Bile duct cancer is a rare disease in which malignant (cancer) cells form in the bile ducts. Bile duct cancer is also called cholangiocarcinoma.
A network of tubes, called ducts, connects the liver, gallbladder, and small intestine. This network begins in the liver where many small ducts collect bile (a fluid made by the liver to break down fats during digestion). The small ducts come together to form the right and left hepatic ducts, which lead out of the liver. The two ducts join outside the liver and form the common hepatic duct. The cystic duct connects the gallbladder to the common hepatic duct. Bile from the liver passes through the hepatic ducts, common hepatic duct, and cystic duct and is stored in the gallbladder.
When food is being digested, bile stored in the gallbladder is released and passes through the cystic duct to the common bile duct and into the small intestine.
Types of bile duct cancer
There are two types of bile duct cancer:
Intrahepatic bile duct cancer: This type of cancer forms in the bile ducts inside the liver. Only a small number of bile duct cancers are intrahepatic. Intrahepatic bile duct cancers are also called intrahepatic cholangiocarcinomas. EnlargeAnatomy of the intrahepatic bile ducts. Intrahepatic bile ducts are a network of small tubes that carry bile inside the liver. The smallest ducts, called ductules, come together to form the right and left hepatic ducts, which lead out of the liver. The two ducts join outside the liver and form the common hepatic duct. The cystic duct from the gallbladder joins the common hepatic duct to form the common bile duct. The common bile duct passes through the pancreas and ends in the small intestine. Bile is made by the liver and stored in the gallbladder. When food is being digested, bile is released from the gallbladder and passes through the common bile duct, pancreas, and ampulla of Vater into the small intestine.
Extrahepatic bile duct cancer: This type of cancer forms in the bile ducts outside the liver. The two types of extrahepatic bile duct cancer are perihilar bile duct cancer and distal bile duct cancer:
Perihilar bile duct cancer: This type of cancer is found in the area where the right and left bile ducts exit the liver and join to form the common hepatic duct. Perihilar bile duct cancer is also called a Klatskin tumor or perihilar cholangiocarcinoma.
Distal bile duct cancer: This type of cancer is found in the area where the ducts from the liver and gallbladder join to form the common bile duct. The common bile duct passes through the pancreas and ends in the small intestine. Distal bile duct cancer is also called extrahepatic cholangiocarcinoma.
EnlargeAnatomy of the extrahepatic bile ducts. Extrahepatic bile ducts are small tubes that carry bile from the liver and gallbladder to the small intestine. They are made up of the common hepatic duct (perihilar region) and the common bile duct (distal region). Bile is made in the liver and flows through the common hepatic duct and the cystic duct to the gallbladder, where it is stored. When food is being digested, bile is released from the gallbladder and flows through the common bile duct, pancreas, and ampulla of Vater into the small intestine.
Signs and symptoms of bile duct cancer
These and other signs and symptoms may be caused by bile duct cancer or by other conditions. Check with your doctor if you have any of the following:
jaundice (yellowing of the skin or whites of the eyes)
dark urine
clay colored stool
pain in the abdomen
fever
itchy skin
nausea and vomiting
weight loss for an unknown reason
There are no routine screening tests to check for bile duct cancer before signs and symptoms occur. To learn about tests that are used to diagnose bile duct cancer, see Bile Duct Cancer Diagnosis.
There are different types of treatment for people with liver cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials.
Types of treatment
Surveillance
Surveillance is used for lesions smaller than 1 centimeter found during screening. Follow-up every 3 months is common. Surveillance is closely watching a person’s condition but not giving any treatment unless there are changes in test results that show the condition is getting worse. During active surveillance, certain exams and tests are done on a regular schedule.
Surgery
A partial hepatectomy (surgery to remove the part of the liver where cancer is found) may be done. A wedge of tissue, an entire lobe, or a larger part of the liver, along with some of the healthy tissue around it is removed. The remaining liver tissue takes over the functions of the liver and may regrow.
Liver transplant
In a liver transplant, the entire liver is removed and replaced with a healthy donated liver. A liver transplant may be done when the disease is in the liver only and a donated liver can be found. If the person has to wait for a donated liver, other treatment is given as needed.
Ablation therapy
Ablation therapy removes or destroys tissue. Different types of ablation therapy are used for liver cancer:
Radiofrequency ablation: Special needles are inserted directly through the skin or through an incision in the abdomen to reach the tumor. High-energy radio waves heat the needles and tumor which kills cancer cells.
Microwave therapy: The tumor is exposed to high temperatures created by microwaves. This can damage and kill cancer cells or make them more sensitive to the effects of radiation and certain anticancer drugs.
Percutaneous ethanol injection: A small needle is used to inject ethanol (pure alcohol) directly into a tumor to kill cancer cells. Several treatments may be needed. Usually local anesthesia is used, but if the person has many tumors in the liver, general anesthesia may be used.
