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Decisions about your treatment

Find out the different types of treatment for bile duct cancer (cholangiocarcinoma) and how your doctor decides on which treatment you need.

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

The treatment you have depends on:

  • where your cancer is
  • how far it has grown or spread (the stage)
  • the type of cancer
  • how abnormal the cells look under a microscope (the grade)
  • your general health and level of fitness

Your doctor will talk to you about your treatment, its benefits and the possible side effects.

Treatment to try to cure bile duct cancer

Surgery gives the best chance of curing bile duct cancer. Your surgeon will suggest surgery if it’s possible to remove your cancer and you are fit enough to cope with a major operation.

Usually you have the chemotherapy drug capecitabine after surgery to lower the chance of the cancer coming back.

Unfortunately, even after treatment to try to cure bile duct cancer it can come back.

Treatment to relieve symptoms

You might have chemotherapy, radiotherapy or both, if you can't have surgery or if the cancer has spread. This can help to control the growth of the cancer and relieve symptoms.

Bile duct cancer can block the bile ducts and cause jaundice (yellowing of the skin and whites of the eyes). Your doctor usually puts in a tube called a stent to relieve the blockage and allow bile to flow into the bowel again.

In some cases, if it hasn’t been possible to put in a stent, you might have an operation to relieve the blockage. This is called bypass surgery.

Clinical trials

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.

Getting a second opinion

You might feel that you would like to get an opinion from a second doctor before deciding about your treatment. If so, ask your specialist or your GP to refer you to a doctor specialising in liver and bile duct cancers.

It can be better to arrange a second opinion through your specialist because they can send all your notes and test results with you.

Do remember that a second opinion does not necessarily mean that the second doctor will take over your care. Your treatment will usually still be managed by your original specialist.

Last reviewed: 
21 Feb 2018
  • Biliary cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow up
    JW Valle and others
    Annals of Oncology, 2016. Volume 27, Pages 28-37

  • Guidelines for the diagnosis and treatment of cholangiocarcinoma: an update
    SA Khan and others 
    Gut, 2012. Volume 61, Pages 1657-1669

  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser
    Wiley Blackwell, 2015

  • Cancer: Principles and Practice of Oncology (10th edition)
    VT De Vita, TS Lawrence and SA Rosenberg
    Lippincott, Williams and Wilkins, 2015

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