Receiving a gallbladder cancer diagnosis may be frightening for you and your loved ones. You may have a lot of unanswered questions and concerns. At the OSUCCC – James, our renowned team of experts is committed to helping you understand your disease so that you can make the best choice for your cancer care.
The OSUCCC – James uses a collaborative multidisciplinary approach, where oncologists, surgeons and other members of your care team develop a highly targeted treatment plan.
Gallbladder cancer is an aggressive disease typically not diagnosed until its more advanced stages. Depending on your diagnosis, there are different treatments available; your doctor may recommend one or a combination of them.
Gallbladder and bile duct cancer treatment options
There are several surgical and nonsurgical approaches for treating gallbladder and bile duct cancers.
Surgical treatment options for gallbladder cancer
Depending on the location of your cancer and if any blockage due to a tumor is found, one of the procedures below may be recommended.
Cholecystectomy
Resectable gallbladder cancer is cancer that is local to the gallbladder and can be surgically removed. A cholecystectomy involves your surgeon removing the gallbladder and potentially some surrounding tissue (your surgeon may recommend removing a portion of the liver and nearby lymph nodes). If tissue, lymph nodes or a portion of the liver need to be removed, this is known as an extended cholecystectomy.
This surgery is performed using a laparoscope (assisted by robotics) and is used to remove cancer that has not spread beyond the gallbladder.
Surgical biliary bypass
Biliary bypass is a surgical procedure intended to remove blockage from your bile duct(s). Cancerous tumors can also block the small intestine and cause bile buildup in the gallbladder. Your surgeon will make a small incision in your gallbladder or bile duct and reattach the small intestine, creating a new path for bile distribution around the blocked area.
Percutaneous transhepatic biliary drainage
Bile is drained from a blocked area using X-ray or ultrasound technology, which guides a stent to the blockage and removes the bile buildup.
Endoscopic stent placement
If needed, a stent can be placed through a catheter to drain bile buildup and create a new path around blockage. This helps bile be drained from the bile duct into the small intestine.
Surgical treatment options for bile duct cancer
If your bile duct cancer is operable, your doctor may recommend one of several treatment options.
Bile duct removal
There are two elements to bile duct removal surgery. First, your surgeon will remove a tumor that is located only in the bile duct. Second, nearby lymph nodes are removed and examined to determine if they are cancerous.
Surgical biliary bypass
Localized extrahepatic bile duct cancer, i.e., cancer that has not spread beyond the bile duct, can be treated with a stent placement or biliary bypass. These procedures remove bile duct blockages and alleviate the jaundice those blockages cause.
Partial hepatectomy
A portion of the liver, where cancer has been found, is removed via surgery.
Whipple procedure
The Whipple is an innovative and minimally invasive robotic procedure that removes the head of the pancreas, gallbladder, part of the stomach, part of the small intestine and the bile duct. Enough of the pancreas remains so that insulin and digestive liquids can still be produced.
The Whipple procedure is performed to prevent cancer from spreading beyond the bile duct.
Stent placement
If a tumor is blocking the bile duct, your surgeon may place a thin tube-like device (called a stent) into the bile duct to allow the bile to drain.
Nonsurgical treatments for gallbladder and bile duct cancer
Advancements in medicine and medical technology have led to new treatment options that don’t involve surgery. Your doctor may recommend one or more nonsurgical treatments if surgery is not necessary or feasible.
Chemotherapy
Following surgery, your doctor may recommend chemotherapy treatment to destroy any remaining gallbladder or bile duct cancer cells. Chemotherapy uses drugs that destroy cancer cells or stop them from dividing and is administered either through injection into a vein or by mouth (pill).
There are two common types of chemotherapy, and they may also be given prior to surgery to shrink a tumor or prevent it from returning. Systemic chemotherapy is by injection or mouth and reaches cancer cells throughout the body. Regional chemotherapy administers drugs directly into the gallbladder or surrounding area(s) affected by cancer.
Radiation therapy
Radiation therapy uses high-energy X-rays (or other forms of radiation) to destroy cancer cells and limit their growth. Radiation may be recommended in place of surgery or in addition to surgery.
Targeted therapy
Targeted therapies use drugs to attack cancer cells without damaging or destroying healthy surrounding tissue, and effectively treat gallbladder and bile duct cancer with fewer side effects than chemotherapy.
Immunotherapy
Immunotherapies are medicines that help your immune system recognize and destroy cancer cells. One example of immunotherapy is PD-1, a drug that targets the PD-1 protein on the T cells of your immune system. PD-1 helps keep T cells from attacking other cells — including some cancer cells.
Hyperthermia therapy
Diseased or cancerous tissue is exposed to high temperatures, aiming to damage or destroy cancer cells or make cancer cells more sensitive to radiation.
Clinical trials for gallbladder and bile duct cancers
For those who have unresectable (inoperable) cancer, recurrent (cancer that has returned) or metastatic (gallbladder cancer that has spread to other parts of the body), clinic trials are available. Those treated for cancer at the OSUCCC – James have access to more clinical trials than any other hospital network in the region, along with the latest advancements in targeted treatment and drugs. Your doctors will determine if you qualify for a clinical trial.
If you have received a gallbladder or bile duct cancer diagnosis, or if you want a second opinion, we are here to help you. Call 800-293-5066 to make an appointment.
Related Resources
Gallbladder Cancer Prevention and Risk Factors
Gallbladder Cancer Screening and Diagnosis
Gallbladder Cancer Treatment Team