Bile Duct Cancer (Cholangiocarcinoma) Treatment
General Information(Symptoms and Diagnosis)
Stages
Treatment
General Information About Bile Duct Cancer
Key Points
- Bile duct cancer is a rare disease in which malignant
(cancer) cells form in the bile ducts.
- Having colitis or certain liver diseases can increase the
risk of bile duct cancer.
- Signs of bile duct cancer include jaundice and pain in the
abdomen.
- Tests that examine the bile ducts and nearby organs are
used to detect (find), diagnose, and stage bile duct cancer.
- Different procedures may be used to obtain a sample of
tissue and diagnose bile duct cancer.
- Certain factors affect prognosis (chance of recovery) and
treatment options.
Bile
duct cancer is a rare disease in which malignant (cancer) cells form in
the bile ducts.
A network of tubes,
called ducts,
connects the liver,
gallbladder,
and small
intestine. This network begins in the liver where many
small
ducts collect bile
(a fluid
made by the liver to break down fats during digestion).
The small ducts come together to form the right and left hepatic
ducts, which lead out of the liver. The two ducts join outside the
liver and form the common
hepatic duct. The cystic
duct connects the gallbladder to the common hepatic duct.
Bile from the liver passes through the hepatic ducts, common hepatic
duct, and cystic duct and is stored in the gallbladder.
When food is being
digested, bile stored in the gallbladder is released and passes through
the cystic duct to the common
bile duct and into the small intestine.
Bile
duct cancer is also called cholangiocarcinoma.
There are two types of
bile duct cancer:
- Intrahepatic
bile duct cancer : This type of cancer
forms in the bile ducts inside the liver. Only a small number of bile
duct cancers are intrahepatic.
Intrahepatic bile duct cancers are also called intrahepatic
cholangiocarcinomas.
Anatomy of the
intrahepatic bile ducts. Intrahepatic bile ducts are a network of small
tubes that carry bile inside the liver. The smallest ducts, called
ductules, come together to form the right hepatic bile duct and the
left hepatic bile duct, which drain bile from the liver. Bile is stored
in the gallbladder and is released when food is being digested.
- Extrahepatic
bile duct cancer : The extrahepatic
bile duct is made up of the hilum region and the distal
region. Cancer can form in either region:
- Perihilar bile duct cancer:
This type of cancer is found in the hilum region, the area where the
right and left bile ducts exit the liver and join to form the common
hepatic duct. Perihilar bile duct cancer is also called a Klatskin
tumor or perihilar cholangiocarcinoma.
- Distal extrahepatic bile duct cancer:
This type of cancer is found in the distal
region. The distal region is made up of the common bile duct which
passes through the pancreas
and ends in the small intestine. Distal extrahepatic bile duct cancer
is also called extrahepatic cholangiocarcinoma.
Anatomy of the
extrahepatic bile ducts. Extrahepatic bile ducts are small tubes that
carry bile outside of the liver. They are made up of the common hepatic
duct (hilum region) and the common bile duct (distal region). Bile is
made in the liver and flows through the common hepatic duct and the
cystic duct to the gallbladder, where it is stored. Bile is released
from the gallbladder when food is being digested.
Having
colitis or certain liver diseases can increase the risk of bile duct
cancer.
Anything that increases
your risk of getting a disease is called a risk factor. Having a risk
factor does not mean that you will get cancer; not having risk factors
doesn't mean that you will not get cancer. People who think they may be
at risk should discuss this with their doctor.
Risk factors for bile
duct cancer include the following conditions:
- Primary sclerosing cholangitis (a progressive disease in
which the bile ducts become blocked by inflammation
and scarring).
- Chronic
ulcerative
colitis.
- Cysts
in the bile ducts (cysts block the flow of bile and can cause swollen
bile ducts, inflammation, and infection).
- Infection with a Chinese liver fluke parasite.
Signs
of bile duct cancer include jaundice and pain in the abdomen.
These and other signs
and symptoms
may be caused by bile duct cancer or by other conditions. Check with
your doctor if you have any of the following:
- Jaundice
(yellowing of the skin or whites of the eyes).
- Dark urine.
- Clay colored stool.
- Pain in the abdomen.
- Fever.
- Itchy skin.
- Nausea
and vomiting.
- Weight loss for an unknown reason.
Tests
that examine the bile ducts and nearby organs are used to detect
(find), diagnose, and stage bile duct cancer.