Cryoablation: An instrument is used to freeze and destroy cancer cells. This type of treatment is also called cryotherapy and cryosurgery. The doctor may use ultrasound to guide the instrument. Learn more at Cryosurgery to Treat Cancer.
Electroporation therapy: Electrical pulses are sent through an electrode placed in a tumor to kill cancer cells. Electroporation therapy is being studied in clinical trials.
Embolization therapy
Embolization therapy is used for people who cannot have surgery to remove the tumor or ablation therapy and whose tumor has not spread outside the liver. Embolization therapy is the use of substances to block or decrease the flow of blood through the hepatic artery to the tumor. When the tumor does not get the oxygen and nutrients it needs, it will not continue to grow.
The liver receives blood from the hepatic portal vein and the hepatic artery. Blood that comes into the liver from the hepatic portal vein usually goes to the healthy liver tissue. Blood that comes from the hepatic artery usually goes to the tumor. When the hepatic artery is blocked during embolization therapy, the healthy liver tissue continues to receive blood from the hepatic portal vein.
There are two main types of embolization therapy:
Transarterial embolization (TAE): A small incision (cut) is made in the inner thigh and a catheter (thin, flexible tube) is inserted and threaded up into the hepatic artery. Once the catheter is in place, a substance that blocks the hepatic artery and stops blood flow to the tumor is injected.
Transarterial chemoembolization (TACE): This procedure is like TAE except an anticancer drug is also given. The procedure can be done by attaching the anticancer drug to small beads that are injected into the hepatic artery or by injecting the anticancer drug through the catheter into the hepatic artery and then injecting the substance to block the hepatic artery. Most of the anticancer drug is trapped near the tumor and only a small amount of the drug reaches other parts of the body. This type of treatment is also called chemoembolization.
Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies used to treat advanced liver cancer include:
Immunotherapy is a treatment that uses the person’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer.
Immune checkpoint inhibitors are a type of immunotherapy. Immune checkpoint inhibitors that may be used to treat liver cancer include:
atezolizumab with the targeted therapy drug bevacizumab or cabozantinib
External radiation therapy uses a machine outside the body to send high-energy x-rays or other types of radiation toward the area of the body with cancer. Radiation is given in a series of treatments to allow healthy cells to recover and to make radiation more effective. The number of treatments is based on details about the cancer, such as the size and location of the tumor. Certain ways of giving external radiation therapy can help keep radiation from damaging nearby healthy tissue:
Conformal radiation therapy: Conformal radiation therapy uses a computer to make a 3-dimensional, or 3-D, picture of the tumor and shapes the radiation beams to fit the tumor. This allows a high dose of radiation to reach the tumor and causes less damage to nearby healthy tissue.
Stereotactic body radiation therapy: Stereotactic body radiation therapy uses special equipment to place the person in the same position for each radiation treatment. Once a day for several days, a radiation machine aims a larger than usual dose of radiation directly at the tumor. By having the person in the same position for each treatment, there is less damage to nearby healthy tissue. This procedure is also called stereotactic external beam radiation therapy and stereotaxic radiation therapy.
Proton beam radiation therapy: Proton beam radiation therapy is a type of high-energy, external radiation therapy that uses streams of protons (tiny particles with a positive charge) to kill tumor cells. This type of treatment can lower the amount of radiation damage to healthy tissue near a tumor.
For some people, joining a clinical trial may be an option. There are different types of clinical trials for people with cancer. For example, a treatment trial tests new treatments or new ways of using current treatments. Supportive care and palliative care trials look at ways to improve quality of life, especially for those who have side effects from cancer and its treatment.
You can use the clinical trial search to find NCI-supported cancer clinical trials accepting participants. The search allows you to filter trials based on the type of cancer, your age, and where the trials are being done. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
This page describes the stages of liver cancer for adults. The stage describes the extent of cancer in the body. Knowing the stage of liver cancer helps the doctor plan the best treatment.
To learn about the tests and procedures used to diagnose and stage primary liver cancer, see Liver Cancer Diagnosis.
There are several staging systems for liver cancer. The Barcelona Clinic Liver Cancer (BCLC) Staging System is widely used to stage primary liver cancer. The system is used to predict the patient’s chance of recovery and to plan treatment, based on the following:
whether the cancer has spread within the liver or to other parts of the body
how well the liver is working
the general health and wellness of the patient
the symptoms caused by the cancer
The BCLC staging system has five stages:
stage 0: very early
stage A: early
stage B: intermediate
stage C: advanced
stage D: end-stage
For liver cancer in adults, stages are also grouped according to how the cancer may be treated:
Localized liver cancer has not spread outside the liver and can be removed by surgery. This includes BCLC stages 0, A, and B.
