Gallbladder Cancer Treatment

About Gallbladder Cancer

At Penn's Abramson Cancer Center, patients with gallbladder cancer receive their care from a multidisciplinary team of nationally recognized experts in the diagnosis, treatment and research of gastrointestinal cancer.

Gallbladder cancer is cancer that forms in the tissue of the gallbladder, a pear-shaped organ located near the liver in the upper abdomen that collects and stores bile.

Primary cancer of the gallbladder is very rare. Most gallbladder cancers are adenocarcinomas, meaning they are located in the surface area tissue of the organ. They can be further classified, depending on how the cancer appears under a microscope, as follows:

  • Papillary
  • Nodular
  • Tubular

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right physician.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Read more About Gallbladder Cancer

Diagnosing Gallbladder Cancer

An accurate cancer diagnosis from trusted cancer specialists is the first step in getting personalized treatment options to treat gallbladder cancer.

Patients who choose Penn’s Abramson Cancer Center, benefit from a multidisciplinary team of cancer specialists including gastroenterologists, radiologists, pathologists and surgeons who work together to provide a diagnosis and treatment plan custom designed for each patient with gallbladder cancer.

Cancer specialists at Penn Medicine are highly experienced in using the most advanced techniques for diagnosing gallbladder cancer and are actively researching better and more precise ways to detect gallbladder cancer.

Navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right person. Penn Medicine’s contact center has experienced cancer nurses available and ready to guide patients in finding the cancer specialist right for them.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Read more Diagnosing Gallbladder Cancer

Gallbladder Cancer Treatment

Following the diagnosis and staging of gallbladder cancer, cancer specialists at Penn Medicine's Abramson Cancer Center develop a personalized treatment plan. Penn's treatment options for gallbladder cancer include:

  • Surgery
    • Cholecystectomy (gallbladder removal)
    • Partial hepectomy
    • Surgical biliary bypass
    • Percutaneous transhepatic biliary drainage
    • Endoscopic stent placement
  • Radiation therapy
    • 3-D conformal radiation therapy
    • Intensity-modulated radiation therapy (IMRT)
    • Volumetric-modulated arc therapy
    • Proton therapy
    • Photdynamic therapy (PDT)
    • Brachytherapy
  • Chemotherapy and biologic therapies
    • Chemotherapy
    • Chemoradiotherapy
    • Liver-directed biologic therapies
  • Clinical trials
  • Other treatments

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right physician.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN.


Surgery for Gallbladder Cancer

Early stage gallbladder cancers may be cured by surgery. However, most gallbladder cancers are detected at a more advanced stage. The surgical expertise and experience of Penn’s gastroenterology team combined with leading-edge research at Penn offers patients a significant advantage.

Cholecystectomy (gallbladder removal)

In a cholecystectomy, the entire gallbladder and some healthy surrounding tissue is removed. Typically, this is a minimally invasive surgical procedure performed laparoscopically.

Partial Hepatectomy

A partial hepatectomy removes the part of the liver where gallbladder cancer may be found. The part removed may be a wedge of tissue, an entire lobe, or a larger portion of the liver, along with some of the healthy tissue around it. The remaining liver tissue takes over the functions of the liver.

Surgical Biliary Bypass

If a tumor is blocking the bile duct and bile is building up in the liver, a biliary bypass may be performed. In this procedure, the gallbladder or bile duct is cut and sewn directly to the small intestine to create a new pathway around the blockage. 

Percutaneous Transhepatic Biliary Drainage

A procedure in which bile is drained when there is a blockage and placement of an endoscopic stent is not possible. Ultrasound images are used to guide placement of a stent that drains bile into the liver, or into a bag outside of the body. This procedure may be done to relieve jaundice before surgery.

Endoscopic Stent Placement

If the tumor is blocking the bile duct, a stent may be placed via ERCP or interventional radiology to drain bile that has built up in the liver.

Radiation Therapy for Gallbladder Cancer

Radiation oncologists at Penn Medicine are recognized for techniques that target radiation precisely to the disease site while sparing nearby tissue.

Radiation therapy uses high-energy radiation to kill cancer cells. A radiation therapy schedule usually consists of a specific number of treatments given over an extended period of time.

If radiation therapy is a treatment option, it will be discussed with patients as part of the treatment plan.

3-D Conformal Radiation Therapy

The imaging technology used by radiation oncologists at Penn Medicine helps shape the radiation treatment beam to the shape of the tumor. Conformal radiation therapy gives doctors more control when treating tumors.

Special computers use CT imaging scans to create 3-D maps of the location of the cancer in the body. The system permits the delivery of radiation from several directions, and the beams can then be shaped, or conformed, to match the shape of the cancer. Conformal radiation therapy limits radiation exposure to nearby healthy tissue as well as the tissue in the beam's path.