Procedures that make
pictures of the bile ducts and the nearby area help diagnose
bile duct cancer and show how far the cancer has spread. The process
used to find out if cancer cells have spread within and around the bile
ducts or to distant parts of the body is called staging.
In order to plan
treatment, it is important to know if the bile duct cancer can be
removed by surgery.
Tests and procedures to detect, diagnose, and stage bile duct cancer
are usually done at the same time.
The following tests and
procedures may be used:
- Physical
exam and history
: An exam of the body to check general signs of
health, including checking for signs of disease, such as lumps or
anything else that seems unusual. A history of the patient's health
habits and past illnesses and treatments will also be taken.
- Liver
function tests : A procedure in which a blood
sample is checked to measure the amounts of bilirubin
and alkaline phosphatase released into the blood by the liver. A higher
than normal amount of these substances can be a sign of liver disease
that may be caused by bile duct cancer.
- Laboratory
tests : Medical procedures that test
samples
of tissue,
blood, urine, or other substances in the body. These tests help to
diagnose disease, plan and check treatment, or monitor the disease over
time.
- Carcinoembryonic
antigen (CEA) and CA
19-9 tumor marker test : A procedure in
which
a sample of blood, urine, or tissue is checked to measure the amounts
of certain substances made by organs,
tissues, or tumor cells in the body. Certain substances are linked to
specific types of cancer when found in increased levels in the body.
These are called tumor
markers. Higher than normal levels of carcinoembryonic
antigen (CEA) and CA
19-9 may mean there is bile duct cancer.
- Ultrasound
exam : A procedure in which high-energy
sound
waves (ultrasound) are bounced off internal tissues or organs, such as
the abdomen, and make echoes. The echoes form a picture of body tissues
called a sonogram.
The picture can be printed to be looked at later.
- CT
scan (CAT scan): A procedure that makes a
series of detailed pictures of areas inside the body, such as the
abdomen, taken from different angles. The pictures are made by a
computer linked to an x-ray
machine. A dye
may be injected
into a vein
or swallowed to help the organs or tissues show up more clearly. This
procedure is also called computed tomography, computerized tomography,
or computerized axial tomography.
- MRI
(magnetic resonance imaging): A procedure that uses a
magnet, radio
waves, and a computer to make a series of detailed
pictures
of areas inside the body. This procedure is also called nuclear
magnetic resonance imaging (NMRI).
- MRCP (magnetic resonance
cholangiopancreatography): A procedure that uses a
magnet, radio waves, and a computer to make a series of detailed
pictures of areas inside the body such as the liver, bile ducts,
gallbladder, pancreas, and pancreatic
duct.
Different
procedures may be used to obtain a sample of tissue and diagnose bile
duct cancer.
Cells and tissues are
removed during a biopsy
so they can be viewed under a microscope
by a pathologist
to check for signs of cancer. Different procedures may be used to
obtain the sample of cells and tissue. The type of procedure used
depends on whether the patient is well enough to have surgery.
Types of biopsy
procedures include the following:
- Laparoscopy
: A surgical procedure to look at the organs inside
the abdomen, such as the bile ducts and liver, to check for signs of
cancer. Small incisions
(cuts) are made in the wall of the abdomen and a laparoscope
(a thin, lighted tube) is inserted into one of the incisions. Other
instruments may be inserted through the same or other incisions to
perform procedures such as taking tissue samples to be checked for
signs of cancer.
- Percutaneous
transhepatic cholangiography (PTC): A
procedure used to x-ray the liver and bile ducts. A thin needle is
inserted through the skin below the ribs and into the liver. Dye is
injected into the liver or bile ducts and an x-ray is taken. A sample
of tissue is removed and checked for signs of cancer. If the bile duct
is blocked, a thin, flexible tube called a stent
may be left in the liver to drain
bile into the small intestine or a collection bag outside the body.
This procedure may be used when a patient cannot have surgery.
- Endoscopic
retrograde cholangiopancreatography (ERCP):
A
procedure used to x-ray the ducts (tubes) that carry bile from the
liver to the gallbladder and from the gallbladder to the small
intestine. Sometimes bile duct cancer causes these ducts to narrow and
block or slow the flow of bile, causing jaundice. An endoscope is
passed through the mouth and stomach
and into the small intestine. Dye is injected through the endoscope
(thin, tube-like instrument with a light and a lens
for viewing) into the bile ducts and an x-ray is taken. A sample of
tissue is removed and checked for signs of cancer. If the bile duct is
blocked, a thin tube may be inserted into the duct to unblock it. This
tube (or stent) may be left in place to keep the duct open. This
procedure may be used when a patient cannot have surgery.
