Gallbladder cancer, according to the National Institutes of Health (NIH), is rare. It is usually found in late stages, making it difficult to treat. The Mayo Clinic explains that the choice of treatment depends on the stage of the cancer, the patient's state of health and personal preferences. There are three standard treatments for gallbladder cancer.
Surgery
According to the Mayo Clinic, cancer still confined to the gallbladder is treated with cholecystectomy, or surgical removal of the gallbladder. The gall bladder is usually removed by open cholecystectomy, whereby a large incision is made through the front of the abdomen. This is the recommended approach whenever cancer of the gallbladder is present, according to the American Cancer Society (ACS). Another method of removing the gallbladder, laparoscopic cystectomy, is best avoided in the treatment of gallbladder cancer as there is a danger of accidental spread of the cancer during the procedure. Extension of the cancer beyond the gallbladder usually involves more extensive surgery, or radical cholecystectomy. This involves removal of portions of the liver surrounding the gallbladder, removal of the bile duct and surrounding lymph nodes. According to the ACS, depending on the extent of spread, radical cholecystectomy can involve removal of other organs close to the gallbladder like the pancreas, duodenum, common bile duct and more of the liver--up to a whole lobe.
In advanced cases of cancer, where there is extensive spread of the cancer, surgery may be used to reduce discomfort and prolong the life of the patient. This is called palliative surgery. According to the National Cancer Institute (NCI), procedures like relieving intestinal obstruction and biliary bypass to provide alternative routes for emptying a blocked gallbladder are all examples of palliative surgery.
Radiation Therapy
Radiation uses high-powered beams of energy, such as X-rays, to kill cancer cells or stop them from growing. Radiation therapy can be used prior to gallbladder surgery to shrink the tumor mass and make the surgery simpler, states the ACS. This is called neoadjuvant radiation therapy. Radiation therapy could also be used after surgery in an attempt to kill any cancerous cells missed by surgery, a procedure known as adjuvant therapy. Additionally, radiation therapy is also used as palliative treatment in terminal cases of gallbladder cancer.
The usual method of radiation therapy is external beam radiation therapy (EBRT), which uses sources of radiation placed outside the body. A more modern approach of external radiation therapy, called 3-dimensional conformal radiation therapy (3D-CRT), allows more precise delivery of radiation to the tumor mass. According to the ACS, a combination of radiation therapy and chemotherapy, called chemoradiation, has been shown to prolong life after surgery in patients with lymph node involvement in gallbladder cancer. The same combination is also used to treat advanced, usually inoperable, cases of gallbladder cancer, especially where there is widespread metastasis.
Chemotherapy
According to the ACS, chemotherapy has not been found to be very effective against gallbladder cancer, thus it is not a common treatment for this type of cancer. Chemotherapy is sometimes used with radiation therapy after surgery to prevent relapse in gallbladder cancer. It can also be used as a palliative treatment. Chemotherapy is not usually recommended for people with poor health. According to the ACS, commonly used drugs in gallbladder cancer are gemcitabine, 5-fluorouracil and cisplatin. Other drugs mentioned by the ACS in the treatment of gallbladder cancer are mitomycin C, doxorubicin and capecitabine.
