Find out about the latest UK research looking at gallbladder cancer.
Tests of treatments on patients are called clinical trials. Cancer Research UK supports many UK and international clinical trials. The video shows what it is like to take part in a trial.
Ash: I was offered a place on a trial by my cancer nurse
Jean: There was a new trial with new drugs and they were confident it would work and they offered it to me and I’m so glad I took it.
Nilesh: What we did, my wife and I, was to do some research on the internet. We came across the source trial which is what I went on and we took that to the doctor and then requested that we be put on to that.
Amy: The only thing that did sort of trouble us as a family when they did tell us was that it was possibly quite painful and there may be some side effects that they didn’t know about.
Ash: I was quite concerned about taking part in a trial because you hear the word trial and you think its test.
Nilesh: You know you hear about trials, clinical trials, drug trials things like that. My reservations were what the side effects were going to be.
Ash: I decided it was the right thing for me because it would potentially offer patients in the future less side effect risk.
Jean: There were lots of questions I had to ask and they were all answered and I was confident in going through the trial and the after care.
Nilesh: Right from day one they’ve been monitoring me. You know I have regular checkups and all that.
Amy: Any symptoms that arose with Poppy, somebody was always there to make sure that she wasn’t in any pain or any suffering.
Ash: I didn’t feel that they were hiding anything from me which when you’re talking about a clinical trial is so important.
Jean: It’s a really warm feeling knowing that what you did has helped other people.
Nilesh: I just hope that I played a part in a new drug that’s out there.
Ash: For other patients and also for society in general.
Nilesh: You’ve got to feel comfortable about the trial itself before you sign up for it. So do your background knowledge and just be 100% that that’s where you want to go.
Ash: Think about it very carefully. Read all of the background literature and ask lots and lots of questions because there’s no harm in doing that.
Research into new tests
Doctors use various tests to diagnose gallbladder cancer. A new test is being researched that may help doctors be sure of the diagnosis. It is called the Mcm5 protein test, and the Mcm stands for minichromosome maintenance protein. A trial is looking at the Mcm5 protein test. It will find out how accurate and reliable this test is and how good it might be at helping to diagnose cancer.
One study is looking at a type of test called SPECT CT to help diagnose liver tumours, gallbladder cancers and bile duct cancers. The test is a combination of a CT scan and a SPECT scan. It uses a radioactive tracer which is taken up by liver cancer cells. Doctors want to know whether the SPECT CT scan is better than the scans they already use. This study has now closed and we are waiting for the results.
We know that the best way to treat gallbladder cancer that can be removed is surgery. If your cancer has grown too far to be removed with surgery, or if it has come back, your specialist may suggest treatment with chemotherapy and radiotherapy (chemoradiation).
Radiotherapy can help to control gallbladder cancer to some extent, but not as much as doctors would like. Researchers have been trying to improve results by using radiotherapy and chemotherapy together.
Trials have looked into using combined chemotherapy and radiotherapy before or after surgery. This is still experimental and if your specialist suggests this, it should be as part of a clinical trial.
The aim of the treatment is to lower the risk of the cancer coming back. Doctors have hoped that combined treatment before surgery could shrink an inoperable tumour and make it possible to remove.
This sort of combined treatment can have quite severe side effects and we still don’t know if the increase in side effects is outweighed by any extra benefit in stopping the cancer coming back.
We are not aware of any UK trials into combined chemoradiation before or after surgery for gallbladder cancer that are open at the moment.
In the past, research trials found that the combination of gemcitabine and cisplatin chemotherapy worked better than gemcitabine alone for advanced gallbladder cancer. The combination is now often used.
Trials are comparing other chemotherapy drugs and also seeing if having chemotherapy after surgery delays or stops the cancer coming back.
Photodynamic therapy (PDT) is used to relieve symptoms, such as jaundice for gallbladder cancer.
Some small studies have used PDT alone compared with PDT with a stent in place. The results have been promising for PDT alone. This treatment is to help relieve symptoms, not to try to cure cancer of the gallbladder.
The PHOTOSTENT - 02 trial is looking into photodynamic therapy (PDT) to treat symptoms of gallbladder cancer that can't be removed with surgery. It is comparing PDT with a stent, to using a stent on its own.
This trial has now closed. We are waiting for the results.
Reducing side effects of treatment
The ACUFOCIN trial is looking at whether acupuncture can reduce the nerve damage that chemotherapy treatment can cause for some people.
Quality of life
It is important to research how symptoms of gallbladder and bile duct cancer and side effects of treatment affect people's quality of life.
There is a study to test a quality of life questionnaire for people who have gallbladder or bile duct cancer. The aim is to see if this questionnaire is more helpful than a general quality of life questionnaire.
This trial has now closed and we are waiting for the results.
Finding a trial
If you are interested in taking part in a clinical trial, ask your specialist if there are any suitable current studies. Unfortunately, there are not many trials for gallbladder cancer (or biliary tract cancer) treatment in the UK as it is not a common cancer in this country. Most of the research takes place in countries where gallbladder cancer is more common.
It can take longer to recruit enough patients for research studies than with a more common cancer. The studies are likely to be smaller, which means there must be a more marked difference between treatments for it to show up.