What Is Bile Duct Cancer? Symptoms, Causes, Treatments, and More

The location, size, and stage of your cancer will determine your treatment options. Doctors usually use a combination of different therapies to treat bile duct cancer.

Surgery

Surgery is an option for bile duct cancers that have been caught early and haven’t spread to other areas of the body. Surgeons will try to remove as much of the cancer as possible. If the cancer is more advanced, they may have to also remove liver tissue, pancreatic tissue, and/or lymph nodes.

In some cases, doctors might recommend a liver transplant. This involves removing the liver and replacing it with a donor liver. This procedure can sometimes cure people with very specific types of bile duct cancer. However, finding a donor is often challenging, and very few people are candidates for a liver transplant, according to the American Cancer Society.

Chemotherapy

Chemotherapy, which uses drugs to kill cancer cells, may be an option for certain people with bile duct cancer. Common chemotherapy regimens, according to the National Cancer Institute, include:

Sometimes, doctors perform the following special procedures to deliver chemotherapy directly to the affected bile duct:

• Transarterial Chemoembolization Tiny beads are placed into the blood vessels to stop blood from reaching the tumor. The beads also release chemotherapy drugs to shrink the tumor.
• Hepatic Artery Infusion This procedure involves using a surgically implanted pump to inject chemo directly into the main artery that supplies blood to the liver.

Radiation

Radiation therapy uses beams of energy to kill cancer cells in the body. According to the American Cancer Society, radiation isn’t a common treatment for bile duct cancer, but it can be used in some situations, such as before or after surgery or for advanced cancers. The treatment may be delivered using the following methods:

• External Beam Radiation A machine directs radiation beams at your body.
• Brachytherapy Radioactive materials are placed inside your body near the cancer site.

Targeted Therapy

Targeted therapy involves using treatments that block specific abnormalities in cancer cells. These therapies may be suitable for people with bile duct cancer caused by a faulty gene that allows proteins to develop on their cancer cells. According to the American Cancer Society, some targeted treatments used for bile duct cancer are:

Immunotherapy

Immunotherapy employs your body’s own immune system to fight cancer. It can be an option for advanced bile duct cancers when other treatments have failed.

The immunotherapy medicine pembrolizumab (Keytruda) may help treat some cases of bile duct cancer, according to the National Cancer Institute.

In September of 2022, the U.S. Food and Drug Administration also approved the immunotherapy drug durvalumab (Imfinzi) in combination with the chemotherapy regimen of gemcitabine (Gemzar) and cisplatin (Platinol) for people with advanced bile duct cancer. The approval came after a clinical trial found that adding the immunotherapy treatment extended survival by about six weeks in people with advanced biliary tract cancers.

Ablation

Bile duct cancer that forms in the liver may be treated with ablation methods, such as:

• Cryotherapy This involves using extreme cold to freeze abnormal tissue.
• Radiofrequency Ablation This method uses heat to destroy cancer cells.

While these treatments may help control tumors, nearly all will start to grow back in the future, according to the American Cancer Society.

Palliative Treatments

Palliative treatments are used to help relieve symptoms of advanced bile duct cancer, rather than cure the disease. Chemotherapy, radiation, ablation, and surgery may all be used to provide palliative care. Other approaches may include:

• Biliary Stent or Catheter If cancer blocks a bile duct, doctors can place a small stent or catheter into the duct to keep it open.
• Biliary Bypass Surgeons create a bypass around a blocked bile duct by connected parts of the duct or the intestine.
• Photodynamic Therapy A light-activated medicine that collects in cancer cells is injected into your vein. A few days later, doctors use a special laser to activate the drug and kill cancer cells.
• Alcohol Injection Doctors inject affected nerves with alcohol to help lessen pain.

Clinical Trials

Clinical trials may be an option if you have bile duct cancer. These research studies test experimental therapies that aren’t yet available to the public. If you participate in a clinical trial, you may receive a novel treatment that wouldn’t be offered to you otherwise.

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