Bile duct cancer (cholangiocarcinoma) - Treatment

Treatment-Bile duct cancer (cholangiocarcinoma)

Treatment for bile duct cancer usually aims to control the symptoms for as long as possible. But if it's caught early enough, there's sometimes a chance it could be cured.
The main treatments are:
  • surgery to remove the affected area
  • stent insertion – an operation to widen and unblock the bile duct
  • chemotherapy– where medication is used to kill the cancer cells
  • radiotherapy–where a beam of radiation is used to kill the cancer cells
In early stage bile duct cancer, a cure may be possible by removing the affected part of the bile duct and gallbladder, and usually some of the liver or pancreas.
A cure is unlikely to be possible in more advanced cancer, but stenting, chemotherapy, radiotherapy and surgery can help relieve the symptoms.

Surgery

If it's possible to cure your cancer, surgery to remove the cancerous tissue will be recommended.
Depending on exactly where the cancer is, it may be necessary to remove:
  • the part of your bile duct that contains cancerous cells
  • your gallbladder
  • nearby lymph glands
  • part of your liver
  • part of your pancreas
Surgery may be carried out through a single large incision (cut) in your tummy, or occasionally by using special surgical instruments inserted through smaller incisions (called "keyhole" or laparoscopic surgery).
It's possible to live a normal life after surgery. You can live without a gallbladder, and surgeons can often reconstruct bile ducts. Your liver should still work even if part of it was removed.
Overall, around one or two in every five people who have surgery for bile duct cancer live at least five years or more after their operation.

Unblocking the bile duct

If your bile duct becomes blocked as a result of cancer, treatment to unblock it may be recommended.
This will help reduce symptoms such as:
  • yellowing of the skin and the whites of the eyes (jaundice) 
  • itchy skin
  • abdominal (tummy) pain
The bile duct can be unblocked using a small hollow tube called a stent, which widens the bile duct and keeps it open.
The stent can be inserted using either a long, flexible tube (endoscope) passed down your throat, or by making a small incision in your skin.
Occasionally, a stent can become blocked. If this occurs, it will need to be removed and replaced.

Chemotherapy

Chemotherapy is used to relieve the symptoms of bile duct cancer, slow down the rate it spreads and prolong life.
It's used when the cancer is unsuitable for surgery but you're in good enough general health to have chemotherapy.
It's usually given through a drip into a vein in your arm.
Side effects of chemotherapy can include:
  • tiredness
  • feeling and being sick
  • hair loss
  • a higher chance of picking up infections
The side effects should pass once the course of treatment has finished.
Read more about chemotherapy.

Radiotherapy

Like chemotherapy, radiotherapy is occasionally used with the aim of relieving symptoms, slowing the spread of the cancer and prolonging life, although it's not clear how effective it is in bile duct cancer.
It's usually given using a machine that carefully aims a beam of radiation at the cancerous area.
Side effects of radiotherapy can include:
  • tiredness
  • feeling and being sick
  • diarrhoea
  • reddening of the skin and loss of hair in the treatment area
The side effects should pass once the course of treatment has finished.
Read more about radiotherapy.

Clinical trials and research

Research is being carried out to look for newer and better treatments for bile duct cancer.
For example, recent trials have looked at new combinations of chemotherapy medication and whether treatment with medicines called targeted therapies is effective.
You may be asked if you want to take part in a clinical trial as part of your treatment. You can also ask your care team about any ongoing trials you may be able to participate in.