If you're facing biliary tract cancer treatment, it's easy to feel overwhelmed by all the possible options. Here's a look at the most common treatment options and what your health care team considers when creating your treatment plan.

One person's biliary tract cancer treatment might be different from another person's treatment. So it's difficult to compare your cancer journey with someone else's. Your health care team considers many factors when making a treatment plan. Your care team might consider:

• Which part of the biliary tract has cancer.
• How large the cancer has grown.
• Whether the cancer involves the liver.
• Whether the cancer has spread to other parts of the body.
• The results of tests on your cancer cells, which can be used to select the medicines that are best for you.
• Your overall health and fitness.
• Other health problems that you have.
• Whether you are healthy enough to have surgery.
• Your goals for treatment.
• The amount of side effects you're willing to accept.
• Your expectations for the treatments you receive.

Your health care team makes a treatment plan just for you based on these factors. Your care team chooses the treatments that are most likely to help you.

Biliary tract cancers are rare. Relatively few institutions have expertise in this type of cancer. Consider seeking care at a cancer center that has experience in caring for people with your type of cancer.

Your biliary tract cancer treatment plan might have one or more of the following treatments. Options generally include:

• Surgery. The goal of surgery is to remove all of the cancer. Some of the healthy tissue around the cancer also is taken out. This helps make sure that all of the cancer cells are removed.

  If the cancer is small and hasn't spread, surgery might be the first treatment. Often nearby organs are removed in order to get all of the cancer. This might mean part of the liver or pancreas is removed along with the cancer. Most people with biliary tract cancer will get other treatments after surgery.

  Often, surgery isn't an option for biliary tract cancer. It might not be an option if the cancer has grown to a size that makes it hard to get all the cancer. Also, surgery might not be an option if the cancer has spread. When you can't have surgery, chemotherapy is often the first treatment.

• Chemotherapy. Chemotherapy uses strong medicines to kill cancer cells. There are many chemotherapy medicines. Some are given through a vein, and others come in pill form. Treatment often involves a combination of medicines.

  Chemotherapy is often used after surgery to kill any cancer cells that are left. It can lower the risk that the cancer will come back. When used in this way, chemotherapy can be considered a preventive treatment.

  If surgery isn't an option, chemotherapy might be the first treatment. If the cancer has spread to other parts of the body, chemotherapy can help control it.

• Radiation therapy. Radiation therapy uses powerful energy beams to kill cancer cells. The energy can come from X-rays, protons and other sources. During radiation therapy, you lie on a table. A machine moves around you, pointing the energy beams to precise points on your body. Radiation therapy treatment schedules vary, so ask your health care team what you can expect. Some people need daily treatments for several weeks.

  Radiation therapy is sometimes used after surgery to kill any cancer cells that are left. It might be recommended if there is a risk that the cancer might come back. It's often done at the same time as chemotherapy. Using the two treatments together makes them work better.

  When surgery isn't an option, radiation therapy might help control the cancer.

• Targeted therapy. Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted therapy causes the cancer cells to die.

  The cancer cells are often tested in a lab to see if targeted therapy might work against them. The tests look for the specific chemicals and other changes in the cancer cells or on the cells' surfaces that the medicines can target, called biomarkers. Based on the results, your health care team selects the targeted therapy medicine that's most likely to help you. Choosing a medicine based on your individual biomarkers is sometimes called precision medicine.

  Targeted therapy might be an option if you can't have surgery for biliary cancer or if the cancer has spread.

• Immunotherapy. Immunotherapy is a treatment with medicine that helps your body's immune system kill cancer cells. Your immune system fights off diseases by attacking germs and other cells that shouldn't be in your body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells.

  Your cancer cells may be tested to see if immunotherapy medicine might help you. Immunotherapy might be an option if you can't have surgery or if your biliary tract cancer has spread. Immunotherapy can be used alone or at the same time as chemotherapy medicines.

Other treatments might be options in certain situations. Discuss your biliary tract cancer treatment options with your health care team. Members of your care team can explain why they recommend certain treatments. This can help you feel confident in the plan as you start your biliary tract cancer treatment.

March 24, 2023

Original article: https://www.mayoclinic.org/diseases-conditions/cholangiocarcinoma/in-depth/treatment-options-biliary-tract-cancer/art-20544662