Bile Duct Cancer

Treatment

There are treatments for all patients with extrahepatic bile duct cancer. Types of bile duct cancer treatment that are used include:

  • Surgery (taking out the cancer or taking steps to relieve symptoms caused by the cancer)

  • Radiation therapy (using high-dose x-rays to kill cancer cells)

Other extrahepatic bile duct treatments are being studied in clinical trials. These include:

  • Chemotherapy (using drugs to kill cancer cells)

  • Biological therapy (using the body’s immune system to fight cancer)

Surgery is a common treatment of extrahepatic bile duct cancer. If the cancer is small and is only in the bile duct, a doctor may remove the whole bile duct and make a new duct by connecting the duct openings in the liver to the intestine. The doctor will also remove lymph nodes and look at them under the microscope to see if they contain cancer. If the cancer has spread outside the bile duct, a surgeon may remove the bile duct and the tissues around it.

If the bile duct cancer has spread and it cannot be removed, the doctor may do surgery to relieve symptoms. If the cancer is blocking the small intestine and bile builds up in the gallbladder, the doctor may do surgery to go around (bypass) all or part of the small intestine. During this operation, the doctor will cut the gallbladder or bile duct and sew it to the small intestine. This is called biliary bypass. Surgery or x-ray procedures may also be done to put in a tube (catheter) to drain bile that has built up in the area. During these procedures, the doctor may make the catheter drain through a tube to the outside of the body or the catheter may go around the blocked area and drain the bile to the small intestine. In addition, if the cancer is blocking the flow of food from the stomach, the stomach may be sewn directly to the small intestine so the patient can continue to eat normally.

Radiation therapy is the use of high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy).

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by inserting a needle into a vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the bile duct.

Biological therapy tries to get the body to fight cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body’s natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy or immunotherapy. This treatment is currently only being given in clinical trials.

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