Radiotherapy for gallbladder cancer

Radiotherapy means the use of radiation, usually x-rays, to treat cancer. For gallbladder cancer, doctors use a type of radiotherapy called external radiotherapy.

External radiotherapy uses a machine outside the body to direct radiation beams at the cancer to destroy it.

When you might have radiotherapy for gallbladder cancer

You might have radiotherapy:

  • after surgery
  • to shrink and control the cancer for as long as possible
  • to help relieve symptoms

You might have radiotherapy on its own or with chemotherapy (chemoradiotherapy).

Having chemotherapy helps the radiotherapy work better but can also increase side effects. For chemoradiotherapy you usually have the chemotherapy drug capecitabine.

Radiotherapy after surgery

Radiotherapy after surgery is called adjuvant therapy. 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 Open a glossary item your surgeon took out when you had your surgery

You usually have a course (series of sessions) of radiotherapy treatment over 4 or 5 weeks. You will have around 20-25 sessions of radiotherapy. Treatment is usually Monday to Friday.

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

Radiotherapy for advanced gallbladder cancer

You may have radiotherapy to relieve the symptoms of advanced gallbladder cancer. Or 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. This is called palliative Open a glossary item radiotherapy. You often have this in fewer fractions and sometimes it is just one treatment. Palliative radiotherapy has fewer side effects.

Your doctor will discuss with you how many sessions you need.

Types of radiotherapy for gallbladder cancer

You usually have external radiotherapy. This means that a radiotherapy machine aims the radiation beams at the cancer. 

There are different types of external radiotherapy. Your doctor decides which is best for you.

You might have a type of external radiotherapy called conformal radiotherapy or intensity modulated radiotherapy (IMRT). These shape the radiation beams to closely fit the area of the cancer.

Stereotactic body radiation therapy (SBRT)

SBRT gives radiotherapy from many different positions around the body. The beams meet at the tumour. This means the cancer receives high amounts (doses) of radiation, but the surrounding tissues only get a low dose. This lowers the risk of side effects. 

Your doctor might ask you to enter a clinical trial looking at SBRT for gallbladder cancer. 

Planning your radiotherapy treatment

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 takes from 15 minutes to 2 hours.

You usually have a planning CT scan in the radiotherapy department.

The scan shows the cancer and the area around it. You might have other types of scans or x-rays to help your treatment team plan your radiotherapy. The plan they create is just for you.

Photo of a CT scanner

Your radiographers tell you what is going to happen. They help you into position on the scan couch. You might have a type of firm cushion called a vacbag to help you keep still.

The CT scanner couch is the same type of bed that you lie on for your treatment sessions. You need to lie very still. Tell your radiographers if you aren't comfortable.

Injection of dye

You might need an injection of contrast into a vein in your hand. This is a dye that helps body tissues show up more clearly on the scan.

Before you have the contrast, your radiographer asks you about any medical conditions or allergies. Some people are allergic to the contrast.

Having the scan

Once you are in position your radiographers put some markers on your skin. They move the couch up and through the scanner. They then leave the room and the scan starts.

The scan takes about 5 minutes. You won't feel anything. Your radiographers can see and hear you from the CT control area where they operate the scanner. 

Ink and tattoo marks 

The radiographers make pin point sized tattoo marks on your skin. They use these marks to line you up into the same position every day. The tattoos make sure they treat exactly the same area for all of your treatments. They may also draw marks around the tattoos with a permanent ink pen, so that they are clear to see when the lights are low.

Photograph of radiotherapy tattoo marks

The radiotherapy staff tell you how to look after the markings. The pen marks might start to rub off in time, but the tattoos won’t. Tell your radiographer if that happens. Don't try to redraw them yourself. 

After your planning session

You might have to wait a few days before you start treatment.

During this time the physicists and your radiographer doctor (clinical oncologist) decide the final details of your radiotherapy plan. They make sure that the area of the cancer will receive a high dose and nearby areas receive a low dose. This reduces the side effects you might get during and after treatment. 

Having radiotherapy

The radiotherapy room

Radiotherapy machines are very big and could make you feel nervous when you see them for the first time. The machine might be fixed in one position. Or it might rotate around your body to give treatment from different directions. The machine doesn't touch you at any point.

Before your first treatment, your therapy radiographers Open a glossary item will explain what you will see and hear. In some departments, the treatment rooms have docks for you to plug in music players. So, you can listen to your own music while you have treatment.

Photo of a linear accelerator

Before each treatment session

The radiographers help you to get onto the treatment couch. You might need to raise your arms over your head.

The radiographers line up the radiotherapy machine using the marks on your body. Once you are in the right position, they leave the room.

During treatment

You need to lie very still. Your radiographers might take images (x-rays or scans) before your treatment to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.

Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.

The short video below shows how you have radiotherapy.

You won't be radioactive

External radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.

Side effects of radiotherapy

Radiotherapy for gallbladder cancer can cause side effects. You may have only a few side effects, or you may have several. This will depend on how long you have radiotherapy for. Also if you have it with other treatments such as chemotherapy.

The side effects you have will depend on what tissues and organs are in the way of the radiotherapy beam.

Side effects tend to start a week after the radiotherapy begins. They gradually get worse during the treatment and for a couple of weeks after the treatment ends. But they usually begin to improve after around 2 weeks or so.

Some of the side effects include:

Tiredness and weakness

You might feel tired during your treatment. It tends to get worse as the treatment goes on. 

Various things can help you to reduce tiredness and cope with it, such as exercise. Some research has shown that taking gentle exercise can give you more energy. It's important to balance exercise with resting.

Feeling or being sick

You might feel sick at times. Let your treatment team know if you feel sick, as they can give you anti sickness medicines.

Reddening or darkening of your skin

Your skin might go red or darker in the treatment area. You might also get slight redness or darkening on the other side of your body. This is where the radiotherapy beams leave the body. 

The red or darker areas can feel sore. Your radiographers will give you creams to soothe your skin. The soreness usually goes away within 2 to 4 weeks of ending the treatment. But your skin might always be slightly darker in that area.

The hair in that area might also fall out. 


Radiotherapy to the tummy (abdomen) can cause diarrhoea. Drink plenty of fluids and let your doctor know if you have frequent diarrhoea.

The following video talks about the general side effects of radiotherapy. This video is around 8 minutes.

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    A. Vogel and others
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  • Cancer: Principles and Practice of Oncology (12th edition)
    VT DeVita, TS Lawrence, SA Rosenberg
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  • Gallbladder Cancer: Current Multimodality Treatment Concepts and Future Directions
    N Sturm and others
    Cancers (Basel), 2022. Volume 14, Issue 22, Page 558

  • Handbook of Treatment Planning in Radiation Oncology
    G Videtic, A Vassil and N Woody
    Springer Publishing Company, 2020

  • Gallbladder cancer: current and future treatment options
    Y Zhou and others
    Frontiers in Pharmacology, 2023

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact with details of the particular issue you are interested in if you need additional references for this information.

Last reviewed: 
12 Oct 2023
Next review due: 
12 Oct 2026

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