Gallbladder Cancer

Treatment

Treatment may include surgery, chemotherapy, radiation, photodynamic therapy and investigational care provided through clinical trials.

The options for treatment are based on many factors, including:

• The location and size of the tumor
• How much the cancer has spread
• The overall health of the patient
• The stage (extent) of the cancer

Surgery

Surgery offers the best chance of curing gallbladder cancer. To determine if surgery is possible, Mayo specialists may order images of the gallbladder, bile ducts and the liver. Physicians often perform a laparoscopic procedure before a major operation to look for tumor metastasis (spread) not seen on noninvasive images. When physicians determine that surgery will benefit a patient, removal of the gallbladder, adjacent liver tissue and nearby lymph nodes (extended cholecystectomy) is the most common surgery. If the tumor is very small and hasn't spread to the deeper layers of gallbladder tissue, the surgeon may perform a simple cholecystectomy, which removes only the gallbladder. Occasionally this procedure can be done laparoscopically, using a camera and miniature instruments inserted through tiny incisions in the abdomen.

Chemotherapy

When the cancer has spread to other organs, medical oncologists may recommend chemotherapy. Current regimens do not cure gallbladder cancer, but sometimes slow the disease's progression. Prolonged tumor regression is unusual, and chemotherapy benefits sometimes last weeks to a few months. As part of an ongoing commitment to finding new and better therapies for patients with gallbladder cancer, Mayo Clinic oncologists actively conduct clinical trials.

Radiation Therapy

In radiation therapy, high-dose X-rays destroy cancer cells and shrink tumors. Used alone, radiation does not cure gallbladder cancer, but may increase a patient's chance of survival.

Mayo Clinic physicians may recommend radiation therapy in combination with chemotherapy (concurrent chemoradiation) either before or after surgery to remove the cancer. Concurrent chemoradiation may be preferred for gallbladder cancers that are localized (have not spread through the body) but cannot be removed with surgery or for cancers that have been removed surgically but are at risk for local relapse if no additional treatment is given. For local cancers that initially can't be removed, physicians may perform surgery and intraoperative radiation (IORT) after a course of preoperative chemoradiation.

When used, the external beam component of radiation is delivered using 3-D conformal techniques in an attempt to maximize the dose to the gallbladder cancer and lymph node regions that are at risk while minimizing the dose to normal organs and structures (liver, kidney, spinal cord, small intestine, stomach). Intensity modulated radiation (IMRT) is also being evaluated for patients with gastrointestinal cancers.