Certain
factors affect prognosis (chance of recovery) and treatment options.
The prognosis
(chance of recovery)
and treatment options depend on the following:
- Whether the cancer is in the upper or lower part of the
bile duct system.
- The stage
of the cancer (whether it affects only the bile ducts or has spread to
the liver, lymph
nodes, or other places in the body).
- Whether the cancer has spread to nearby nerves
or veins.
- Whether the cancer can be completely removed by surgery.
- Whether the patient has other conditions, such as primary
sclerosing cholangitis.
- Whether the level of CA 19-9 is higher than normal.
- Whether the cancer has just been diagnosed or has recurred
(come back).
Treatment options may
also depend on the symptoms caused by the cancer. Bile duct cancer is
usually found after it has spread and can rarely be completely removed
by surgery. Palliative
therapy may relieve symptoms and improve the patient's quality
of life.
Stages of Bile Duct Cancer
Key Points
- The results of diagnostic and staging tests are used to
find out if cancer cells have spread.
- There are three ways that cancer spreads in the body.
- Cancer may spread from where it began to other parts of the
body.
- Stages are used to describe the different types of bile
duct cancer.
- Intrahepatic bile duct cancer
- Perihilar bile duct cancer
- Distal extrahepatic bile duct cancer
- The following groups are used to plan treatment:
- Resectable (localized) bile duct cancer
- Unresectable, metastatic, or recurrent bile duct cancer
The
results of diagnostic and staging tests are used to find out if cancer
cells have spread.
The process used to find
out if cancer
has spread to other parts of the body is called staging.
For bile
duct cancer, the information gathered from tests
and procedures is used to plan treatment, including whether
the tumor
can be removed by surgery.
There
are three ways that cancer spreads in the body.
Cancer can spread
through tissue,
the lymph
system, and the blood:
- Tissue. The cancer spreads from where it began by growing
into nearby areas.
- Lymph system. The cancer spreads from where it began by
getting into the lymph system. The cancer travels through the lymph
vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting
into the blood. The cancer travels through the blood
vessels to other parts of the body.
Cancer
may spread from where it began to other parts of the body.
When cancer spreads
to another part of the body, it is called metastasis.
Cancer cells
break away from where they began (the primary
tumor) and travel through the lymph system or blood.
- Lymph system. The cancer gets into the lymph system,
travels through the lymph vessels, and forms a tumor
(metastatic
tumor) in another part of the body.
- Blood. The cancer gets into the blood, travels through the
blood vessels, and forms a tumor (metastatic tumor) in another part of
the body.
The metastatic
tumor is the same type of cancer as the primary
tumor. For example, if bile duct cancer spreads to the liver,
the cancer cells
in the liver are actually bile duct cancer cells. The disease is
metastatic bile duct cancer, not liver cancer.
Stages
are used to describe the different types of bile duct cancer.
Intrahepatic
bile duct cancer
- Stage 0: Abnormal cells
are found in the innermost layer of tissue
lining the intrahepatic
bile duct. These abnormal cells may become cancer and
spread
into nearby normal tissue. Stage 0 is also called carcinoma in situ.
- Stage I: There is one tumor
that has spread into the intrahepatic
bile duct and it has not spread into any blood
vessels.
- Stage II: There is one tumor
that has spread through the wall of the bile
duct and into a blood
vessel, or there are multiple tumors that may have spread
into a blood vessel.
- Stage III: The tumor
has spread through the tissue
that lines the abdominal
wall or has spread to organs
or tissues
near the liver
such as the duodenum,
colon,
and stomach.
- Stage IV: Stage IV is
divided into stage IVA and stage IVB.
- Stage IVA: The cancer
has spread along the outside of the intrahepatic
bile ducts or the cancer has spread to nearby lymph
nodes.
- Stage IVB: The cancer
has spread to organs
in other parts of the body.
Perihilar
bile duct cancer
- Stage 0: Abnormal cells
are found in the innermost layer of tissue
lining the perihilar bile
duct. These abnormal cells may become cancer
and spread into nearby normal tissue. Stage 0 is also called carcinoma
in situ.
- Stage I: Cancer
has formed in the innermost layer of the wall of the perihilar bile
duct and has spread into the muscle layer or fibrous
tissue
layer of the wall.
