Supportive care for gallbladder cancer

Supportive care helps people meet the physical, practical, emotional and spiritual challenges of gallbladder cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.

Recovering from gallbladder cancer and adjusting to life after treatment is different for each person, depending on the extent of the disease, the type of treatment and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A person who has been treated for gallbladder cancer may have the following concerns.

Pain can occur with gallbladder cancer or its treatment. People with gallbladder cancer may have pain because the tumour grows into nearby nerves and organs, such as the liver, small intestine or pancreas, or blocks the common bile duct.

The amount of pain often increases as the cancer spreads.

Pain may be treated by:

• Palliative radiation therapy may relieve pain in people with advanced gallbladder cancer. It can help to shrink tumours that are pressing on nerves or other organs.
• Palliative surgery is not used to remove the tumour. It is done to relieve pain and restore the flow of bile if a tumour blocks the bile duct. Palliative surgery may include a biliary bypass or inserting a stent or catheter.
• Pain medicines may be needed with advanced gallbladder cancer.
• An alcohol injection may be used to help relieve pain. Alcohol is injected into or around the nerves (nerve block) that carry sensations of pain from the gallbladder and intestinal area to the brain. The alcohol helps deaden the nerves.

Jaundice can happen when a tumour blocks the gallbladder or bile duct or if it spreads to the liver and bile cannot drain properly.

Jaundice can cause:

• yellowing of the skin and whites of the eyes
• dark yellow urine
• severe itching (pruritus)
• pale coloured stools

The following treatments may be given to relieve a blockage of bile and symptoms of jaundice:

• inserting a small metal or plastic tube (stent) to keep the bile duct open
• inserting a tube (catheter) to help drain bile (also called biliary drainage)
• a biliary bypass to create a drainage route for bile around the blockage

Itching may be relieved by:

• anti-itch medicines, such as oral antihistamines or cholestyramine (Questran)
• creams or lotions applied to the skin (topical treatments), such as corticosteroid cream, calamine lotion or antihistamine cream
• using mild soap and applying moisturizing lotions after a bath
• using an oil or oatmeal bath mixture
• not wearing wool clothing or synthetic fabrics that can irritate the skin
• wearing loose-fitting clothing
• keeping the environment humid and cool

Many people with gallbladder cancer have advanced disease when they are diagnosed. When this happens, you can lose your appetite and you may not be able to eat well. You may also lose your appetite from jaundice because it can cause changes in the taste of foods. You may lose your appetite if you have nausea and vomiting.

Antinausea drugs can control nausea and vomiting. If foods have a metallic taste, it may help to eat cold foods and use plastic cutlery. Your doctor may give you medicines to help increase appetite.

People with advanced gallbladder cancer are offered palliative care during and after treatment. This care focuses on making the person as comfortable as possible, relieving symptoms, providing support and improving or maintaining quality of life.

See a list of questions to ask your doctor about supportive care during and after treatment.