Cancer is complex — there is no routine gallbladder cancer, nor is there ever a routine way to treat it.

The OSUCCC – James physicians are nationally and internationally renowned in research and patient care for their one particular cancer. Because of that expertise and understanding of cancer’s complexities and how it acts and reacts differently in each person, the very best outcomes — and the most effective means of treating cancer patients — come from a team approach.

At the OSUCCC – James, gallbladder cancer patients have a team of experts that includes medical oncologists, surgical oncologists, radiation oncologists, geneticists, gastroenterologists, hepatologists, nutritionists and more. Also on that team are gallbladder cancer researchers who help sequence tumors to identify key molecules that fuel each patient’s cancer and who then develop drugs that target only those particular molecules. Many of our experts also help write the national clinical guidelines for treatments.

As one of only four cancer centers in the country funded by the National Cancer Institute to conduct both phase I and phase II clinical trials, the OSUCCC – James offers patients access to more clinical trials than nearly any other cancer hospital in the country and to more of the latest, most targeted, most effective treatment options — many that are available nowhere else but at the OSUCCC – James.

There are several types of treatment for gallbladder cancer. The OSUCCC – James team of subspecialists determine the best treatment for each patient based on his or her specific, individual gallbladder cancer. Patients may receive one treatment or a combination of treatments.

Gallbladder & Bile Duct Cancer Treatment

The following treatments are available for gallbladder and bile duct cancers.

Surgery


Cholecystectomy

If a gallbladder cancer is resectable — that is, if it can be removed with surgery — a surgeon removes the gallbladder and some surrounding tissue. The surgeon also might remove a portion of the liver and nearby lymph nodes. This surgery usually is an option for patients with localized gallbladder cancer. This surgery often is performed using a laparoscope.

Surgical Biliary Bypass

A surgical biliary bypass is used for tumors blocking the small intestine and causing bile to build up in the gallbladder. The surgeon makes an incision in the gallbladder or bile duct and reattaches the small intestine to create a new path around the blocked area.

Percutaneous Transhepatic Biliary Drainage

This procedure drains bile by using X-rays or ultrasound to locate the blockage and ultrasound to guide placement of a stent, a small device that allows bile to continue to drain.

Endoscopic Stent Placement

A stent can be placed through a catheter to drain bile and to make way around a blocked area in the gallbladder or bile duct to drain bile into the small intestine.

Radiation Therapy

Patients who have gallbladder surgery may receive radiation therapy following their surgery. Radiation therapy uses high-energy X-rays or other types of radiation to destroy cancer cells.

Chemotherapy

A patient who has surgery may have chemotherapy following surgery to destroy any remaining gallbladder cancer cells. Chemotherapy uses drugs to destroy cancer cells or stop the cells from dividing. Chemotherapy drugs taken by mouth or injected into a vein or muscle enter the bloodstream and reach cancer cells throughout the body. This is called systemic chemotherapy.

When chemotherapy is placed directly into an organ or a body cavity such as the abdomen, the drugs mainly affect cancer cells in that area, which is called regional chemotherapy. The delivery of the chemotherapy depends on the type and stage of the cancer being treated.

Targeted Therapy

Targeted therapy uses specific drugs that attack cancer cells without destroying healthy cells. These therapies are particularly effective in treating many stages of gallbladder cancer with fewer harmful side effects than traditional chemotherapy. An example is selumetinib, a targeted agent that inhibits the MEK protein, which the cancer cells need to multiply and survive.

Gastrointestinal biomarker

Radiation Sensitizers

Clinical trials are analyzing ways to improve the effect of radiation therapy on tumor cells, including:

  • Hyperthermia Therapy: Cancer tissue is exposed to high temperatures to damage and destroy cancer cells or to make cancer cells more sensitive to the effects of radiation therapy and anticancer drugs
  • Radiosensitizers: Make tumor cells more sensitive to radiation therapy and can destroy more gallbladder tumor cells

Unresectable, Recurrent or Metastatic Gallbladder Cancers

Patients who have cancer that is not operable (unresectable), recurrent (meaning that it has returned) or metastatic (meaning that it has spread to other parts of the body) are often enrolled in a clinical trial.