- Stage II: Cancer
has spread through the wall of the perihilar bile
duct to nearby fatty tissue
or to the liver.
- Stage III: Stage III is
divided into stage IIIA and stage IIIB.
- Stage IIIA: Cancer
has spread to branches on one side of the hepatic
artery or of the portal
vein.
- Stage IIIB: Cancer
has spread to nearby lymph
nodes. Cancer may have spread into the wall of the
perihilar bile
duct or through the wall to nearby fatty tissue,
the liver,
or to branches on one side of the hepatic
artery or of the portal
vein.
- Stage IV: Stage IV is
divided into stage IVA and stage IVB.
Distal
extrahepatic bile duct cancer
- Stage 0: Abnormal cells
are found in the innermost layer of tissue
lining the distal
extrahepatic
bile duct. These abnormal cells may become cancer
and spread into nearby normal tissue. Stage 0 is also called carcinoma
in situ.
- Stage I: Stage I is divided
into stage IA and stage IB.
- Stage IA: Cancer
has formed and is found in the distal
extrahepatic
bile duct wall only.
- Stage IB: Cancer
has formed and has spread through the wall of the distal
extrahepatic
bile duct but has not spread to nearby organs.
- Stage II: Stage II is
divided into stage IIA and stage IIB.
- Stage IIA: Cancer
has spread from the distal
extrahepatic
bile duct to the gallbladder,
pancreas,
duodenum,
or other nearby organs.
- Stage IIB: Cancer
has spread from the distal
extrahepatic
bile duct to nearby lymph
nodes. Cancer may have spread through the wall of the duct
or
to nearby organs.
- Stage III: Cancer
has spread to the large vessels
that carry blood to the organs
in the abdomen.
Cancer may have spread to nearby lymph
nodes.
- Stage IV: Cancer
has spread to organs
in distant parts of the body.
The
following groups are used to plan treatment:
Resectable
(localized) bile duct cancer
The cancer is in an
area, such as the lower part of the common
bile duct or perihilar area, where it can be removed
completely by surgery.
Unresectable,
metastatic, or recurrent bile duct cancer
Unresectable
cancer cannot be removed completely by surgery. Most patients with bile
duct cancer cannot have their cancer completely removed by surgery.
Metastasis
is the spread of cancer from the primary
site (place where it started) to other places in the body. Metastatic
bile duct cancer may have spread to the liver, other parts of the abdominal
cavity,
or to distant parts of the body.
Recurrent
bile duct cancer is cancer that has recurred (come back) after it has
been treated. The cancer may come back in the bile ducts, liver, or
gallbladder. Less often, it may come back in distant parts of the body.
Treatment Option Overview
Key Points
- There are different types of treatment for patients with
bile duct cancer.
- Three types of standard treatment are used:
- Surgery
- Radiation therapy
- Chemotherapy
- New types of treatment are being tested in clinical trials.
- Patients may want to think about taking part in a clinical
trial.
- Patients can enter clinical trials before, during, or after
starting their cancer treatment.
- Follow-up tests may be needed.
There
are different types of treatment for patients with bile duct cancer.
Different types of
treatments are available for patients with 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.
When clinical trials show that a new treatment is better than the
standard treatment, the new treatment may become the standard
treatment. Patients may want to think about taking part in a clinical
trial. Some clinical trials are open only to patients who have not
started treatment.
Three
types of standard treatment are used:
Surgery
The following types of surgery
are used to treat bile duct cancer:
- Removal of the bile
duct: A surgical procedure to remove part of the bile duct
if
the tumor
is small and in the bile duct only. Lymph
nodes are removed and tissue
from the lymph nodes is viewed under a microscope
to see if there is cancer.
- Partial hepatectomy:
A surgical procedure in which the part of the liver
where cancer is found is removed. 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.
Even if the doctor
removes all the cancer that can be seen at the time of the operation,
some patients may be given chemotherapy
or radiation
therapy after surgery to kill any cancer cells
that are left. Treatment given after the surgery, to lower the risk
that the cancer will come back, is called adjuvant
therapy. It is not yet known whether chemotherapy or
radiation therapy given after surgery helps keep the cancer from coming
back.
The following types of palliative
surgery may be done to relieve symptoms
caused by a blocked bile duct and improve quality
of life:
- Biliary
bypass: A surgical procedure in which the part of the bile
duct before the blockage is connected with part of the bile duct that
is past the blockage or to the small intestine. This allows bile
to flow to the gallbladder or small intestine.