Locally advanced liver cancer has not spread from the liver to distant parts of the body but cannot be safely removed by surgery. This includes BCLC stage C.
Metastatic liver cancer is cancer that has spread from the liver to distant parts of the body. Metastatic liver cancer cannot be completely removed by surgery. This includes BCLC stage D. To learn more about metastatic cancer, see Metastatic Cancer: When Cancer Spreads.
Recurrent liver cancer is cancer that came back after treatment. The cancer may come back in the liver or in other parts of the body. To learn more about recurrent cancer, see Recurrent Cancer: When Cancer Comes Back.
To learn about other ways cancer stages can be described, see Cancer Staging.
Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat.
It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms. If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.
Tests to screen for liver cancer
Although there is no standard or routine screening tests for liver cancer, the following tests are being used or studied to screen for it:
Ultrasound
Ultrasound is a procedure in which high-energy waves (ultrasound) are bounced off the liver and make echoes. The echoes form a picture of the liver called a sonogram.
CT scan
CT scan is a procedure that makes a series of detailed pictures of the liver, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the liver show up more clearly. This procedure is also called CAT scan or computed tomography.
Alpha-fetoprotein tumor marker
Tumor markers, also called biomarkers, are substances made by the tumor that may be found in the blood, other body fluids, or tissues. A high level of a specific tumor marker may mean that a certain type of cancer is present in the body.
Alpha-fetoprotein (AFP) is the most widely used tumor marker for detecting liver cancer. However, other cancers and certain conditions, including pregnancy, hepatitis, and other types of cancer, may also increase AFP levels.
Specific tumor markers that may lead to early detection of liver cancer are being studied.
Doctors use these screening tests to find, or diagnose, liver cancer. Learn more about Liver Cancer Diagnosis.
Risks of liver cancer screening
Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risk of harms associated with them. Before having any screening test, you may want to discuss the test with your doctor. It is important to be aware of any possible harms of the test and whether the test has been proven to reduce the risk of dying from cancer.
The risks of liver cancer screening include the following:
False-negative test results can occur. Screening test results may appear to be normal even though liver cancer is present. A person who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if there are symptoms.
False-positive test results can occur. Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isn’t) can cause anxiety and is usually followed by diagnostic tests and procedures, such as a liver biopsy, which also have risks.
Procedures to diagnose liver cancer can cause complications. Abnormal screening results may be followed up with a liver biopsy to diagnose liver cancer. Liver biopsy may cause the following rare, but serious, complications:
Tests that examine the liver and the blood are used to detect and diagnose liver cancer. Every person will not receive all the tests described below.
The following tests and procedures may be used:
Physical exam and health history: A physical exam of the body will be done to check a person’s health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Alpha-fetoprotein (AFP) tumor marker test: Tumor markers are released into the blood by organs, tissues, or tumor cells in the body. An increased level of AFP in the blood may be a sign of liver cancer. Other cancers and certain noncancerous conditions, including cirrhosis and hepatitis, may also increase AFP levels. Sometimes the AFP level is normal even when there is liver cancer.
Liver function tests: These blood tests measure the amounts of certain substances released into the blood by the liver. A higher-than-normal amount of a substance can be a sign of liver cancer.
CT scan (CAT scan): This procedure uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body, such as the abdomen, taken from different angles. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. Images may be taken at three different times after the dye is injected, to get the best picture of abnormal areas in the liver. This is called triple-phase CT. A spiral or helical CT scan makes a series of very detailed pictures of areas inside the body using an x-ray machine that scans the body in a spiral path.
Magnetic resonance imaging (MRI): This procedure uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the liver. To create detailed pictures of blood vessels in and near the liver, dye is injected into a vein. This procedure is called magnetic resonance angiography. Images may be taken at three different times after the dye is injected, to get the best picture of abnormal areas in the liver. This is called triple-phase MRI.
Ultrasound exam: This procedure uses high-energy sound waves (ultrasound) that are bounced off the liver and make echoes. The echoes form a picture of the liver called a sonogram.
Biopsy: During a biopsy, cells or tissues are removed so they can be viewed under a microscope by a pathologist to check for signs of cancer. Procedures used to collect the sample of cells or tissues include the following:
Fine-needle aspiration biopsy: A sample of fluid, tissue, or cells is removed using a thin needle.
Core needle biopsy: A sample of cells or tissue is removed using a slightly wider needle.
Laparoscopy: This surgical procedure is done to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Another instrument is inserted through the same or another incision to remove the tissue samples.
A biopsy is not always needed to diagnose liver cancer. Sometimes the doctors can diagnose liver cancer based on the results of imaging tests such as CT scans and MRI.
After primary liver cancer has been diagnosed, tests are done to find out if cancer cells have spread within the liver or to other parts of the body. The process of determining the size and location of the cancer and whether it has spread is called staging.