These patients may receive one of the following treatments, along with the clinical trial therapy:

  • Surgery to relieve symptoms
  • Chemotherapy to stop progression of the cancer cells
  • Percutaneous transhepatic biliary drainage and stent placement to relieve symptoms

Bile Duct Cancer Treatment

Your targeted treatment for bile duct cancer can include a number of options, based on your cancer type and stage. Treatment often includes a combination of therapies to manage the cancer and to relieve symptoms. 

Your treatment also may be combined with enrollment in a clinical trial.

Surgery

Types of surgery for bile duct cancer include:

Bile Duct Removal

A surgeon removes a tumor located only in the bile duct and creates a new duct. Nearby lymph nodes are removed and analyzed under a microscope to determine whether they are cancerous.

Surgical Biliary Bypass

Localized extrahepatic bile duct cancer may be treated with stent placement or a biliary bypass. These procedures relieve blockages of the bile duct and the resulting jaundice, or yellowing of the skin, caused by such blockages.

Partial Hepatectomy

A partial hepatectomy is removal of the portion of the liver where cancer is found.

Whipple Procedure

In a Whipple procedure, the head of the pancreas, the gallbladder, part of the stomach, part of the small intestine and the bile duct are removed. The surgeon leaves enough of the pancreas so that it can still produce digestive liquids and insulin.

Stent Placement

A stent, or thin tube-like device, can be placed in a bile duct if a tumor is blocking the duct. The stent allows bile to drain.

Radiation Therapy

Patients may have radiation therapy in addition to surgery or be treated with radiation therapy alone. Radiation therapy uses high-energy X-rays or other types of radiation to destroy cancer cells.

Chemotherapy

A patient who has surgery may have chemotherapy following surgery to destroy any remaining bile duct cancer cells. Chemotherapy uses drugs to destroy cancer cells or stop the cells from dividing. Chemotherapy drugs taken by mouth or injected into a vein or muscle enter the bloodstream and reach cancer cells throughout the body. This is called systemic chemotherapy.

When chemotherapy is placed directly into an organ or a body cavity such as the abdomen, the drugs affect cancer cells in that area, which is called regional chemotherapy. The delivery of the chemotherapy depends on the type and stage of the cancer being treated.

Targeted Therapy

Targeted therapies are drugs that attack cancer cells without destroying healthy surrounding tissue. These therapies are particularly effective in treating many stages of bile duct cancer with fewer harmful side effects than traditional chemotherapy. An example is selumetinib, a targeted agent that inhibits the MEK protein, which the cancer cells need to multiply and survive.

Gastrointestinal biomarker

Radiation Sensitizers

Clinical trials are analyzing ways to improve the effect of radiation therapy on tumor cells, including:

  • Hyperthermia Therapy: Diseased tissue is exposed to high temperatures to damage and destroy cancer cells or to make cancer cells more sensitive to the effects of radiation therapy and anticancer drugs
  • Radiosensitizers: Make tumor cells more sensitive to radiation therapy and can destroy more tumor cells

Clinical Trials

For cancer patients, clinical trials mean hope. Hope for a cancer-free world and for better, more targeted ways to prevent, detect, treat and cure individual cancers. Patients can enter clinical trials before, during or after starting their cancer treatment.

The OSUCCC – James has more than 500 open clinical trials at any given time, with some of the world’s latest discoveries available to clinical trial patients right here in Columbus, Ohio. In fact, patients have access to more cancer clinical trials here than at nearly any other hospital in the region as well as access to some of the most advanced, targeted treatments and drugs available.

The OSUCCC – James is one of only four U.S. cancer centers funded by the National Cancer Institute (NCI) to conduct phase I and phase II clinical trials. These trials go only to centers that demonstrate an exemplary capacity for research and clinical care, the expertise to deliver the latest in treatments and the infrastructure to interpret and track treatment results.

Additionally, Ohio State has nearly 300 cancer researchers dedicated to understanding what makes each patient’s cancer grow, move, metastasize or reoccur. Because of the OSUCCC – James’ NCI phase I and phase II approvals, these experts can move research discoveries into clinical trials and make them available to patients sooner.

 

If you have received a gallbladder or bile duct cancer diagnosis, or if you want a second opinion or just want to speak to a gallbladder or bile duct cancer specialist, we are here to help you. Call 800-293-5066 or 614-293-5066 to make an appointment.

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The James Cancer Hospital and Solove Research Institute

460 West 10th Avenue

Columbus, Ohio 43210

800-293-5066 or 614-293-5066

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