- Stent
placement: A surgical procedure in which a stent (a thin, flexible tube
or metal tube) is placed in the bile duct to open it and allow bile to
flow into the small intestine or through a catheter
that goes to a collection bag outside of the body.
- Percutaneous
transhepatic biliary drainage: A procedure used to x-ray
the liver and bile ducts. A thin needle is inserted through the skin
below the ribs and into the liver. Dye
is injected
into the liver or bile ducts and an x-ray is taken. If the bile duct is
blocked, a thin, flexible tube called a stent may be left in the liver
to drain
bile into the small intestine or a collection bag outside the body.
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.
External and internal
radiation therapy are used to treat bile duct cancer.
It is not yet known
whether external radiation therapy helps in the treatment of resectable
bile duct cancer. In unresectable,
metastatic,
or recurrent
bile duct cancer, new ways to improve the effect of external radiation
therapy on cancer cells are being studied:
- Hyperthermia
therapy: A treatment in which body tissue is exposed to
high
temperatures to make cancer cells more sensitive to the effects of
radiation therapy and certain anticancer drugs.
- Radiosensitizers:
Drugs that make cancer cells more sensitive to radiation therapy.
Combining radiation therapy with radiosensitizers may kill more cancer
cells.
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). When chemotherapy is placed directly into
the cerebrospinal
fluid, an organ,
or a body cavity
such as the abdomen,
the drugs mainly affect cancer cells in those areas (regional
chemotherapy).
Systemic chemotherapy is
used to treat unresectable, metastatic, or recurrent bile duct cancer.
It is not yet known whether systemic chemotherapy helps in the
treatment of resectable bile duct cancer.
In unresectable,
metastatic, or recurrent bile duct cancer, intra-arterial
embolization is being studied. It is a procedure in which
the
blood supply to a tumor is blocked after anticancer drugs are given in blood
vessels near the tumor. Sometimes, the anticancer drugs
are
attached to small beads that are injected into an artery
that feeds the tumor. The beads block blood flow to the tumor as they
release the drug. This allows a higher amount of drug to reach the
tumor for a longer period of time, which may kill more cancer cells.
New
types of treatment are being tested in clinical trials.
This summary section
describes treatments that are being studied in clinical
trials. It may not mention every new treatment being
studied.
Information about clinical trials is available from the NCI
website.
Liver
transplant
In a liver transplant,
the entire liver is removed and replaced with a healthy donated
liver. A liver transplant may be done in patients with perihilar bile
duct cancer. If the patient has to wait for a donated liver, other
treatment is given as needed.
Patients
may want to think about taking part in a clinical trial.
For some patients,
taking part in a clinical
trial may be the best treatment choice. Clinical trials
are
part of the cancer research process. Clinical trials are done to find
out if new cancer treatments are safe and effective or better than the standard
treatment.
Many of today's
standard treatments for cancer are based on earlier clinical trials.
Patients who take part in a clinical trial may receive the standard
treatment or be among the first to receive a new treatment.
Patients who take part
in clinical trials also help improve the way cancer will be treated in
the future. Even when clinical trials do not lead to effective new
treatments, they often answer important questions and help move
research forward.
Patients
can enter clinical trials before, during, or after starting their
cancer treatment.
Some clinical trials
only include patients who have not yet received treatment. Other trials
test treatments for patients whose cancer has not gotten better. There
are also clinical trials that test new ways to stop cancer from recurring
(coming back) or reduce the side
effects of cancer treatment.
Clinical trials are
taking place in many parts of the country. See the Treatment Options
section that follows for links to current treatment clinical trials.
These have been retrieved from NCI's
listing of clinical trials.
Follow-up
tests may be needed.
Some of the tests that
were done to diagnose
the cancer or to find out the stage
of the cancer may be repeated. Some tests will be repeated in order to
see how well the treatment is working. Decisions about whether to
continue, change, or stop treatment may be based on the results of
these tests.
Some of the tests will
continue to be done from time to time after treatment has ended. The
results of these tests can show if your condition
has changed or if the cancer has recurred
(come back). These tests are sometimes called follow-up
tests or check-ups.
Treatment Options for Bile Duct Cancer
Intrahepatic Bile Duct Cancer
Resectable Intrahepatic Bile Duct Cancer
Treatment of resectable
intrahepatic
bile duct cancer may include:
- Surgery
to remove the cancer,
which may include partial hepatectomy.
