Gallbladder Cancer: Chemotherapy

What is chemotherapy?

Chemotherapy uses anticancer medicines to kill cancer cells. The medicines are made to attack and kill cancer cells that grow quickly. Some normal cells also grow quickly. Because of this, chemotherapy can also harm those cells. This can cause side effects.

When might chemotherapy be used to treat gallbladder cancer?

Chemotherapy can help some people with gallbladder cancer. But it’s not as helpful as other treatments may be. Chemotherapy may be used for these reasons: 

• After surgery, often with radiation therapy, to try to lower the risk that the cancer will come back

• To help shrink tumors to relieve symptoms, if you can't have surgery or for cancer that has spread

How is chemotherapy given for gallbladder cancer?

The medicines may be injected into a vein or given by mouth. They then enter the bloodstream and reach all areas of the body. This is called systemic treatment.

Chemotherapy in a vein doesn't always help treat gallbladder cancer. Because of this, it may be given right into the main artery going into the liver (hepatic artery). This is called hepatic artery infusion (HAI). The hepatic artery sends blood to most gallbladder tumors. Injecting the medicine here sends more medicine right to the tumor. The liver then removes most of the remaining medicine before it can reach the rest of the body. This can lessen the side effects.

In some cases, HAI may help some people whose cancer can’t be removed by surgery.

What are the medicines used to treat gallbladder cancer?

The medicines used most often for gallbladder cancer include:

• Gemcitabine

• Cisplatin

• 5-fluorouracil

• Capecitabine

• Oxaliplatin

In many cases, two of these are combined as one treatment. This can help the chemotherapy work better.

Possible side effects

Chemotherapy is designed to attack and kill cells that divide quickly, including cancer cells. These medicines can also affect quickly dividing normal cells. These include hair and bone marrow cells where new blood cells are made. The side effects of chemotherapy are different for everyone. They depend on:

• The type of medicines you're taking

• How often you take them

• How long your treatment lasts

• Your age, overall health, and other factors

Side effects can include:

• Hair loss

• Mouth and throat sores

• Appetite loss

• Nausea and vomiting

• Diarrhea

• Increased chance of infections from low levels of white blood cells

• Easy bruising or bleeding from low levels of blood platelets

• Tiredness from low levels of red blood cells

These side effects usually go away over time after treatment ends. There are often ways to lessen these side effects. For example, medicines can help prevent or reduce nausea and vomiting. Be sure to ask your healthcare provider what can be done to help reduce side effects.

Some medicines can have their own extra side effects. For instance, cisplatin and oxaliplatin can damage nerves (neuropathy). This can cause numbness, tingling, weakness, and sensitivity to cold or heat, especially in the hands and feet. It goes away in most people after treatment stops. But in some cases the effects can last a long time.

Tell your healthcare team about what side effects you have. Most side effects can be treated. In some cases, the dose of medicines may need to be reduced. Or treatment may need to be delayed or stopped.

Working with your healthcare provider

It's important to know which medicines you're taking. Write your medicines down, and ask your healthcare team how they work and what side effects they might have.

Talk with your healthcare providers about what signs to look for and when to call them. For example, chemotherapy can make you more likely to get infections. Make sure you know how to contact your healthcare provider, including evenings and weekends.

It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.