Some of the tests and procedures used to diagnose liver cancer, such as CT scan and MRI, may be used in the staging process. A positron emission tomography (PET) scan may also be used:
PET scan: This procedure is used to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
What affects liver cancer prognosis?
Once liver cancer has been diagnosed, the prognosis (chance of recovery) and treatment options depend on the following:
the stage of the cancer (the size of the tumor, whether it affects part or all of the liver, or has spread to other places in the body)
how well the liver is working
the patient’s general health, including whether there is cirrhosis of the liver
Finding and treating liver cancer early may prevent death from liver cancer.
Worldwide, liver cancer is the sixth most common cancer and the third leading cause of cancer death. In the United States, rates are highest in American Indian or Alaska Native individuals. Liver cancer is the sixth leading cause of cancer deaths in the United States.
Liver cancer causes and risk factors
The most common type of liver cancer in adults, hepatocellular carcinoma (HCC), typically develops in people with chronic (long-lasting) liver disease caused by hepatitis virus infection or cirrhosis. Men are more likely to develop HCC than women. People with multiple risk factors have an even higher risk.
Many risk factors have been associated with liver cancer. Not everyone with one or more of these risk factors will develop the disease, and the disease will develop in some people who don’t have any known risk factors. Risk factors include the following:
Hepatitis B virus (HBV) infection: HBV can be transmitted in blood, semen, or other body fluids. The infection can be passed from mother to child during childbirth, through sexual contact, or by sharing needles that are used to inject drugs. It can cause inflammation (swelling) of the liver that leads to cancer. Routine HBV vaccination in infancy is reducing the incidence of HBV infection. Chronic HBV infection is the leading cause of liver cancer in Asia and Africa.
Hepatitis C virus (HCV) infection: HCV can be transmitted in the blood. The infection can be spread by sharing needles that are used to inject drugs or, less often, through sexual contact. In the past, it was also spread during blood transfusions or organ transplants. Today, blood banks test all donated blood for HCV, which greatly lowers the risk of getting the virus from blood transfusions. It can cause cirrhosis that may lead to liver cancer. Chronic HCV infection is the leading cause of liver cancer in North America, Europe, and Japan.
Cirrhosis: The risk of developing liver cancer is increased for people who have cirrhosis, a disease in which healthy liver tissue is replaced by scar tissue. The scar tissue blocks the flow of blood through the liver and keeps it from working as it should. Chronic alcoholism and chronic hepatitis infections are common causes of cirrhosis. People with HCV-related cirrhosis have a higher risk of developing liver cancer than people with cirrhosis related to HBV or alcohol use.
Heavy alcohol use: Heavy alcohol use can cause cirrhosis, which is a risk factor for liver cancer. Liver cancer can also occur in heavy alcohol users who do not have cirrhosis. Heavy alcohol users who have cirrhosis are ten times more likely to develop liver cancer, compared with heavy alcohol users who do not have cirrhosis.
Studies have shown there is also an increased risk of liver cancer in people with HBV or HCV infection who use alcohol heavily.
Aflatoxin B1: The risk of developing liver cancer may be increased by eating foods that contain aflatoxin B1 (poison from a fungus that can grow on foods, such as corn and nuts, that have been stored in hot, humid places). It is most common in sub-Saharan Africa, Southeast Asia, and China.
Nonalcoholic steatohepatitis (NASH): NASH is a condition that can cause cirrhosis that may lead to liver cancer. It is the most severe form of nonalcoholic fatty liver disease, where there is an abnormal amount of fat in the liver. In some people, this can cause inflammation and injury to the cells of the liver.
Having NASH-related cirrhosis increases the risk of developing liver cancer. Liver cancer has also been found in people with NASH who do not have cirrhosis.
Cigarette smoking: Cigarette smoking has been linked to a higher risk of liver cancer. The risk increases with the number of cigarettes smoked per day and the number of years the person has smoked.
Other conditions: Certain rare medical and genetic conditions may increase the risk of liver cancer. These conditions include the following:
Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer.
Anything that increases your chance of getting cancer is called a risk factor. Anything that lowers your chance of getting cancer is called a cancer protective factor. Prevention includes avoiding risk factors and increasing protective factors.
The following are protective factors for liver cancer:
Getting the hepatitis B vaccine: Preventing HBV infection (by being vaccinated for HBV as a newborn) has been shown to lower the risk of liver cancer in children. It is not yet known if being vaccinated lowers the risk of liver cancer in adults.
Getting treatment for chronic hepatitis B infection: Treatment options for people with chronic HBV infection include interferon and nucleos(t)ideanalog therapy. These treatments may reduce the risk of developing liver cancer.
Reducing exposure to aflatoxin B1: Replacing foods that contain high amounts of aflatoxin B1 with foods that contain a much lower level of the poison can reduce the risk of liver cancer.
