Treatment

Different types of treatment are available for patients with extrahepatic bile duct cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. (A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer.)

Your treatment options depend on the stage of cancer, your overall health and your preferences about treatment. In metastatic disease, the location and extent of the bile duct cancer is also an important consideration.

In all cases, treatment should be individualized for you. Although cancers are classified into particular stages, each person is unique.

You do not have to rush to make a decision, so consider the options carefully. Ask questions if you do not understand any aspect of treatment or the terms your doctors are using. Research shows that cancer survivors of all educational levels and backgrounds can have a hard time communicating with their health care team. One of the best ways to improve communication with your health care team is to prepare your visits so that you can best make use of the time.

A treatment plan is a way to deal with both the short and long term goals of managing your bile duct cancer. There are several treatment options for this cancer, depending on the stage and the patient’s age and general health. Patients have time for second opinions and to talk through all of their options with their doctors and develop a treatment plan that best fits their needs.

Standard Treatments
 Three types of standard treatment are used to treat bile duct cancer. They are the following:

Surgery
There are several different types of surgical procedures to treat bile cancer. Following are those most commonly used:
  • 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 removed may be a wedge 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 it may go around the blocked area and drain the bile into the small intestine. 
Radiation Therapy
Radiation Therapy is a cancer treatment that 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 send radiation toward 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. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Social networking and online support groups are important tools. Reaching out to others who have or have had similar experiences can provide you with valuable insights. Check out Cancer Support Community's The Living Room for more information on clinically facilitated support online. 

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