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Radiotherapy for advanced gallbladder cancer

Radiotherapy uses high energy rays to kill cancer cells. You may have radiotherapy if it isn’t possible to completely remove your gallbladder cancer with surgery, because it has spread too far. 

The treatment will not cure the cancer, but it may help to shrink it or slow it down. Doctors are not completely sure how much benefit there is from this treatment. Results from more clinical trials are needed. You are likely to have radiotherapy in combination with chemotherapy.

Radiotherapy after surgery

Radiotherapy after surgery is called adjuvant therapy. Small studies have suggested this may help to stop your cancer coming back. You might have this treatment because your surgeon thinks there may be cancer cells left behind after your operation. Or cancer cells were found in the lymph nodes your surgeon took out when you had your surgery. 

You are likely to have this treatment only as part of a clinical trial.

Radiotherapy to relieve symptoms

You may have radiotherapy to relieve the symptoms of advanced gallbladder cancer. This is called palliative radiotherapy.

Side effects

Radiotherapy generally causes tiredness, and sore, red skin in the treatment area.Radiotherapy to the abdomen (tummy) can cause sickness and diarrhoea. Speak to your doctor or radiographer for help if you are troubled by side effects.

 

CR PDF Icon View a summary of treating gallbladder cancer.

 

What radiotherapy is

Radiotherapy uses high energy rays to kill cancer cells. These are a bit like X-rays. But they can kill cancer cells, whilst doing far less damage to normal body tissues. You cannot feel radiotherapy when you have it, however a course of a few weeks will usually have some side effects.

 

Radiotherapy for advanced gallbladder cancer

You may have radiotherapy if it isn’t possible to completely remove your cancer with surgery, because it has spread too far. The treatment will not cure the cancer, but it may help to shrink it or slow it down. 

Doctors are not completely sure how much this treatment helps. We need results from more clinical trials before we know how useful it is. You are likely to have radiotherapy combined with chemotherapy.

 

Radiotherapy after surgery for gallbladder cancer

Radiotherapy after surgery is called adjuvant therapy. Doctors have been researching to see if it can help to stop your cancer from coming back. Small studies have suggested it helps but we need larger studies to know this for sure.

So you might have this treatment because

  • Your surgeon thinks there may be cancer cells left behind after your operation
  • Cancer cells were found in the lymph nodes your surgeon took out when you had your surgery

You usually have this type of treatment over 4 or 5 weeks, from Monday to Friday. So you will have between 20 and 25 separate treatments. These treatments are called fractions. You have radiotherapy in a large number of small fractions, because this helps to reduce side effects.

At the end of your course of treatment you may have a boost of additional radiotherapy. You have this in the same way as your first lot of treatment. You are most likely to have adjuvant therapy as part of a clinical trial.

 

Radiotherapy to relieve gallbladder cancer symptoms

You may have radiotherapy to relieve the symptoms of advanced gallbladder cancer. You may hear this being called palliative radiotherapy.

Your cancer may be blocking your bile duct, causing jaundice or pressing on nerves, causing pain. The treatment can shrink the cancer for a time and relieve symptoms. You usually have this type of treatment daily, as a short course over a few days.

 

Planning radiotherapy

Before you begin your treatment, the radiotherapy team carefully plan your external beam radiotherapy. This means working out how much radiation you need to treat the cancer and exactly where you need it. 

Your planning appointment may take from 15 minutes up to a couple of hours. You will have a planning CT scan. The scan shows the cancer and the structures around it.

CT scanner

You lie on the scanner couch with the treatment area exposed. The radiographers will put some markers on your skin. You need to lie very still. Once you are in position the radiographers move the couch up and through the scanner. The scanner is a doughnut shape. 

The radiographers leave the room and the scan starts. It takes up to 5 minutes. You won't feel anything. The radiographers watch from the next door room.

Before the planning appointment you may also have other scans, such as MRI scans or PET scans. Your treatment team can feed the other scans into the planning scanner.

Ink marks

Once the treatment team has planned your radiotherapy, they may put ink marks on your skin to make sure they treat exactly the same area every day. They may also make pin point sized tattoo marks in these areas.

After your planning session

You may have to wait a few days or up to 2 weeks before you start treatment. During this time the physicists and your radiotherapy doctor decide the final details of your plan. 

Your doctor will plan the areas that need treatment and outline areas to limit the dose to or avoid completely. They call this contouring. Then the physicists and staff called dosimetrists plan the treatment very precisely using advanced computers.

 

Having radiotherapy

Radiotherapy machines are very big. The machine may be fixed in one position or able to rotate around your body to give treatment from different directions. Before your first treatment your radiographers will explain what you will see and hear. The treatment rooms usually have docks for you to plug in music players. So you can listen to your own music.

You can't feel radiotherapy when you actually have the treatment. It takes anything from 15 to 30 minutes. It is important to lie in the same position each time, so the radiographers may take a little while to get you ready.

A photo of a linear accelerator, which gives radiotherapy

Once you are in the right position, the staff leave you alone in the room for a few minutes. They watch you carefully on a closed circuit television screen.

Our page about having external radiotherapy has a video about having radiotherapy that you may want to watch.

External radiotherapy doesn't make you radioactive. It is perfectly safe to be with other people, including children, throughout your course of treatment.

 

Radiotherapy side effects

You may not have any side effects at first. Radiotherapy side effects usually come on gradually during your course of treatment. They will usually be at their worst at the end of your course. Over the 2 to 3 weeks following your treatment they will slowly get better.

Generally, radiotherapy to the abdomen (tummy) can cause

  • Tiredness
  • Sore, red skin in the treatment area
  • Feeling or being sick
  • Diarrhoea

If you have side effects, do speak to your radiographer or nurse at the radiotherapy department where you are having treatment. They will be able to help. Very rarely, where side effects are particularly severe, they will suggest you stop treatment so that you can recover.

 

More about radiotherapy

Find out about

External radiotherapy

Radiotherapy skin markings

Side effects from radiotherapy given to the abdomen

General radiotherapy side effects

For general information and support

Contact the Cancer Research UK nurses on freephone 0808 800 4040 (Open 9am - 5pm, Monday to Friday)

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Updated: 29 September 2014