short-term and go away after treatment ends. There are often ways to lessen these side effects or even prevent them. 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.
Report any side effects you notice to your medical team so that they can be treated right away. Most side effects can be treated. In some cases, the doses of the chemo drugs may need to be reduced or treatment might need to be delayed or stopped to keep the effects from getting worse.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Abou-Alfa GK, Jarnagin W, Lowery M, D’Angelica M, Brown K, Ludwig E, Covey A, Kemeny N, Goodman KA, Shia J, O’Reilly EM. Liver and bile duct cancer. In: Neiderhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, PA. Elsevier; 2014:1373-1395.
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National Cancer Institute. Gallbladder Cancer Treatment (PDQ®)–Health Professional Version. January, 2018. Accessed at www.cancer.gov/types/gallbladder/hp/gallbladder-treatment-pdq#section/_51 on June 25, 2018.
National Comprehensive Cancer Network, Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Hepatobiliary Cancers, Version 2.2018 -- June 7, 2018. Accessed at www.nccn.org/professionals/physician_gls/pdf/hepatobiliary.pdf on June 25, 2018.
Patel T, Borad MJ. Carcinoma of the biliary tree. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2015:715-735.
Zaidi MY, Maithel SK. Updates on gallbladder cancer management. Cur Onc Rep. 2018;20(21):1-7.
Last Revised: July 12, 2018
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