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 advanced 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 is not always helpful for gallbladder cancer. Because of this, it may be given directly 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. HAI may not be helpful in some people because it often needs surgery. The surgery is done to put a catheter into the hepatic artery. Many people with gallbladder cancer may not do well with this surgery.
Chemotherapy medicine is given in cycles. Each period of treatment is followed by a rest period. This gives the body time to recover. The cycles usually last about 3 to 4 weeks.
What are the medicines used to treat gallbladder cancer?
The medicines used most often for gallbladder cancer include:
In some cases, two of these are combined as one treatment. This can make the chemotherapy work better.
Possible side effects
Chemotherapy medicines are 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:
Loss of appetite
Nausea and vomiting
Increased chance of infections, from low levels of white blood cells
Easy bruising or bleeding, from low levels of blood platelets
Tiredness, from having low levels of red blood cells
These side effects usually go away after treatment. There are often ways to lessen these side effects. For example, medicines can be given to help prevent or reduce nausea and vomiting. Be sure to ask your doctor or nurse about medicines to help reduce side effects.
Some medicines can have their own additional side effects. 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. This 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. 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 what number to call with questions. Is there a different number for 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.