Our Treatment Approach to Bile Duct Cancer

At City of Hope, our goal is to ensure treatment for bile duct cancer is not only effective, but also comprehensive and compassionate. Our skilled team of specialists design customized treatment programs using the latest technologies and capabilities available.

Bile duct cancer is often in an advanced stage when it is diagnosed, requiring rapid intervention by a group of specialists experienced in treating the disease. The multidisciplinary team at City of Hope includes medical experts from the departments of surgery, medical oncology and radiation oncology.
Experience of the surgeon is a key factor and City of Hope offers several surgical options for removing the tumor. These include:
  • Radical Excision of the Bile Duct Tumor: 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.
  • Whipple Operation: A surgical procedure in which the head of the pancreas, the gallbladder, part of the small intestine, the bile duct and occasionally part of the stomach are removed. Enough of the pancreas is left to produce digestive juices and insulin.
  • Bile Duct Excision with concomitant Liver Resection
  • Bypasses and Stenting: 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 percutaneous transhepatic cholangiography, or with an endoscope.
Chemotherapy – the use of anticancer medicines – includes a wide range of drugs and treatment strategies to treat primary and metastatic bile duct cancer. City of Hope provides both standard chemotherapies as well as access to newly developed drugs through an extensive program of clinical trials.
As part of the treatment team, a medical oncologist will evaluate the best options, so that a course of chemotherapy, if appropriate, can be tailored to the patient.
Radiation therapy uses energy beams to kill cancer cells. Specialists in the Department of Radiation Oncology have developed highly accurate new treatments that maximize the delivery of radiation to malignant cells while minimizing unnecessary exposure of healthy tissues.
  • Radiation implants (brachytherapy)
  • Intraoperative radiation
  • Intensity-modulated radiation therapy