Chemotherapy for bile duct cancer

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. It is usually used to treat bile duct cancer. Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of chemotherapy. You may also receive other treatments.

Chemotherapy is often combined with radiation therapy to treat bile duct cancer. This is called chemoradiation. The 2 treatments are given during the same time period.

Chemotherapy is given for different reasons. You may have chemotherapy or chemoradiation to:

• destroy cancer cells left behind after surgery and reduce the risk that the cancer will come back (recur) (called adjuvant chemotherapy or chemoradiation)
• relieve pain or control the symptoms of advanced bile duct cancer (called palliative chemotherapy or chemoradiation)
• as a treatment for extrahepatic bile duct cancer that comes back

Chemotherapy is usually a systemic therapy. This means that the drugs travel through the bloodstream to reach and destroy cancer cells all over the body, including those that may have broken away from the primary tumour in the bile duct.

Chemotherapy may also be a regional therapy, which means that it is given to a specific area of the body. In intrahepatic bile duct cancer, chemotherapy may be given as chemoembolization.

The most common chemotherapy drugs used to treat bile duct cancer are:

• gemcitabine (Gemzar)
• capecitabine (Xeloda)
• cisplatin (Platinol AQ)
• 5-fluorouracil (Adrucil, 5-FU)

The most common chemotherapy drug combinations used to treat bile duct cancer are:

• gemcitabine and cisplatin
• gemcitabine and capecitabine
• gemcitabine and 5-fluorouracil
• 5-fluorouracil and cisplatin

Side effects can happen with any type of treatment for bile duct cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Chemotherapy may cause side effects because it can damage healthy cells as it kills cancer cells. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after chemotherapy. Sometimes late side effects develop months or years after chemotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of chemotherapy will depend mainly on the type of drug, the dose, how it’s given and your overall health. Side effects can be more severe when chemotherapy is given with radiation therapy.

Some of the side effects of chemotherapy drugs used for bile duct cancer are:

• low blood cell counts
• loss of appetite
• nausea and vomiting
• fatigue
• sore mouth
• diarrhea
• kidney damage
• skin problems
• flu-like symptoms
• hair loss

Almost all of the drugs used to treat extrahepatic bile duct cancer can cause numbness and tingling (pins and needles) or a burning sensation in the hands or feet. This may be a sign of peripheral nerve damage (peripheral neuropathy). Cisplatin can cause hearing problems, such as ringing in the ears or hearing loss. It can also cause trouble with balance or walking, which can be signs of neurotoxicity. Nerve damage is often related to the dose of the chemotherapy drug given. Most people experience temporary nervous system problems. In a few people, nervous system damage can become a long-term problem. Nervous system damage can develop months or years after treatment and may take months to go away.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.