Intensity-Modulated Radiation Therapy (IMRT)

This advanced type of radiation therapy uses a computer-controlled device, called a linear accelerator, to deliver precise doses of radiation to tumors or specific areas within the tumors. Radiation therapy, including IMRT, stops cancer cells from dividing and growing, thus slowing or stopping tumor growth.

Using 4-D computed tomography (CT) images along with computerized dose calculations, IMRT allows for the radiation dose to conform more precisely to the shape of the tumor by controlling, or modulating, the intensity of the radiation beam while tracking any movement of the tumor. The therapy allows higher radiation doses to be delivered to areas within the tumor while minimizing the dose to the surrounding area.

Volumetric-Modulated Arc Therapy (VMAT)

Volumetric modulated arc therapy (VMAT) is a type of specialized intensity modulated radiation therapy, or IMRT. VMAT delivers radiation by rotating the radiation machine, through one or more arcs while radiation is continuously delivered.

VMAT allows Penn radiation oncologists to treat complex cancers while minimizing exposure to surrounding healthy tissue. VMAT shortens radiation delivery time, and offers patient more comfort because it does not require patients to lie completely still for long periods of time.

Penn radiation oncologists use RapidArc™ radiotherapy technology to treat hard to reach tumors.

Proton Therapy

Penn Medicine is the only academic medical center in the country that is using proton therapy to treat recurrent gastrointestinal tumors in clinical trials. Also, radiation oncologists at Penn Medicine will soon use proton therapy to treat gastrointestinal cancers in the upper digestive tract.

Penn Medicine's Roberts Proton Therapy Center is the largest and most advanced facility in the world for this precise form of cancer radiation. Patients have access to one of the most sophisticated weapons against cancer, seamlessly integrated with the full range of oncology services available at Penn Medicine. Proton therapy is external beam radiotherapy in which protons are directed at a tumor.

The radiation dose that is given through protons is very precise, and limits the exposure of normal tissues. This allows the radiation dose delivered to the tumor to be increased beyond conventional radiation. The result is the potential for a better chance to improve outcomes with fewer harmful side effects.

Proton therapy, like all forms of radiation therapy, works by aiming the energized particles, in this case protons, onto the target tumor. The particles damage the DNA of cells, ultimately causing their death. Unlike X-rays, protons can be manipulated to release most of their energy only when they reach their target. With more energy reaching the cancerous cells, more damage is administered by each burst of radiation.

Photodynamic Therapy (PDT)

Penn was first health care system in the Philadelphia area to begin researching the use of photodynamic therapy (PDT) to treat cancer. Also known as photoradiation therapy, phototherapy or photochemotherapy, PDT brings together light-sensitive medication with low-level beams of light to destroy cancer cells.

When the treated cancer cells are exposed to the light, the light-sensitive medication absorbs the light and produces a form of oxygen that destroys cancer cells. PDT precisely targets cancer cells while minimizing damage to healthy surrounding tissue.

Brachytherapy

Radiation oncologists at Penn Medicine use both internal and external forms of radiation therapy to treat cancer. Brachytherapy is an internal therapy in which the radiation source is placed inside the body.

Brachytherapy for bile duct cancer involves placing radioactive wires inside tubes in small sealed holders in the body. The implants are left in the body for only a short time. This allows the doctor to give a high dose of radiation to a smaller area than is possible with external radiation treatment.

Chemotherapy and Biologic Therapies for Gallbladder Cancer

Penn Medicine specializes in a team approach to treatment with interdisciplinary care and innovative approaches that use chemotherapy to target tumors prior to and after surgery.

Penn medical oncologists are experienced in providing chemotherapy for gallbladder cancer and are pioneering the use of biologic therapies for cancer.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. It is delivered through the bloodstream, targeting cancer cells throughout the body. Chemotherapy is usually delivered intravenously through a catheter, or orally by pill.

Chemoradiotherapy

Chemoradiotherapy is the practice in which chemotherapy and radiation therapy are used simultaneously.

Liver-directed Therapies

Chemoembolization of the Hepatic Artery
Injecting an anticancer drug into the hepatic artery, which supplies blood to the liver, blocks blood flow to the liver and disrupts the blood supply to the tumor. This starves the tumor of blood and other nutrients.

Monoclonal Antibody Therapy

Monocolonal antibody (mAb) therapy targets cells in order to stimulate an immune response from the body. Monoclonal antibody therapy can be used to block cancer cells, and destroy tumors.

Clinical Trials for Gallbladder Cancer

Today, more and more people are surviving cancer. Clinical trials benefit patients with access to breakthrough therapies and treatments. These new advances in cancer treatment are occurring every day at Penn Medicine, giving patients hope that even greater discoveries lie ahead. Through clinical trials:

  • Diagnosing cancer has become more precise.
  • Radiation and surgical techniques have advanced.
  • Medications are more successful.
  • Combinations of medical, surgical and radiation therapy are improving treatment effectiveness and enhancing outcomes.
  • Strategies to address the late effects of cancer and its treatment are improving quality of life.

