Bile Duct Cancer

Treatment

Treatments for bile duct cancer vary with the type of cancer, size of the tumor and how far it has advanced (stage), as well as your age, overall health and personal preferences. Options include:

• Surgery. For very small tumors, surgical removal of part of the bile duct is usually the best choice. Sometimes this can be done using minimally invasive surgery. If the cancer is caught early, removing part of the bile duct may eliminate all the cancerous cells. If bile duct cancer is more advanced, nearby liver tissue and lymph nodes may be removed, as well as the tumor.
• Liver transplant. A liver transplant may be an option when bile duct tumors have not spread outside the liver but they cannot be completely removed by surgery. Radiation therapy and chemotherapy are usual treatments before a liver transplant. Although tumors can recur after transplantation, in some cases, liver transplantation is considered a cure.
• Chemotherapy. Current chemotherapy regimens for bile duct cancer do not result in cures, but typically slow or stop disease progression for a period of time.
• Radiation therapy. Radiation therapy uses high-dose X-rays to damage or destroy cancer cells and shrink tumors. Radiation may also be delivered internally using radioactive sources placed temporarily inside the bile duct. Typically both radiation therapy and chemotherapy are given, and they may be used in addition to surgery or transplant.
• Photodynamic therapy. In photodynamic therapy, a light-sensitive chemical is injected into a vein and accumulates in the fast-growing tumor cells. Laser light directed at the tumor causes a chemical reaction in the tumor cells, killing them. This treatment is limited to cells on the surface that can be exposed to light.
• Biliary drainage. Biliary drainage by surgery or placement of stents (a tube inserted for draining) is a palliative treatment that provides relief of symptoms rather than a cure. Stents provide symptom relief in people who have obstruction of the main bile ducts.
• Other treatment options. Treatments directed specifically to the liver may also be used. These treatments include inserting a needle into the tumor and heating it (radiofrequency ablation) to kill the tumor. In addition, chemotherapy or small radioactive beads may be given directly into the liver (chemoembolization, radioembolization).
• Investigational treatments. Periodically, new promising treatments may become available through clinical trials, providing access to therapies not yet approved for use outside of a clinical trial.