Infantile choriocarcinoma of the liver is a very rare type of cancer that starts in the placenta and spreads to the fetus. The tumor is usually found during the first few months after the baby is born.
The liver is one of the largest organs in the body. It has two lobes and fills the upper right side of the abdomen inside the rib cage. Three of the many important functions of the liver are:
to store glycogen (sugar), which the body uses for energy
to filter harmful substances from the blood so they can be passed from the body in stools and urine
EnlargeAnatomy of the liver. The liver is in the upper abdomen near the stomach, intestines, gallbladder, and pancreas. The liver has a right lobe and a left lobe. Each lobe is divided into two sections (not shown).
The mother of the child may also be diagnosed with choriocarcinoma. For more information on the treatment of choriocarcinoma in the mother, visit Gestational Trophoblastic Disease Treatment.
Symptoms of infantile choriocarcinoma of the liver
Children may not have symptoms of infantile choriocarcinoma of the liver until the tumor has grown bigger. It’s important to check with your child’s doctor if your child has:
slow growth, poor eating, or is not meeting developmental milestones
These symptoms may be caused by problems other than infantile choriocarcinoma of the liver. The only way to know is to see your child’s doctor.
Tests to diagnose infantile choriocarcinoma of the liver
If your child has symptoms that suggest infantile choriocarcinoma of the liver, the doctor will need to find out if these are due to cancer or another problem. The doctor will ask when the symptoms started and how often your child has been having them. They will also ask about your child’s personal and family medical history and do a physical exam. Based on these results, the doctor may recommend other tests. If your child is diagnosed with liver cancer, the results of these tests will help you and your child’s doctor plan treatment.
The tests used to diagnose infantile choriocarcinoma of the liver may include:
Serum tumor marker test
Serum tumor marker tests measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers. The blood of children who have liver cancer may have increased amounts of a hormone called beta-human chorionic gonadotropin (beta-hCG) or a protein called alpha-fetoprotein (AFP). Other cancers, benign liver tumors, and certain noncancer conditions, including cirrhosis and hepatitis, can also increase AFP levels.
the amount of hemoglobin (the protein that carries oxygen) in the red blood cells
the portion of the blood sample made up of red blood cells
Liver function tests
Liver function tests measure the amounts of certain substances released into the blood by the liver. A higher-than-normal amount of a substance can be a sign of liver damage or cancer.
Blood chemistry studies
Blood chemistry studies measure the amounts of certain substances, such as bilirubin or lactate dehydrogenase (LDH), released into the blood by organs and tissues in the body. An unusual amount of a substance can be a sign of disease.
Magnetic resonance imaging (MRI) with gadolinium
MRI uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the liver. A substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear MRI.
EnlargeMagnetic resonance imaging (MRI) scan. The child lies on a table that slides into the MRI machine, which takes a series of detailed pictures of areas inside the body. The positioning of the child on the table depends on the part of the body being imaged.
CT scan (CAT scan)
A CT scan uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body, taken from different angles. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
A CT scan of the chest and abdomen is usually done to help diagnose childhood liver cancer.
EnlargeComputed tomography (CT) scan. The child lies on a table that slides through the CT scanner, which takes a series of detailed x-ray pictures of areas inside the body.
Ultrasound exam
An ultrasound exam uses high-energy sound waves (ultrasound) that bounce off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. An ultrasound exam of the abdomen to check the large blood vessels is usually done to help diagnose childhood liver cancer.
EnlargeAbdominal ultrasound. An ultrasound transducer connected to a computer is pressed against the skin of the abdomen. The transducer bounces sound waves off internal organs and tissues to make echoes that form a sonogram (computer picture).
Chest x-ray
An x-ray is a type of high-energy radiation that can go through the body onto film, making a picture of areas inside the body. A chest x-ray is one that makes pictures of the lungs.
Immunohistochemistry
Immunohistochemistry uses antibodies to check for certain antigens (markers) in a sample of a patient’s tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type.
Getting a second opinion
You may want to get a second opinion to confirm your child’s diagnosis and treatment plan. If you seek a second opinion, you will need to get medical test results and reports from the first doctor to share with the second doctor. The second doctor will review the pathology report, slides, and scans before giving a recommendation. This doctor may agree with the first doctor, suggest changes to the treatment plan, or provide more information about your child’s cancer.
To learn more about choosing a doctor and getting a second opinion, visit Finding Cancer Care. You can contact NCI’s Cancer Information Service via chat, email, or phone (both in English and Spanish) for help finding a doctor or hospital that can provide a second opinion. For questions you might want to ask at your child’s appointments, visit Questions to Ask Your Doctor.
Prognostic factors for infantile choriocarcinoma of the liver
If your child has been diagnosed with infantile choriocarcinoma of the liver, you likely have questions about how serious the cancer is and your child’s chances of survival. The likely outcome or course of a disease is called prognosis.