Embolization
may be done before surgery.
- Surgery followed by chemotherapy
and/or radiation
therapy.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage
I intrahepatic bile duct cancer and stage
II intrahepatic bile duct cancer. For more specific results,
refine the search by using other search features, such as the location
of the trial, the type of treatment, or the name of the drug. Talk with
your doctor about clinical trials that may be right for you. General
information about clinical trials is available from the NCI
website.
Unresectable, Recurrent, or Metastatic
Intrahepatic Bile Duct Cancer
Treatment of unresectable,
recurrent,
or metastatic
intrahepatic
bile duct cancer may include the following:
- Stent
placement as palliative
treatment to relieve symptoms
and improve quality
of life.
- External
or internal
radiation therapy as palliative treatment to relieve
symptoms
and improve the quality of life.
- Chemotherapy.
- A clinical
trial of external radiation therapy combined with hyperthermia
therapy, radiosensitizer
drugs,
or chemotherapy.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage
III intrahepatic bile duct cancer, stage
IV intrahepatic bile duct cancer and recurrent
intrahepatic bile duct cancer. For more specific results,
refine the search by using other search features, such as the location
of the trial, the type of treatment, or the name of the drug. Talk with
your doctor about clinical trials that may be right for you. General
information about clinical trials is available from the NCI
website.
Perihilar Bile Duct Cancer
Resectable Perihilar Bile Duct Cancer
Treatment of resectable
perihilar bile
duct cancer may include the following:
- Surgery
to remove the cancer,
which may include partial hepatectomy.
- Stent
placement or percutaneous
transhepatic biliary drainage as palliative
therapy, to relieve jaundice
and other symptoms
and improve the quality
of life.
- Surgery followed by radiation
therapy and/or chemotherapy.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage
I perihilar bile duct cancer and stage
II perihilar bile duct cancer. For more specific results,
refine the search by using other search features, such as the location
of the trial, the type of treatment, or the name of the drug. Talk with
your doctor about clinical trials that may be right for you. General
information about clinical trials is available from the NCI
website.
Unresectable, Recurrent, or Metastatic
Perihilar Bile Duct Cancer
Treatment of unresectable,
recurrent,
or metastatic
perihilar bile
duct cancer may include the following:
- Stent
placement or biliary
bypass as palliative
treatment to relieve symptoms
and improve the quality
of life.
- External
or internal
radiation therapy as palliative treatment to relieve
symptoms
and improve the quality of life.
- Chemotherapy.
- A clinical
trial of external radiation therapy combined with hyperthermia
therapy, radiosensitizer
drugs,
or chemotherapy.
- A clinical trial of chemotherapy and radiation
therapy followed by a liver
transplant.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage
III perihilar bile duct cancer, stage
IV perihilar bile duct cancer and recurrent
perihilar bile duct cancer. For more specific results, refine
the search by using other search features, such as the location of the
trial, the type of treatment, or the name of the drug. Talk with your
doctor about clinical trials that may be right for you. General
information about clinical trials is available from the NCI
website.
Distal Extrahepatic Bile Duct Cancer
Resectable Distal Extrahepatic Bile Duct
Cancer
Treatment of resectable
distal
extrahepatic
bile duct cancer may include the following:
- Surgery
to remove the cancer,
which may include a Whipple
procedure.
- Stent
placement or percutaneous
transhepatic biliary drainage as palliative
therapy, to relieve jaundice
and other symptoms
and improve the quality
of life.
- Surgery followed by radiation
therapy and/or chemotherapy.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with localized
extrahepatic bile duct cancer. For more specific results,
refine the search by using other search features, such as the location
of the trial, the type of treatment, or the name of the drug. Talk with
your doctor about clinical trials that may be right for you. General
information about clinical trials is available from the NCI
website.
Unresectable, Recurrent, or Metastatic
Distal Extrahepatic Bile Duct Cancer
Treatment of unresectable,
recurrent,
or metastatic
distal
extrahepatic
bile duct cancer may include the following:
- Stent
placement or biliary
bypass as palliative
treatment to relieve symptoms
and improve the quality
of life.
- External
or internal
radiation therapy as palliative treatment to relieve
symptoms
and improve the quality of life.
- Chemotherapy.
- A clinical
trial of external radiation therapy combined with hyperthermia
therapy, radiosensitizer
drugs,
or chemotherapy.
-NIH
