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Treatment Option Overview
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There are different types of treatment for patients with
extrahepatic bile duct cancer.
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. 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.
Two types of standard treatment are used:
Surgery
The following types of surgery are used to treat extrahepatic bile duct
cancer:
- 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 made by connecting the duct
openings in the liver 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: If the tumor cannot be removed but is
blocking the small intestine and causing bile to build up in the gallbladder, a biliary
bypass may be done. During this operation, the gallbladder
or bile duct will be cut and sewn to the small intestine to create a new pathway around
the blocked area. This procedure helps to relieve jaundice caused by the
build-up of bile.
- 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. The doctor may
place the stent during surgery or PTC, or with an endoscope.
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.
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 Web site.
Radiation sensitizers
Clinical trials are studying ways to improve the effect of
radiation therapy on tumor cells, including the following:
- Hyperthermia therapy: A treatment in which body tissue is exposed
to high temperatures to damage and kill cancer cells or to make cancer cells
more sensitive to the effects of radiation therapy and certain anticancer drugs.
- Radiosensitizers: Drugs that make tumor cells more
sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more
tumor 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 spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Biologic therapy
Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
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 clinical trials database.
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. This is sometimes called re-staging.
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.
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