The prognosis for infantile choriocarcinoma of the liver depends on:
the size of the tumor
your child’s health
how the cancer responds to chemotherapy
whether the cancer can be removed completely by surgery
whether your child can have a liver transplant
whether the cancer has just been diagnosed or has come back
For infantile choriocarcinoma of the liver that comes back after initial treatment, the prognosis depends on:
where in the body the tumor recurred
the type of treatment used to treat the initial cancer
No two people are alike, and responses to treatment can vary greatly. Your child’s cancer care team is in the best position to talk with you about your child’s prognosis.
Types of treatment for infantile choriocarcinoma of the liver
There are different types of treatment for children with infantile choriocarcinoma of the liver. You and your child’s care team will work together to decide treatment. Many factors will be considered, such as your child’s overall health and whether the cancer is newly diagnosed or has come back.
A pediatric oncologist, a doctor who specializes in treating children with cancer, will oversee treatment of infantile choriocarcinoma of the liver. The pediatric oncologist works with other health care providers who are experts in treating children with infantile choriocarcinoma of the liver and who specialize in certain areas of medicine. It is especially important to have a pediatric surgeon with experience in liver surgery who can send patients to a liver transplant program if needed. Other specialists may include:
Your child’s treatment plan will include information about the cancer, the goals of treatment, treatment options, and the possible side effects. It will be helpful to talk with your child’s care team before treatment begins about what to expect. For help every step of the way, visit our booklet, Children with Cancer: A Guide for Parents.
Surgery
When possible, the cancer is removed by surgery. The types of surgery that may be done are:
Partial hepatectomy is surgery to remove the part of the liver where cancer is found. The part removed may be a wedge of tissue, an entire lobe, or a larger part of the liver, along with some of the healthy tissue around it. The remaining liver tissue takes over the functions of the liver and may regrow.
Liver transplant is the removal of the entire liver by surgery, followed by a transplant of a healthy liver from a donor. A liver transplant may be done when the cancer is in the liver only, and a donated liver can be found. If the patient has to wait for a donated liver, other treatment is given as needed.
Chemotherapy is sometimes given before surgery to shrink the tumor and make it easier to remove. This is called neoadjuvant therapy.
Chemotherapy
Chemotherapy (also called chemo) uses drugs to stop the growth of cancer cells. Chemotherapy either kills the cancer cells or stops them from dividing. Chemotherapy may be given alone or with other types of treatment.
For infantile choriocarcinoma of the liver, the chemotherapy is injected into a vein. When given this way, the drugs enter the bloodstream and can reach cancer cells throughout the body.
Chemotherapy drugs used alone or in combination to treat infantile choriocarcinoma of the liver include:
Other chemotherapy drugs not listed here may also be used.
Learn more about how chemotherapy works, how it is given, common side effects, and more at Chemotherapy to Treat Cancer.
Clinical trials
For some children, joining a clinical trial may be an option. There are different types of clinical trials for childhood cancer. For example, a treatment trial tests new treatments or new ways of using current treatments. Supportive care and palliative care trials look at ways to improve quality of life, especially for those who have side effects from cancer and its treatment.
You can use the clinical trial search to find NCI-supported cancer clinical trials accepting participants. The search allows you to filter trials based on the type of cancer, your child’s age, and where the trials are being done. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Treatment of infantile choriocarcinoma of the liver
Treatment of newly diagnosed infantile choriocarcinoma of the liver may include:
chemotherapy to help shrink the tumor, followed by surgery to remove the tumor
surgery to remove the tumor, followed by chemotherapy
chemotherapy, followed by liver transplant if surgery to remove the tumor is not possible
Sometimes infantile choriocarcinoma of the liver continues to grow or recurs (comes back) after treatment. The cancer may come back in the liver or in other parts of the body. Your child’s doctor will work with you to plan treatment if your child is diagnosed with recurrent infantile choriocarcinoma of the liver.
Side effects and late effects of treatment
Cancer treatments can cause side effects. Which side effects your child might have depends on the type of treatment they receive, the dose, and how their body reacts. Talk with your child’s treatment team about which side effects to look for and ways to manage them.
To learn more about side effects that begin during treatment for cancer, visit Side Effects.
Problems from cancer treatment that begin 6 months or later after treatment and continue for months or years are called late effects. Late effects of cancer treatment may include:
physical problems that affect hearing
changes in mood, feelings, thinking, learning, or memory
second cancers (new types of cancer)
Some late effects may be treated or controlled. It is important to talk with your child’s doctors about the long-term effects cancer treatment can have on your child. Learn more about Late Effects of Treatment for Childhood Cancer.
