Mayo Clinic offers the latest advances in treatment, such as surgery, chemotherapy and radiation therapy. Treatment options depend on several factors, including:
- Location and size of the tumor
- Stage (extent) of the cancer
- Your overall health
Surgery offers the best chance of curing early-stage cancer that has not spread beyond the gallbladder. To determine if surgery is possible, Mayo specialists may order images of your gallbladder, bile ducts and the liver. Doctors typically will use a camera and miniature instruments inserted through tiny incisions in the abdomen (laparoscopic surgery) to see if the tumor has spread (metastasized). Surgery options include:
- Simple cholecystectomy (ko-luh-sys-TEK-tuh-me). If the tumor is very small and has not spread to the deeper layers of gallbladder tissue, the surgeon may use this procedure, which removes only the gallbladder. Occasionally this procedure can be done using laparoscopic surgery.
- Extended cholecystectomy. This is the most commonly performed surgery, involving removal of the gallbladder, the liver tissue next to it, and nearby lymph nodes.
- When the cancer has spread to other organs, medical oncologists may recommend chemotherapy.
- Chemotherapy currently does not cure advanced gallbladder cancer, but sometimes slows the disease's progression.
Radiation refers to high-dose X-rays that destroy cancer cells and shrink tumors. Used alone, radiation does not cure gallbladder cancer, but may increase the chance of survival.
Mayo Clinic doctors may recommend radiation therapy in combination with chemotherapy (chemoradiation) either before or after surgery. Chemoradiation may be used for gallbladder cancers that have not spread throughout the body but cannot be removed by surgery, or for cancers that have been removed but might come back without more treatment. Radiation options given with chemotherapy include:
- 3-D CRT. In three-dimensional conformal radiation therapy (3-D CRT), a computer is used to create a 3-D picture of the tumor to conform or match the radiation beam to the shape of the tumor. Many radiation beams are aimed at the tumor from different angles, sparing normal tissue as much as possible.
- IMRT. Some patients may benefit from intensity modulated radiation therapy (IMRT). As with 3-D CRT, this technique attempts to maximize the radiation dose to the gallbladder cancer and lymph node regions at risk, while minimizing the dose to nearby healthy organs.
In some cases, doctors may use chemoradiation before surgery, followed by intraoperative radiation therapy (IORT). IORT delivers a concentrated beam of radiation to tumors as they are found during surgery.
Jul. 23, 2011
- Gallbladder cancer treatment (PDQ). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/gallbladder/Patient/AllPages. Accessed May 23, 2011.
- Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008:1580.
- Blechacz B, et al. Tumors of the bile ducts, gallbladder and ampulla. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed May 23, 2011.
- Hepatobiliary cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed May 23, 2011.