Radiation Therapy for Gallbladder Cancer

Radiation therapy uses high-energy rays (such as x-rays) or particles to destroy cancer cells. Doctors aren't sure of the best way to use radiation therapy to treat gallbladder cancer, but it might be used in one of these ways:

• After surgery has removed the cancer: Radiation may be used to try to kill any cancer that might have been left after surgery but was too small to see. This is called adjuvant therapy.
• As part of the main therapy for some advanced cancers: Radiation therapy might be used as a main therapy for some patients whose cancer has not spread widely throughout the body, but can't be removed with surgery. While treatment in this case does not cure the cancer, it may help patients live longer.
• As palliative therapy: Radiation therapy is used often to help relieve symptoms if the cancer is too advanced to be cured. It may be used to help relieve pain or other symptoms by shrinking tumors that block blood vessels or bile ducts, or press on nerves.

External beam radiation therapy (EBRT)

For gallbladder cancer, a large machine is used to create a beam of x-rays or particles that are aimed at the cancer. This is called external beam radiation therapy (EBRT).

Before your treatments start, the radiation team will take careful measurements to determine the correct angles for aiming the radiation beams and the proper dose of radiation. The treatment is much like getting an x-ray, but the radiation is much stronger. The procedure itself is painless. Each treatment lasts only a few minutes, but the set-up time − getting you into place for treatment − usually takes longer. Most often, radiation treatments are given 5 days a week for many weeks. These are some of the ways EBRT might be given:

Three-dimensional conformal radiation therapy (3D-CRT) Uses special computers to precisely map the location of the tumor(s). Radiation beams are then shaped and aimed at the tumor(s) from several directions, which makes it less likely to damage normal tissues.

Intensity modulated radiation therapy (IMRT)This is an advanced form of 3D-CRT. It uses a computer-driven machine that moves around you as it delivers radiation. Along with shaping the beams and aiming them at the cancer from many angles, the intensity (strength) of the beams can be adjusted to limit the dose reaching the most sensitive normal tissues. This lets doctors deliver an even higher dose to the cancer.

Chemoradiation: Chemotherapy (chemo) is given along with EBRT to help it work better. This is the way radiation is most often used for gallbladder cancer. The main drawback of this approach is that the side effects tend to be worse than giving radiation alone. Still, some studies have shown that giving chemoradiation after surgery may help patients live longer, especially those whose cancer had spread to lymph nodes.

Possible side effects of radiation therapy

Some common side effects of radiation therapy to treat gallbladder cancer include:

• Sunburn-like skin problems, like redness, blisters, and peeling in the area being treated
• Nausea and vomiting
• Diarrhea
• Tiredness (fatigue)
• Liver damage

Side effects from radiation often start a week or 2 into treatment, and usually get better over time once treatment is over. Ask your doctor or nurse what side effects to expect and how you might prevent or relieve them.