Chemotherapy for gallbladder cancer

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.

Chemotherapy is a common treatment for people with advanced gallbladder cancer. This means that the cancer has spread outside the gallbladder or has come back sometime after you were first treated. 

When you have it

Chemotherapy won’t cure gallbladder cancer on its own. You might have chemotherapy:

• to prevent the cancer coming back after surgery
• to shrink the cancer or slow down its growth
• as part of a clinical trial

Chemotherapy after surgery

Your doctor might suggest you have the chemotherapy drug capecitabine after surgery to remove gallbladder cancer. This is to prevent the cancer from coming back. 

Chemotherapy to shrink the cancer

Your doctor might suggest that you have chemotherapy if you can’t have surgery. You are most likely to have a combination of gemcitabine and cisplatin.  

Some people feel better after chemotherapy. Some may live longer after treatment. But others unfortunately won't benefit from having chemotherapy.

Your doctor will talk to you about the benefits of chemotherapy and the possible side effects. It is a good opportunity to ask them any questions you might have. 

Chemotherapy as part of a clinical trial

Your doctor may ask you to take part in a clinical trial looking at chemotherapy or other treatments. Trials are an important way to find out which treatments work best.

Types of chemotherapy

You may have one drug or a combination of drugs to treat gallbladder cancer. The most common types of chemotherapy drugs are:

• gemcitabine and cisplatin
• capecitabine (Xeloda)
• 5-fluorouracil (5FU)
• oxaliplatin (Eloxatin)
• a combination of chemotherapy drugs called FOLFOX
• irinotecan

You might have gemcitabine and cisplatin in combination with immunotherapy. 

Check the name of the chemotherapy treatment with your doctor or nurse. You can then search for it on our A to Z list of cancer drugs.

How you have chemotherapy

You have most chemotherapy drugs for gallbladder cancer into your bloodstream (intravenously). Capecitabine is a tablet.

Into your bloodstream

You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment. This means your doctor or nurse won't have to put in a cannula every time you have treatment.

Taking tablets

Speak to your pharmacist if you have problems swallowing the tablets.

Whether you have a full or an empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, no more or less.

Talk to your healthcare team before you stop taking a cancer drug or if you miss a dose.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.

Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test. 

Before starting treatment with capecitabine or 5-fluorouracil (5FU) you have a blood test to check levels of an enzyme called dihydropyrimidine dehydrogenase (DPD). A low DPD level might mean you are more likely to have severe side effects from these drugs. So you may start treatment with a lower amount (dose) of the drug, or have a different treatment. Your doctor or nurse will talk to you about this.

Side effects

Common chemotherapy side effects include:

• feeling sick

• loss of appetite

• losing weight

• feeling very tired

• increased risk of getting an infection

• bleeding and bruising easily

• diarrhoea or constipation

• hair loss

Side effects depend on:

• which drugs you have

• how much of each drug you have

• how you react

Tell your treatment team about any side effects that you have.

Most side effects only last for a few days or so. Your treatment team can help to manage any side effects that you have.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you:

• take any supplements
• have been prescribed anything by alternative or complementary therapy practitioners

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.

When you go home

Chemotherapy for gallbladder cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. Your nurse will give you telephone numbers to call if you have any problems at home.