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Palliative care is treatment used to help control or reduce symptoms caused by cancer. It's not meant to cure the cancer.
If gallbladder cancer has spread too far to be removed by surgery, doctors may focus on palliative treatments. For instance, pain medicines and drugs to control nausea or itching might be used to help you feel better. Radiation and chemotherapy can also be used to help relieve problems caused by the tumor(s). Sometimes, surgery or other treatments are used to help you feel better or to help prevent problems the cancer might cause. Because gallbladder cancers tend to grow and spread quickly, doctors try to use palliative therapies that are less likely to have unpleasant short-term side effects, whenever possible. Your cancer care team will talk with you about the pros and cons of all the treatments that might help you
Here are some examples of procedures that might be used as part of palliative care for gallbladder cancer:
If cancer is blocking a duct that carries bile from the gallbladder or liver to the small intestine, it can lead to jaundice (yellowing of the skin and eyes) and other problems, like infection and liver failure. A small tube or a catheter can be put into the bile duct or the gallbladder to help the bile drain out.
These procedures can be done as part of a cholangiography procedure such as ERCP or PTC (see Tests for Gallbladder Cancer) or, in some cases, during surgery. They're often done to help relieve or prevent symptoms in more advanced cancers, but they can also be done to help relieve jaundice before potentially curative surgery is done. This helps lower the risk of complications from the surgery.
The stent or catheter may need to be replaced every few months to help reduce the risk of infection and gallbladder inflammation. It will also need to be replaced if it becomes clogged.
In people who are healthy enough, a surgery called biliary bypass is another option to allow bile to drain from the liver and gallbladder. There are different biliary bypass operations. Deciding which one to use depends on where the blockage is. In these procedures, the surgeon creates a bypass around the tumor blocking the bile duct by connecting part of the bile duct before the blockage with a part of the duct that lies past the blockage, or with the intestine itself. For instance:
Sometimes these operations can be done using special long surgical tools put through several small holes made in the abdomen (belly). This is called laparoscopic or keyhole surgery.
A biliary bypass can often give longer-lasting relief than a stent, which might need to be cleaned out or replaced. Still, this can be a major operation, so it’s important that you're healthy enough to withstand it and that you talk with your doctor about the possible benefits and risks before you have the surgery.
To relieve pain, doctors may deaden the nerves that carry pain signals from the gallbladder and intestinal area to the brain by injecting these nerves with alcohol. This can be done during surgery or through a long, hollow needle that's guided into place with the help of a CT scan.
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.
Labib PL, Davidson BR, Sharma RA, Pereira SP. Locoregional therapies in cholangiocarcinoma. Hepat Oncol. 2017;4(4):99-109.
National Cancer Institute. Gallbladder Cancer Treatment (PDQ®)–Patient Version. March 22, 2018. Accessed at www.cancer.gov/types/gallbladder/patient/gallbladder-treatment-pdq on June 26, 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 26, 2018.
Last Revised: July 12, 2018
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