Bile duct cancers can also occur at the far end of the duct, near where it empties into the intestine. Removing these tumors may also require a Roux-en-Y, as well as removal of parts of the intestines and pancreas (called a Whipple procedure). This extensive surgery is extremely complicated and has many side effects. It should be done only when a tumor has not spread beyond the local area.
Chemotherapy Studies have not shown that chemotherapy can prolong survival, but the standard
drugs used (mitomycin-C or 5-fluorouracil) may cause tumors to shrink and help about 25 percent of patients. Even with tumor shrinkage, however, patients may not be better off after chemotherapy. The treatment has side effects and the tumor ultimately regrows.
There may be a role for chemotherapy after surgery, although this has not been studied systematically. In the hopes of finding a better chemotherapy treatment and improving survival, patients should be considered for clinical trials if chemotherapy is planned.
Radiation Radiation is effective against bile duct cancers and may play a significant role. If the
tumor is fairly small, it may be treated with radiation without causing much damage to the surrounding noncancerous liver tissue .
Treatment may include placing a radiation-containing probe into the bile duct (brachytherapy). This therapy may also apply to patients with a small bit of tumor left after surgery or as a supplemental (adjuvant) therapy