Follow-up care
As your child goes through treatment, they will have follow-up tests or check-ups. Some of the tests that were done to diagnose the cancer or to find out the treatment group may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child’s condition has changed or if the cancer has come back. To learn more about follow-up tests, visit Tests to diagnose infantile choriocarcinoma of the liver.
Coping with your child's cancer
When your child has cancer, every member of the family needs support. Taking care of yourself during this difficult time is important. Reach out to your child’s treatment team and to people in your family and community for support. To learn more, visit Support for Families: Childhood Cancer and the booklet Children with Cancer: A Guide for Parents.
Childhood Undifferentiated Embryonal Sarcoma of the Liver
Childhood undifferentiated embryonal sarcoma of the liver is a rare cancer that usually forms in the tissues of the right lobe of the liver. This type of liver cancer usually occurs in children between 5 and 10 years but can also occur in adolescence. It often spreads throughout the liver and/or to the lungs.
The liver is one of the largest organs in the body. It has two lobes and fills the upper right side of the abdomen inside the rib cage. Three of the many important functions of the liver include:
to store glycogen (sugar), which the body uses for energy
to filter harmful substances from the blood so they can be passed from the body in stools and urine
EnlargeAnatomy of the liver. The liver is in the upper abdomen near the stomach, intestines, gallbladder, and pancreas. The liver has a right lobe and a left lobe. Each lobe is divided into two sections (not shown).
Symptoms of childhood undifferentiated embryonal sarcoma of the liver
Children may not have symptoms of undifferentiated embryonal sarcoma of the liver until the tumor has grown bigger. It’s important to check with your child’s doctor if your child has:
a lump in the abdomen
abdominal pain
weight loss for no known reason
loss of appetite
fatigue or loss of energy
These symptoms may be caused by problems other than undifferentiated embryonal sarcoma of the liver. The only way to know is to see your child’s doctor.
Tests to diagnose childhood undifferentiated embryonal sarcoma of the liver
If your child has symptoms that suggest undifferentiated embryonal sarcoma of the liver, the doctor will need to find out if these are due to cancer or another problem. The doctor will ask when the symptoms started and how often your child has been having them. They will also ask about your child’s personal and family medical history and do a physical exam. Based on these results, the doctor may recommend other tests. If your child is diagnosed with liver cancer, the results of these tests will help you and your child’s doctor plan treatment.
The tests used to diagnose undifferentiated embryonal sarcoma of the liver may include:
the amount of hemoglobin (the protein that carries oxygen) in the red blood cells
the portion of the blood sample made up of red blood cells
Liver function tests
Liver function tests measure the amounts of certain substances released into the blood by the liver. A higher-than-normal amount of a substance can be a sign of liver damage or cancer.
Blood chemistry studies
Blood chemistry studies measure the amounts of certain substances, such as bilirubin or lactate dehydrogenase (LDH), released into the blood by organs and tissues in the body. An unusual amount of a substance can be a sign of disease.
Magnetic resonance imaging (MRI) with gadolinium
MRI uses a magnet, radio waves, and a computer to take a series of detailed pictures of areas inside the liver. A substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. The procedure is also called nuclear MRI.
EnlargeMagnetic resonance imaging (MRI) scan. The child lies on a table that slides into the MRI machine, which takes a series of detailed pictures of areas inside the body. The positioning of the child on the table depends on the part of the body being imaged.
CT scan (CAT scan)
A CT scan uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body, taken from different angles. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
A CT scan of the chest and abdomen is usually done to help diagnose childhood liver cancer.
EnlargeComputed tomography (CT) scan. The child lies on a table that slides through the CT scanner, which takes a series of detailed x-ray pictures of areas inside the body.
Ultrasound exam
An ultrasound exam uses high-energy sound waves (ultrasound) that bounce off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. An ultrasound exam of the abdomen to check the large blood vessels is usually done to help diagnose childhood liver cancer.
EnlargeAbdominal ultrasound. An ultrasound transducer connected to a computer is pressed against the skin of the abdomen. The transducer bounces sound waves off internal organs and tissues to make echoes that form a sonogram (computer picture).
Chest x-ray
An x-ray is a type of high-energy radiation that can go through the body onto film, making a picture of areas inside the body. A chest x-ray is one that makes pictures of the lungs.
Biopsy
Biopsy is a procedure in which a sample of tissue is removed from the tumor so that a pathologist can view it under a microscope to check for cancer. The doctor may remove as much tumor as safely possible during the same biopsy procedure.
Immunohistochemistry
Immunohistochemistry uses antibodies to check for certain antigens (markers) in a sample of a patient’s tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type.
Getting a second opinion
You may want to get a second opinion to confirm your child’s diagnosis and treatment plan. If you seek a second opinion, you will need to get medical test results and reports from the first doctor to share with the second doctor. The second doctor will review the pathology report, slides, and scans. This doctor may agree with the first doctor, suggest changes to the treatment plan, or provide more information about your child’s cancer.
