Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. You might have it as part of your treatment for gallbladder cancer.
The drugs circulate throughout the body in the bloodstream. Chemotherapy alone won't cure gallbladder cancer but specialists use it in several different situations.
Chemotherapy for early stage gallbladder cancer
Chemotherapy is not often used for early stage gallbladder cancer. Early stage means that the cancer hasn't spread beyond the gallbladder.
Doctors are researching using chemotherapy before surgery for some patients with localised gallbladder cancer. This is to see if it helps to stop the cancer from coming back. This is called neoadjuvant chemotherapy. There is not enough evidence at the moment to know if this can help people live longer. We need more results from clinical trials.
Doctors are also looking at chemotherapy after surgery, to see if it helps prevent gallbladder cancer coming back. This is called adjuvant chemotherapy. Although some studies show that adjuvant chemotherapy can help, the evidence from these studies is weak. We need more results from clinical trials before we know whether or not adjuvant chemotherapy is helpful.
Chemotherapy for advanced gallbladder cancer
If you have advanced gallbladder cancer, your doctor may suggest chemotherapy to try to shrink the cancer, slow it down, or relieve any symptoms you have.
Most chemotherapy drugs for gallbladder cancer are given into the bloodstream through a vein in your arm. Some drugs are tablets that you swallow.
Into your bloodstream
You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.
You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.
Taking your tablets or capsules
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Never stop taking a cancer drug without talking to your specialist first.
Where you have chemotherapy
You usually have treatment into your bloodstream at the cancer day clinic. You’ll sit in a chair for a few hours so it’s a good idea to take newspapers, books or electronic devices to help to pass the time.
You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump 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.
Clare Disney (nurse): Hello, my name is Clare and this is a cancer day unit.
So when you arrive and you’ve reported into with the receptionist, one of the nurses will call you through when your treatment is ready, sit you down and go through all the treatment with you.
Morning, Iris. My name is Clare. I am the nurse who is going to be looking after you today. We’re going to start by putting a cannula in the back of your hand and giving you some anti sickness medication. And then I am going to come back to you and talk through the chemotherapy with you and the possible side effects you may experience throughout your treatment. Is that okay?
Before you have each treatment you’ll need to have a blood test to check your bloods are okay. And you’ll also be reviewed by one of the doctors to make sure you’re fit and well for your treatment. Sometimes you’ll have the blood test taken on the day of your treatment; other times you’ll have it the day before your treatment when you see the doctor.
Each chemotherapy is made up for each individual patient, depending on the type of cancer they have and where it is and depending their height, weight and blood results.
So, depending on where your cancer is some people have their chemotherapy drug, their cancer drug by drip, some will have an injection and other people will have tablets.
So, Iris, your chemotherapy is going to be given to you in what we call cycles and the cycles are given every three weeks for a period of six cycles. So, you will be coming in for approximately five months for your chemotherapy.
Depending on where your cancer is and what type of cancer you have will be dependent on how often you come in for treatment. An example of a treatment cycle would be for you to come in on Day 1, Day 8 and Day 15 then to have a week’s break before you come back again for Day 1 treatment.
Depending on the type of treatment that you are having we will also give you some anti sickness tablets to take alongside your chemotherapy and also some drugs to prevent any reactions if that’s appropriate.
All chemotherapy is given over different time periods so it’s best to check with your nurse about how long you are likely to be in the unit for. This can range from anything up to an hour to an all day treatment slot so please be prepared to bring along some bits to keep you occupied books and music.
So, before you go home it’s important to make sure you have got the tablets you need to go home with your anti sickness medications and any other symptom control tablets that you may require. Also, to make sure that you’ve got the telephone numbers for the oncology unit to phone if you have a temperature or you are experiencing any other symptoms at home that you need to ask advice about.
So, please make sure when you leave the unit that you’ve got all the information you require and if you’ve got any questions at all don’t hesitate to ask the nurse who will be able to answer them for you.
Before your next cycle of treatment you will come in and see the doctor in the clinic room, you’ll have a blood test and an examination to make sure you are fit and well for treatment you will then come back the following day or later on that week for treatment.
Before you start chemotherapy
You need to have blood tests to make sure it’s safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.
Common chemotherapy side effects include:
- feeling sick
- loss of appetite
- losing weight
- feeling very tired
- a lower resistance to infections
- bleeding and bruising easily
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 the few days that you’re having the chemotherapy drugs. The team caring for you can help to reduce your side effects.
Dietary or herbal supplements
We don't yet know much scientifically about how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.
It is very important to tell your doctors if you take any supplements, or if you are prescribed them by alternative or complementary therapy practitioners.
Talk to your specialist about any other tablets or medicines you take while you are having active treatment.
Some studies seem to suggest that fish oil preparations might make some chemotherapy drugs work less well. If you take or are thinking of taking these supplements, talk to your doctor to find out whether they could affect your treatment.
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.