Treatment for bile duct cancer
Chemotherapy uses anti cancer drugs to destroy cancer cells. These drugs are also called . They circulate throughout the body in the bloodstream.
Chemotherapy is a common treatment for people with bile duct cancer.
You might have chemotherapy:
after surgery to remove bile duct cancer
to control the cancer if it can't be removed, or if it has come back after surgery
Your doctor might suggest you have chemotherapy after surgery to remove bile duct cancer. This is to lower the chance of it coming back.
Your doctor might recommend you have chemotherapy if you can’t have surgery to remove bile duct cancer. Or if the cancer comes back after having it removed.
Unfortunately, chemotherapy won’t cure bile duct cancer. You usually have it to control the cancer or slow down its growth. This can help to relieve pain and other symptoms.
Your doctor will talk to you about the benefits of chemotherapy and the possible side effects. It is a good opportunity to ask them any questions you might have.
You may have one chemotherapy drug or a combination of them. This depends on if you are having it after surgery or to control the cancer. The most common chemotherapy drugs for bile duct cancer are:
capecitabine
gemcitabine and cisplatin
a combination called FOLFOX
Your doctor normally recommends you have capecitabine after surgery to remove bile duct cancer. You usually have it for 6 months.
Find out more about capecitabine
This is a chemotherapy combination. You have if the cancer has spread to an area near the bile ducts (locally advanced bile duct cancer) or if the cancer has spread elsewhere in your body. This is called advanced bile duct cancer. You usually have gemcitabine and cisplatin with an immunotherapy drug called durvalumab.
Gemcitabine and cisplatin is a first line treatment for bile duct cancer. This means it is the first treatment you have after being diagnosed. Or the first treatment you have if the cancer comes back.
If your general health is poor you may have gemcitabine on its own. Or you may have the chemotherapy drug oxaliplatin instead of cisplatin if your kidneys don't work very well.
Read more about gemcitabine and cisplatin
This is a combination of the chemotherapy drugs:
folinic acid
fluorouracil (5FU)
oxaliplatin
FOLFOX is a second line treatment for bile duct cancer. This means it is a treatment you have if the first line treatment doesn’t work or the cancer stops responding to it.
You usually have FOLFOX if the cancer doesn't have certain changes (mutations). If it does, you might have an immunotherapy or targeted cancer drug as your second line treatment.
Your doctor may ask you to take part in a clinical trial looking at chemotherapy for bile duct cancer. Or looking at other treatments combined with chemotherapy. Trials are an important way to find out which treatments work best.
Find out about research and clinical trials for bile duct cancer
Before your first chemotherapy, your doctor will explain what drugs you need, how you have them, and what the side effects are. You’ll sign a consent form. This is a good time to ask any questions you might have.
You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment.
Your doctors and pharmacists work out your chemotherapy dose based on your:
blood cell levels
weight and height
general health
Between 2 and 8 out of 100 people (2 to 8%) have low levels of an enzyme called dihydropyrimidine dehydrogenase (DPD) in their bodies. A lack of DPD can mean you’re more likely to have severe side effects from capecitabine or fluorouracil. It might take you a bit longer to recover from the chemotherapy. These side effects can rarely be life threatening.
Before starting treatment with capecitabine or fluorouracil you have a blood test to check levels of DPD. So you may start treatment with a lower amount (dose) of the drug or have a different treatment. Your doctor or nurse will talk to you about this.
Find out more about having a DPD deficiency
You usually have cancer drug treatment in cycles. A cycle means that you have a single cancer drug or a combination of drugs and then have a rest. This gives your body time to recover.
You have blood tests before each cycle of treatment. This is to check your blood cells have recovered from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test.
You have most chemotherapy drugs for bile duct cancer into your bloodstream (intravenously). Capecitabine is a tablet.
You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.
Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment. This means your doctor or nurse won't have to put in a cannula every time you have treatment.
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.
You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.
You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.
For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.
Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.
Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.
Common chemotherapy side effects include:
feeling sick
loss of appetite
losing weight
feeling very tired
increased risk of getting an infection
bleeding and bruising easily
diarrhoea or constipation
hair loss
Side effects depend on:
which drugs you have
how much of each drug you have
how you react
Tell your treatment team about any side effects that you have.
Chemotherapy for bile duct cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.
Last reviewed: 09 Oct 2024
Next review due: 09 Oct 2027
Chemotherapy is a standard treatment for some types of cancer. It uses anti cancer drugs to destroy cancer cells.
Treatments for bile duct cancers include surgery, chemotherapy and treatments to control symptoms. The treatments you have depend on the stage of the cancer.
You might have surgery to remove bile duct cancer if it hasn't spread elsewhere in your body. Your healthcare team will make sure you are well enough for the operation.
Advanced bile duct cancer has spread outside the bile ducts into nearby lymph nodes or organs. Or it has spread to parts of the body further away from the bile ducts.
You may need help and support to cope when you have bile duct cancer. There are people, resources and organisations who can help you and your family.
Bile duct cancer is also called cholangiocarcinoma. It is a rare type of cancer that develops in the small tubes that connect the liver and gallbladder to the small bowel.
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