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Extrahepatic bile duct cancer treatment is often tailored to the individual patient. Standard treatment involves surgical procedures and radiation therapy. However, there are new treatment methods being tested via clinical trials that patients who qualify can take part in if they and their doctor agrees the benefits outweigh the risks.
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There are five main types of surgery used to treat this type of cancer. Removing the bile duct can be done if the tumor is only in the bile duct and the tumor is small. Once removed, a new bile duct is created by connecting the bile duct openings located in the liver to the patient's intestine. The surgeon will remove lymph nodes and they will be examined with a microscope to determine whether or not they contain cancer.
The whipple procedure is a surgical procedure in which the gallbladder,, part of the small intestine, the head of the pancreas, part of the stomach, and the bile duct are removed. However, a portion of the pancreas will be left in place to produce insulin and digestive juices.
Stent placement may be done if the bile duct is blocked by a tumor. The stent may drain bile into the small intestine or outside of the body. The stent can be placed during PTC, surgery, or with an endoscope.
A partial hepatectomy can be done to remove a portion of the liver affected by cancer. The part removed can be a wedge of tissue, a larger part of the liver, or an entire lobe, along with some surrounding normal tissue.
A surgical biliary bypass may be done if the tumor cannot be removed, but bile is building up in the gallbladder due to the tumor blocking the small intestine. The bile duct or gallbladder will be cut and attached to the small intestine resulting in a new pathway to bypass the area that is blocked. This surgery helps to alleviate jaundice associated with bile accumulation.
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This treatment method kills cancer cells or prevents their growth through the use of high-energy x-rays. Patients will receive either internal radiation, external radiation, or a combination of both. The stage of the cancer and the type will determine how radiation therapy is administered.
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New Treatment Types in Clinical Trials
There are three different treatment methods currently in testing as possible extrahepatic bile duct cancer treatment methods. Radiation sensitizers are one of these. Radiosensitizers are a type of drug that are being tested to make tumor cells more sensitive to radiation. Hyperthermia therapy may help to kill or damage cancer cells by exposing body tissue to high temperatures, to make cancer cells more sensitive to certain anticancer drugs and radiation therapy effects.
Chemotherapy and biologic therapy, two treatments used for many other cancers, are also being tested as possible treatments for this cancer.
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The Cleveland Clinic. (2010). Extrahepatic Bile Duct Cancer. Retrieved on September 12, 2010 from The Cleveland Clinic: http://my.clevelandclinic.org/disorders/extrahepatic_bile_duct_cancer/hic_extrahepatic_bile_duct_cancer.aspx
University of Maryland Marlene and Stewart Greenebaum Cancer Center. (2010). Extrahepatic Bile Duct Cancer. Retrieved on September 12, 2010 from the University of Maryland Marlene and Stewart Greenebaum Cancer Center: http://www.umgcc.org/gi_program/extrah-bileduct-cancer.htm
Jang, J. MD. (2006). Actual Long-Term Outcome of Extrahepatic Bile Duct Cancer After Surgical Resection. Retrieved on September 12, 2010 from PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356849/