Treatment will depend on
the type, location, and extent of your cancer
your overall health
the chances of curing the disease, extending your life, or relieving symptoms.
Because gallbladder and bile duct cancers are rare, get a second opinion before deciding on a treatment. Seek treatment at a medical center with a staff that is expert in treating your type of cancer.
Surgery is the main treatment for gallbladder and bile duct cancers. Surgery is the only possible way to cure the disease, but opinions vary as to how advanced a gallbladder or bile duct cancer can be and still be curable. Because there usually are no symptoms early on, these cancers are often fairly advanced when they are discovered. Surgery for gallbladder and bile duct cancer is difficult for both doctors and patients. Unless there is clear evidence that the procedure is likely to significantly extend your life or improve your quality of life, it may not be the best option.
However, surgery sometimes can help to relieve pain or prevent complications. This type of "palliative surgery" includes a biliary bypass. This procedure restores the flow of bile. The surgeon can insert a biliary stent or catheter (tube) to release bile into the small intestine or externally. Biliary stents also can be placed without surgery. A doctor can guide an endoscope from your mouth into your stomach and small intestine, where the bile duct opening can be reached.
Radiation therapy also can be used to treat gallbladder and bile duct cancers. There are two types of radiation therapy:
External beam radiation directs x-ray beams at the cancer from a machine outside the body.
Brachytherapy involves putting radioactive material in the body, near the tumor.
Radiation may be used after surgery to kill any remaining cancer cells. If the cancer has spread too far to be removed completely, it may be the primary treatment. However, radiation therapy cannot cure these cancers.
For advanced cases, radiation also may be used as palliative therapy. That means the goal is not to cure the cancer, but to reduce pain or other symptoms by shrinking the tumor.
If you have bile duct cancer, your doctor might also recommend chemotherapy. Chemotherapy involves the use of drugs—taken by mouth or injected into a vein—to kill cancer cells. Chemotherapy can help shrink a bile duct tumor before surgery. It can also help control symptoms when surgery is not recommended or the tumor has advanced despite other treatments.
Gallbladder cancer does not respond very well to chemotherapy.
In advanced stages of gallbladder cancer, treatment response can sometimes be assessed with tumor markers. Blood tests for CA 19-9 and CEA can be done prior to starting treatment. If one or both levels are high and decrease after cancer therapy, this usually indicates shrinking of the cancer.