Q: My 40 years old wife has been diagnosed with gall bladder cancer with gallstone. The cancer has metastasised to the liver with multiple secondaries found in the liver too. Bile duct was blocked by the tumour and a metallic stent was planted 5 months back. She has been given six cycles of chemotherapy and was given Gemcite and Oxaliplatin and as per the doctors she tolerated it well. CT scan was done after a month of chemotherapy. Though the trace of cancer was still there, the doctor says that the therapy was effective. She seems to be stable now, with no complaints of much pain. However she is taking Tramatour twice daily. She is being given food supplements too. What should we do now? Can she lead a normal life?

A:Your wife has an advanced gall bladder cancer, which has initially responded to the chemotherapy, but she still has a residual stable disease. Unfortunately gall bladder cancer in the advanced stages is a potentially incurable. The goal of treatment in such cases is palliation of symptoms and palliative chemotherapy or radiotherapy. You can try SIRT (Selective Internal Radiation Therapy) with Yttrium 90 microspheres for her if she is not jaundiced and she has metastases confined only to the liver. This may not be curable but can definitely cause good regression of disease and therefore good palliation of her symptoms.