Treatment

Treatments

There are different types of treatment for patients with gallbladder cancer, depending on the stage of the cancer and the person’s overall health. At Siteman, each cancer has a wide range of treatments that can be used alone or in combination to give the best outcome for your specific cancer, including standard therapies and novel therapies only available in clinical trials. That’s why careful diagnosis is so important. As part of a research medical center, physicians at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis have access to a wide range of clinical trials to test new therapies as they emerge. Many of our doctors are principle investigators in these trials, which cover medical, surgical, and radiation therapies. Discuss with your physician how your cancer might benefit from clinical trials.

The standard treatments for gallbladder cancer include surgery, radiation therapy, and chemotherapy. In trials are radiations sensitizing approaches to make radiation and chemotherapy more effective. Clinical trials are testing many other approaches, some of which are becoming standard of care.

Surgery and Other Procedures

Extended Cholecystectomy: For resectable gallbladder cancer, the gallbladder and some tissue around it, including a portion of the liver and lymph nodes can be performed. For bile duct cancers either a liver resection or pancreas resection may be required depending upon which part of the bile duct is involved.

If the cancer has spread and cannot be fully removed, some surgeries can help relieve symptoms:

Biliary bypass: For blockages preventing draining of bile into the small intestine, a pathway can be created around the blockage.

Endoscopic stent placement: For tumors blocking the bile duct, a stent may be placed through a catheter to drain bile to the outside of the body or into the small intestine.

Percutaneous transhepatic biliary drainage: When endoscopic stent placement is not possible, ultrasound guidance can help stent placement to relieve jaundice.

Radiation Therapy

Radiation oncology has active trials for minimizing the duration and amount of radiation a patient receives to reduce long-term side effects. No one should be over or undertreated. Siteman is a leader in using shorter radiation durations than the national average with the same outcomes.

MR-guided adaptive radiation therapy:  Siteman cancer center is the only center in the world performing MR-guided adaptive radiation therapy.  By using an MRI to guide the radiation therapy; Siteman radiation oncologists can adjust, or adapt, the radiation to the patient every day.

Chemotherapy

Chemotherapy involves the administration of drugs, either orally or intravenously to kill cancer cells. Over the last five years, several new drugs have increased the options for physicians treating patients with gallbladder cancer. Therapy that falls under medical treatment has a wide range of approaches, including timing of treatment. It can be given before or after surgery, in conjunction with radiation (chemoradiation) or by itself.

Immunotherapy: Also called biologic therapy, these drugs use the patients’ immune systems to fight the cancer.

Different combinations of therapies may be used depending on the stage of the cancer and the health of the patient. New combinations of therapies are always being tested in clinical trials and are available at Siteman Cancer Center before other places may have access to them.