Penn Medicine is the only academic medical center in the country that is using proton therapy to treat recurrent gastrointestinal tumors in clinical trials. Also, radiation oncologists at Penn Medicine will soon use proton therapy to treat gastrointestinal cancers in the upper digestive tract.

Other Treatments for Gallbladder Cancer

In addition to standard treatments and clinical trials, patients at Penn Medicine may wish to add additional therapies and treatments such as massage therapy, acupuncture and art therapy. These therapies do not have curative intent, and are designed to complement standard treatments, not take their place.

Integrative Medicine and Wellness Programs

At Penn Medicine, integrative medicine and wellness services can supplement traditional cancer treatments such as chemotherapy, surgery and radiation therapy. While conventional medicine plays a critical role in eradicating cancer, integrative medicine and wellness programs offer patients and their families ways to enhance the quality of their lives, minimize or reduce the side effects of cancer and cancer treatment, and promote healing and recovery.

Cancer specialists at Penn Medicine are knowledgeable and supportive of complementary cancer treatments. The cancer team works with patients and families to integrate these supportive programs into the overall care plan, while ensuring the safety and health of patients.

The Abramson Cancer Center’s range of integrative supportive services is designed to help patients cope with the cancer experience and improve their overall sense of well-being. Services include:

The Abramson Cancer Center at Pennsylvania Hospital at Pennsylvania Hospital offers a variety of supportive care programs for patients and families, from diagnosis through survivorship. These programs are available at no cost to the patients treated at Pennsylvania Hospital, and some are open to patients treated elsewhere. These services include social work counseling, nutrition counseling, psychological counseling and spiritual counseling.

The Cancer Appetite and Rehabilitation Clinic focuses on patients with loss of appetite and weight.

The Supportive Care Clinic helps to manage cancer related symptoms. Integrative support programs include:

Support groups and educational programs are available at Pennsylvania Hospital throughout the year.

Palliative Care

Palliative care provides medical and non-medical interventions to ease the symptoms of cancer and its treatment. Palliative care includes physical, emotional and spiritual care that can enhance the quality of life for cancer patients.

Palliative care can be used to complement traditional cancer therapies, or to and improve quality of life when curative therapies are no longer an option.

Palliative care is an approach to patient care that can be integrated with curative therapies at any point from diagnosis to survivorship or end-of-life care.

Palliative care services include palliative chemotherapy, radiation therapy and surgery as well as psychological counseling, art therapy and support groups for patients and families. The goals of palliative care are to enhance the quality of life for cancer patients and their families, and provide emotional and spiritual support to enhance personal growth.

Palliative care services are offered at Pennsylvania Hospital, and at the Hospital of the University of Pennsylvania.  

Penn Home Care and Hospice Services

Penn Home Care and Hospice Services offer a full range of home health care needs by partnering three top-level home health care services under one roof:

Penn Home Care and Hospice Services offer an array of specialized therapies and medications for patients with cancer and cancer-related conditions.

Patient Support Specialists

Every step of cancer treatment – from cancer diagnosis, to surgery and treatment to forming a survivorship plan – comes with different needs and issues that should be addressed.

Oncology Navigation Specialists at the Abramson Cancer Center are available to make a patient’s experience as seamless as possible. As experts in navigating complex health care situations, Patient Navigation specialists serve as a consistent point of contact and a reliable source for advice, support and direction for patients and families. They can help in a variety of ways including provide emotional support, identify resources, and ensure access to information, support services, educational programs and community resources.

Learn more about Patient Navigation specialists at the Abramson Cancer Center.

Gallbladder Cancer Survivorship

Survivorship programs at Penn Medicine are a distinct phase of gallbladder cancer care and are designed to help patients' transition from their gallbladder cancer treatment routine to a post-cancer care lifestyle. There are more than 12 million cancer survivors living and thriving today as a result of advances in cancer treatment. However, cancer treatments can result in physical, emotional and financial complications long after the therapy is complete.

Read more Gallbladder Cancer Survivorship


Nicholas Martell

Nicholas Martell was first diagnosed with prostate cancer more than ten years ago. He was healthy for many years after being treated with radiation therapy. Nick recently experienced a recurrence of his cancer. Physicians at Penn tailored his treatment

Stand Up to Cancer

Peter O'Dwyer, MD, professor of Hematology-Oncology and program director of Development Therapeutics in the Abramson Cancer Center, was interviewed on NBC10's 10! Show about Penn's work as part of the Stand Up to Cancer Dream Team... Read more

Clinical Trials

Clinical Trials

Clinical trials are studies to find new ways to prevent, detect and treat cancer. The purpose of each clinical trial is to answer a specific question. Our physicians carefully design these studies to find new ways to improve care and quality of life ... more about clinical trials