Treatment may also depend on the age and general health of the patient and whether the cancer is causing symptoms.
Gallbladder cancer can be cured only if it is found before it has spread, when it can be removed by surgery. If the cancer has spread,Â palliative treatment can improve the patient's quality of life by controlling the symptoms and complications of this disease
Three types of standard treatment are used:
Gallbladder cancer may be treated with a cholecystectomy, surgery to remove the gall bladder and some of the tissues around it. Nearby lymph nodes may be removed. A laparoscope is sometimes used to guide gallbladder surgery. The laparoscope is attached to a video camera and inserted through anincision (port) in the abdomen. Surgical instruments are inserted through other ports to perform the surgery. Because there is a risk that gallbladder cancer cells may spread to these ports, tissue surrounding the port sites may also be removed.
If the cancer has spread and cannot be removed, the following types of palliative surgery may relievesymptoms:
Surgical biliary bypass: If the tumor is blocking the small intestine and bile is building up in the gallbladder, a biliary bypass may be done. During this operation, the gallbladder or bile duct will be cut and sewn to the small intestine to create a new pathway around the blocked area.
Endoscopic stent placement: If the tumor is blocking the bile duct, surgery may be done to put in a stent (a thin, flexible tube) to drain bile that has built up in the area. The stent may be placed through a catheter that drains to the outside of the body or the stent may go around the blocked area and drain the bile into the small intestine.
Percutaneous transhepatic biliary drainage: A procedure done to drain bile when there is a blockage and endoscopic stent placement is not possible. AnÂ x-ray of the liver and bile ducts is done to locate the blockage. Images made by ultrasound are used to guide placement of a stent, which is left in the liver to drain bile into the small intestine or a collection bag outside the body. This procedure may be done to relieve jaundice before surgery.
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer.Â Internal radiation therapyÂ uses aÂ radioactivesubstance sealed in needles,Â seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type andÂ stageÂ of the cancer being treated.
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injectedÂ into aveinÂ or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into theÂ cerebrospinal fluid, anÂ organ, or a bodyÂ cavityÂ such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated
Treatment Options for Gallbladder Cancer
Localized Gallbladder Cancer
Treatment of localized gallbladder cancer may include the following:
Surgery to remove the gallbladder and some of the tissue around it. Part of the liver and nearbylymph nodes may also be removed. Radiation therapy with or without chemotherapy may follow surgery.
Radiation therapy with or without chemotherapy.
Unresectable, Recurrent, or Metastatic Gallbladder Cancer
Treatment of unresectable, recurrent, or metastatic gallbladder cancer is usually within a clinical trial. Treatment may include the following:
Percutaneous transhepatic biliary drainage or the placement of stents to relieve symptoms caused by blocked bile ducts. This may be followed by radiation therapy as palliative treatment.
Surgery as palliative treatment to relieve symptoms caused by blocked bile ducts.