Standard Treatment  Palliative surgical bypass , bile drainage procedures (see STAGE II description).
• Chemotherapy ( see Stages II and III ) and pain-relieving procedures are standard treatments. Clinical
  chemotherapy trials should be considered.
• Combination chemotherapy with SMF (streptozocin + mitomycin-C + 5-fluorouracil), which has a 30 to 45
  percent response rate, FAM (5-fluorouracil + Adriamycin + mitomycin-C) or 5-fluorouracil + leucovorin .

Three-Year Survival  Less than 1 percent