Chemotherapy (chemo) is treatment with cancer-killing drugs that are usually given into a vein (IV) or taken by mouth. These drugs enter the bloodstream and reach all areas of the body, making this treatment useful for some cancers that have spread to organs beyond the bile duct. Because the drugs reach all the areas of the body, this is known as a systemic treatment.
Chemo can help some people with bile duct cancer, but so far it's not clear how useful it is for this type of cancer. Still, chemo might be used in these ways:
Doctors give chemo in cycles, with each period of treatment followed by a rest period to give the body time to recover. Chemo cycles generally last about 3 to 4 weeks. Chemo usually isn't recommended for patients in poor health, but advanced age by itself is not a barrier to getting chemotherapy.
Because giving chemo into a vein isn't always helpful for bile duct cancer, doctors have tried giving the drugs right into the main artery going into the liver, called the hepatic artery. The hepatic artery also supplies most bile duct tumors, so putting the chemo into this artery means more chemo goes to the tumor. The healthy liver then removes most of the remaining drug before it can reach the rest of the body. This can lessen chemo side effects. HAI may help some people whose cancer couldn't be removed by surgery live longer, but more research is needed. This technique often requires surgery to put a catheter into the hepatic artery, and many people with bile duct cancer are not well enough to have this surgery.
Embolization is a procedure where a substance is put into the blood vessels to help stop blood from getting to a tumor. TACE uses tiny beads of chemo to do this. A catheter is used to put the beads into the artery that "feeds" the tumor. The beads lodge there to block blood flow and give off the chemo. TACE may be used for tumors that can't be removed or to treat bile duct cancer that comes back after surgery.
The drugs used most often to treat bile duct cancer include:
In some cases, 2 or more of these drugs may be combined to try to make them more effective. For example, combining gemcitabine and cisplatin may help people live longer than getting just gemcitabine alone.
Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow (where new blood cells are made), the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells can be affected by chemo, which can lead to side effects.
The side effects of chemo depend on the type and dose of drugs given, how they're given, and the length of treatment. Side effects can include:
Ask your cancer care team what you should watch for. Most side effects are short-term and go away after treatment ends. There are often ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting. Be sure to ask your doctor or nurse about medicines to help reduce side effects.
Report any side effects you notice to your medical team so that they can be treated right away. Most side effects can be treated. In some cases, the doses of the chemo drugs may need to be reduced or treatment might need to be delayed or stopped to keep the effects from getting worse.
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Last Revised: July 3, 2018