Treatments for resectable bile duct cancer

Resectable means that the cancer can be completely removed with surgery. Stage 1 and stage 2 bile duct cancers can often be completely removed with surgery. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

The following are treatment options for resectable bile duct cancer. Surgery is the preferred treatment and offers the best outcome.

Surgery

Surgery is the main treatment for resectable bile duct cancer. The type of surgery done depends on the location, size and spread of cancer in your body. These types of surgery may be done:

  • For extrahepatic bile duct cancer, the bile ductis removed.
  • For perihilar bile duct cancer, the bile duct and part of the liver (partial hepatectomy) are removed.
  • For perihilar bile duct cancer, a liver transplant may be done, but it is not usually done for intrahepatic bile duct cancer.
  • For distal bile duct tumours, the bile duct, gallbladder, part of the pancreas, the first part of the small intestine (duodenum) and part of the stomach (Whipple procedure) are removed.
  • For resectable intrahepatic bile duct tumours, the tumour and part of the liver (hepatectomy) are removed.

Surgery with chemotherapy or chemoradiation

Some studies show improved survival if chemotherapy or chemoradiation is given after surgery (called adjuvant therapy). Chemotherapy or chemoradiation after surgery was linked to better outcomes compared to having only radiation therapy after surgery. Adjuvant therapy may also be helpful if the cancer cannot be completely removed with surgery or if the cancer has spread.

Radiation therapy

Radiation therapy uses high-energy rays or particles, such as x-rays or gamma rays, to damage or destroy cancer cells. Bile duct cancer is usually treated with external beam radiation therapy. A machine directs radiation through the skin to the tumour and some of the tissue around it.

Clinical trials

Some clinical trials in Canada are open to people with bile duct cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Expert review and references

  • Lillemoe KD, Schulick RD, Kennedy AS., et al . Cancers of the biliary tree: clinical management. Kelsen, D. P., Daly, J. M., Kern, S. E., Levin, B., Tepper, J. E., & Van Cutsem, E. (eds.). Principles and Practice of Gastrointestinal Oncology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2008: Chapter 37: pp. 493-507.
  • National Comprehensive Cancer Network (NCCN). Hepatobiliary Cancers Version 2.2015. 2015: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp.
  • Van Beers, B.E. . Diagnosis of cholangiocarcinoma . HPB . 2008 .

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