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Standard Treatments

The following are standard treatments for bile duct cancer:

Surgery

Common surgical procedures used to treat bile cancer include:

  • Removal of the Bile Duct: If the tumor is small and only in the bile duct, the entire bile duct may be removed. A new duct is created by connecting the duct openings in the liver and to the intestine. Lymph nodes are removed and viewed under a microscope to see if they contain cancer. 
  • Partial Hepatectomy: Removal of the part of the liver where cancer is found. The part may be a piece of tissue, an entire lobe or a larger part of the liver, along with some normal tissue around it. 
  • Whipple Procedure: A surgical procedure in which the head of the pancreas, the gallbladder, part of the stomach, part of the small intestine and the bile duct are removed. Enough of the pancreas is left to make digestive juices and insulin. 
  • Surgical Biliary Bypass: This is done if the tumor cannot be removed but is blocking the small intestine and causing bile to build up in the gallbladder. During this procedure, the gallbladder or bile duct will be cut and sewn to the small intestine to create a new pathway around the blocked area. 
  • Stent Placement: If the tumor is blocking the bile duct, a stent (a thin tube) may be placed in the duct to drain bile that has built up in the area. The stent may drain to the outside of the body or to the small intestine. 

Radiation Therapy

Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy.

  • External radiation therapy uses a machine outside the body to direct rays at the cancer.
  • Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires or catheters that are placed directly into or near the cancer.

Chemotherapy

Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or stopping them from dividing. Chemotherapy can be taken by mouth or injected into a vein or muscle.

Side Effect Management

It helps to learn more about the side effects from your treatment(s) before you begin, so you will know what to expect. When you know more, you can work with your health care team to manage your quality of life during and after treatment.

There are effective medications to address traditional side effects from cancer treatment such as nausea, diarrhea, constipation and mouth sores.

Keep in mind that everyone reacts differently to treatment and experiences side effects differently. There are coping mechanisms and strategies that can help.

Side Effects from Extrahepatic Bile Duct Treatments

Radiation Therapy

Side effects of external radiation therapy may include:

  • skin changes
  • nausea and vomiting
  • diarrhea
  • fatigue
  • painful sores in the mouth and throat
  • dry mouth or thick saliva
  • painful swallowing which starts shortly after beginning treatment but typically improves within a few weeks of finishing

Most side effects of radiation are temporary, but some rare serious side effects can be permanent.

Chemotherapy

Chemotherapy has different side effects depending on the type and dose of drugs given and the length of time they are taken. These side effects can include hair loss, mouth sores, loss of appetite, nausea and vomiting, diarrhea, increased chance of infections (due to low white blood cell counts), easy bruising or bleeding (due to low blood platelet counts) and fatigue (due to low red blood cell counts.)