Your doctor will help you decide on the best type of treatment, which will depend on the type of gall bladder cancer you have, whether or not the cancer has spread, your age, fitness and general health, and your preferences.
You will be cared for by a multi-disciplinary team (MDT) of health professionals during your treatment for gall bladder cancer, which may include a surgeon, pathologist, gastroenterologist, dietitian and psychologist, among others.
Surgery is the main treatment for gall bladder cancer, especially for people with early-stage disease where the gall bladder can be completely removed.
Surgery to remove the gall bladder is called a cholecystectomy. Often, surrounding tissue including lymph nodes, adjacent bile ducts and part of the liver will also be removed if gall bladder cancer is suspected. Surgery may be performed as either open surgery or keyhole (laparoscopic) surgery.
If the cancer has spread and the tumour is pressing on or blocking the bile duct, you may need a stent, which is a small tube made of either plastic or metal. A stent holds the bile duct open and allows bile to flow into the small bowel again.
Common side effects of surgery can include bleeding, damage to nearby tissue and organs (including liver failure and bile leakage), pain, infection after surgery, blood clots, weak muscles (atrophy) and lymphoedema.
Your doctor or nurse may suggest you take part in a clinical trial. Doctors run clinical trials to test new or modified treatments and ways of diagnosing disease to see if they are better than current methods. Over the years, trials have improved treatments and led to better outcomes for people diagnosed with cancer.
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External beam radiation therapy
Radiation therapy uses high energy rays to destroy cancer cells, where the radiation comes from a machine outside the body. It is often given with chemotherapy in a treatment known as chemoradiation. It may be used for gall bladder cancer:
- after surgery, to destroy any remaining cancer cells and stop the cancer coming back
- if the cancer can’t be removed with surgery
- if the cancer has spread to other parts of the body (e.g. palliative radiation for the management of symptoms such as pain).
Radiation therapy does not hurt and is usually given in small doses over a period of time to minimise side effects. Each treatment only takes a few minutes, but the set-up time can take longer.
Common side effects of radiation therapy can include fatigue, nausea and vomiting, liver damage, bowel issues such as diarrhoea, skin problems, loss of fertility and early menopause.
Chemotherapy is the use of drugs to kill or slow the growth of cancer cells. You may have one chemotherapy drug or a combination of drugs, usually given through a drip into a vein (intravenously) or as a tablet that is swallowed. Your treatment will depend on your situation and the stage of your tumour.
Chemotherapy is commonly given in treatment cycles which may be daily, weekly or monthly. The length of the cycle and number of cycles depends on the chemotherapy drugs being given.
Common side effects of chemotherapy can include fatigue, loss of appetite, nausea and vomiting, bowel issues such as diarrhoea, hair loss, mouth sores, skin and nail problems, increased chance of infections, loss of fertility and early menopause.
Complementary therapies are designed to be used alongside conventional medical treatments and can increase your sense of control, decrease stress and anxiety, and improve your mood. Some examples include acupuncture, yoga, music therapy, counselling and hypnotherapy, among others.
Some Australian cancer centres have developed 'integrative oncology' services where evidence-based complementary therapies are combined with conventional treatments to create patient-centred cancer care that aims to improve both wellbeing and clinical outcomes.
Nutrition and exercise
Eating well and being physically active can help you cope with some of the side effects of cancer treatment, speed up your recovery and improve your quality of life by giving you more energy, keeping your muscles strong and boosting your mood.
If your gall bladder has been removed, you can still break down fats in your small intestine. The bile simply flows directly from your liver to your duodenum, rather than passing through your gall bladder first. You should still be able to eat a normal diet after your gall bladder is removed, but it is a good idea to avoid high-fat foods for a few weeks after surgery while your body adjusts.
Once your treatment has finished, you will have regular check-ups to confirm that the cancer hasn’t come back. Ongoing surveillance for gall bladder cancer involves a schedule of scans and physical examinations. For some people gall bladder cancer does come back after treatment, which is known as a recurrence.
If this happens, treatment will depend on where the cancer has returned to in your body and may include a mix of surgery, radiation therapy and chemotherapy. In some cases of advanced cancer, palliative treatment will focus on managing symptoms, such as pain, and improving your quality of life without trying to cure the disease.
Some useful questions to consider asking your doctor include:
- What type of gall bladder cancer do I have?
- How far has the cancer spread? What stage of cancer do I have?
- Have you treated this type of cancer before? If so, how many times? Is there another doctor who has more experience treating this type of cancer?
- What are the treatment options for me? What do you recommend and why?
- What are the possible risks and side effects of my treatment? How will these be managed?
- How complex is the surgery and how long does the operation take? Will I have to stay in hospital?
- Is this treatment covered by Medicare/private insurance? Will there be extra expenses?
- Are there any complementary therapies that might help me?
- Do you know of any support groups or support services I can use?
- What are the possible benefits and risks to me joining this clinical trial? What is being tested and why?
- How many people will be involved in this trial?
- If I cannot get onto a clinical trial can I still pay for a drug that is currently in trial?
Understanding Gall Bladder Cancer
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Expert content reviewers:
Kathleen Boys, Consumer; Dr Julian Choi, HPB Surgeon, Western Health and Epworth Hospital, Vic; David Fry, Consumer; Dr Robert Gandy, Hepatobiliary Surgeon, Prince of Wales Hospital, Randwick, NSW; Yvonne King 13 11 20 Consultant, Cancer Council NSW; Elizabeth Lynch, Consumer; Dr Jenny Shannon, Medical Oncologist, Nepean Hospital Cancer Centre, NSW.
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The information on this webpage was adapted from Understanding Gall Bladder Cancer - A guide for people affected by cancer (2021 edition). This webpage was last updated in June 2021.