Arizona Blood and Cancer Specialists

Understanding your Treatment Options for Gallbladder & Bile Duct Cancer

February is Gallbladder & Bile Duct Cancer Awareness Month, raising awareness about Biliary Cancers. Learn more about Gallbladder & Bile Duct Cancer, and treatment options below. As always, consult your cancer care team to discuss your treatment options and weigh the benefits of each treatment option against the possible risks and side effects.

Gallbladder Cancer

The gallbladder is a small organ under the liver and behind the lower ribs. It has the function of concentrating and storing bile, a fluid that is made and released by the liver. The gallbladder aids digestion by sending bile through the cystic duct, a small tube that connects the gallbladder to the hepatic duct, forming the bile duct. The gallbladder isn’t necessary to live, and many people have them removed. The stage of gallbladder cancer is a deciding factor for the best treatment option.

Gallbladder cancer treatment options include:

Surgery:

There are two main types of surgery for gallbladder cancer: potentially curative surgery (resectable and unresectable) and palliative surgery. The operation to remove the gallbladder is called a cholecystectomy.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. Radiation therapy might be used after surgery has removed the cancer, as part of the main therapy for some advanced cancers, or as palliative therapy.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing, and is usually given into a vein (IV) or taken by mouth. Chemotherapy might be used after surgery has removed the cancer, as part of the main therapy for some advanced cancers, or as palliative therapy.

Targeted Therapy Drugs:

Targeted therapy drugs work differently from standard chemotherapy drugs, and sometimes work when standard chemo drugs don’t. They often have different (and less severe) side effects, and can be used either along with chemo or by themselves.

Immunotherapy:

Immunotherapy is the use of medicines to help a person’s immune system better recognize and destroy cancer cells.

Palliative therapy:

Palliative care is a treatment used to help control or reduce symptoms caused by cancer. Although it's not meant to cure the cancer, palliative treatments might be used if the gallbladder cancer has spread too far to be removed by surgery.

Bile Duct Cancer

Although rare, bile duct cancer affects the bile ducts, which are a series of thin tubes that carry bile from the liver to the gallbladder and small intestine. Bile breaks down fats into fatty acids, and can be taken into the body by the digestive tract, helping with digestion. Bile duct cancer, also known as cholangiocarcinoma, can start anywhere in the bile duct system, and can be diagnosed by imaging tests like MRI scans, CT scans, PET scans, and biopsies. The extent of this cancer determines which treatment would be the best option.

Bile duct cancer treatment options include:

Surgery:

The type of surgery done to remove the bile duct cancer depends on the location and extent of the cancer. The following types of surgery are used to treat bile duct cancer:

Removal of the bile duct: This surgery is done to remove part of the bile duct if the tumor is small and is in the bile duct only. Lymph nodes are removed and tissue from the lymph nodes is analyzed to see if there is cancer.
Partial hepatectomy: This surgery removes the part of the liver where cancer is found. The part removed may be a wedge of tissue, an entire lobe, or a larger part of the liver, along with some normal tissue around it.
Whipple procedure: This surgery removes the head of the pancreas, gallbladder, part of the stomach, part of the small intestine, and the bile duct. Enough of the pancreas is left to make digestive juices and insulin.

Radiation therapy:

Radiation therapy might be used to treat bile duct cancer before surgery for cancers that might be able to be taken out after surgery to remove the cancer (adjuvant therapy), as part of the main therapy for some advanced cancers, or as palliative therapy. The main ways radiation might be given to treat bile duct cancer include external radiation or internal radiation therapy.

Chemotherapy:

Chemotherapy can help some people with bile duct cancer. Chemotherapy might be used before surgery, after surgery to remove the cancer, as part of the main treatment for some advanced cancers, as part of the liver transplant process, and as palliative therapy.