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Intrahepatic Bile Duct Cancer Treatment

The American Cancer Society says that intrahepatic bile duct cancer is a malignancy that forms inside the small bile duct branches within the liver. Bile duct cancers remain rare with about 2000 cases diagnosed every year, according to the Mayo Clinic. Intrahepatic bile duct cancer proves typically asymptomatic in the early stages. Treatment for intrahepatic bile can includes surgery, liver transplantation, chemotherapy, radiation therapy, photodynamic therapy, medical therapy and biliary drainage, depending on the tumor size and type and degree of disease progression.

  1. Symptoms

    • Patients with intrahepatic bile duct cancer will eventually have symptoms that include jaundice or yellowing of the skin, clay-colored stools, itching, loss of appetite, weight loss, fever, chills or abdominal and back pain.

    Surgery

    • Surgery is performed if the tumor is small and localized. The surgeon removes the affected part of the bile duct to eliminate the cancer. If the intrahepatic bile duct cancer has become locally advanced, then the surgeon will need to remove the surrounding liver tissue and adjacent lymph nodes as well.

    Liver Transplantation

    • Liver transplantation proves an option for patients whose malignant bile ducts cannot be completely removed. These patients receive radiation therapy and chemotherapy prior to the transplantation procedure.

    Radiotherapy

    • According to the Mayo Clinic, radiotherapy kills intrahepatic bile duct cancer by bombarding it with radioactive particles. Physicians may administer radiotherapy in several different ways including an external beam radiation, which delivers high dose X-rays to the cancer site; intraoperatively, using a radioactive source placed inside the body at the site of the cancer; as radioimmunotherapy, where radioactive drugs, administered intravenously, travel to the site of the cancer to kill it and charged particle radiation, in which an external machine sends focused high energy particles directly into the tumor to kill it. Physicians usually combine radiation therapy with chemotherapy and sometimes with surgery and transplantation. For patients who cannot have surgery, physicians often combine radiation and chemotherapy.

    Photodynamic Therapy

    • In photodynamic therapy, physicians inject a light-sensitive drug that accumulates in the intrahepatic bile duct cancer. A laser, inserted endoscopically (through a surgical hole in the patient’s abdomen) into the bile duct, shines a light on the chemical causing a reaction that kills the tumor cells. Typically, this treatment is reserved for patients who cannot have surgery or transplantation.

    Medical Therapy

    • Medical therapy is reserved for intrahepatic bile duct cancer patients who are not healthy enough for surgery or have inoperable disease. The therapy involves placing a prosthesis or stent into the bile duct to open the constriction caused by the tumor to allow the bile to drain. These methods are palliative; meaning, they relieve symptoms but do not treat the underlying disease or prolong life.

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