To learn more about choosing a doctor and getting a second opinion, visit Finding Cancer Care. You can contact NCI’s Cancer Information Service via chat, email, or phone (both in English and Spanish) for help finding a doctor or hospital that can provide a second opinion. For questions you might want to ask at your child’s appointments, visit Questions to Ask Your Doctor.
Prognostic factors for childhood undifferentiated embryonal sarcoma of the liver
If your child has been diagnosed with undifferentiated embryonal sarcoma of the liver, you likely have questions about how serious the cancer is and your child’s chances of survival. The likely outcome or course of a disease is called prognosis.
The prognosis for undifferentiated embryonal sarcoma of the liver depends on:
the size of the tumor
how the cancer responds to chemotherapy
whether the cancer can be removed completely by surgery
whether your child can have a liver transplant
whether the cancer has spread to other places in the body, such as the lungs
whether the cancer has just been diagnosed or has come back after treatment
For childhood undifferentiated embryonal sarcoma of the liver that comes back after initial treatment, the prognosis depends on:
where in the body the tumor came back
the type of treatment used to treat the initial cancer
No two people are alike, and responses to treatment can vary greatly. Your child’s cancer care team is in the best position to talk with you about your child’s prognosis.
Types of treatment for childhood undifferentiated embryonal sarcoma of the liver
There are different types of treatment for children and adolescents with undifferentiated embryonal sarcoma of the liver. You and your child’s care team will work together to decide treatment. Many factors will be considered, such as your child’s overall health and whether the cancer is newly diagnosed or has come back.
A pediatric oncologist, a doctor who specializes in treating children with cancer, will oversee treatment of undifferentiated embryonal sarcoma of the liver. The pediatric oncologist works with other health care providers who are experts in treating children with undifferentiated embryonal sarcoma of the liver and who specialize in certain areas of medicine. It is especially important to have a pediatric surgeon with experience in liver surgery who can send patients to a liver transplant program if needed. Other specialists may include:
Your child’s treatment plan will include information about the cancer, the goals of treatment, treatment options, and the possible side effects. It will be helpful to talk with your child’s care team before treatment begins about what to expect. For help every step of the way, visit our booklet, Children with Cancer: A Guide for Parents.
Surgery
When possible, the cancer is removed by surgery. The following types of surgery may be done:
Partial hepatectomy is surgery to remove the part of the liver where cancer is found. The part removed may be a wedge of tissue, an entire lobe, or a larger part of the liver, along with some of the healthy tissue around it. The remaining liver tissue takes over the functions of the liver and may regrow.
Liver transplant is the removal of the entire liver by surgery, followed by a transplant of a healthy liver from a donor. A liver transplant may be done when the cancer is in the liver only, and a donated liver can be found. If the patient has to wait for a donated liver, other treatment is given as needed.
Chemotherapy is sometimes given before surgery to shrink the tumor and make it easier to remove. This is called neoadjuvant therapy.
Chemotherapy
Chemotherapy (also called chemo) uses drugs to stop the growth of cancer cells. Chemotherapy either kills the cancer cells or stops them from dividing.
For childhood undifferentiated embryonal sarcoma of the liver, the chemotherapy is injected into a vein. When given this way, the drugs enter the bloodstream and can reach cancer cells throughout the body.
Chemotherapy drugs used alone or in combination to treat undifferentiated embryonal sarcoma of the liver in children include:
Other chemotherapy drugs not listed here may also be used.
Learn more about how chemotherapy works, how it is given, common side effects, and more at Chemotherapy to Treat Cancer.
Clinical trials
For some children, joining a clinical trial may be an option. There are different types of clinical trials for childhood cancer. For example, a treatment trial tests new treatments or new ways of using current treatments. Supportive care and palliative care trials look at ways to improve quality of life, especially for those who have side effects from cancer and its treatment.
You can use the clinical trial search to find NCI-supported cancer clinical trials accepting participants. The search allows you to filter trials based on the type of cancer, your child’s age, and where the trials are being done. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Treatment of childhood undifferentiated embryonal sarcoma of the liver
Treatment of newly diagnosed childhood undifferentiated embryonal sarcoma of the liver may include:
surgery to remove the tumor
chemotherapy before surgery, after surgery, or both
liver transplant if surgery to remove the tumor is not possible
If the first surgery is unable to remove the entire tumor, a second surgery may be done to remove the remaining tumor cells.
Sometimes childhood undifferentiated embryonal sarcoma of the liver continues to grow or recurs (comes back) after treatment. The cancer may come back in the liver or in other parts of the body. Your child’s doctor will work with you to plan treatment if your child is diagnosed with recurrent undifferentiated embryonal sarcoma of the liver.
Side effects and late effects of treatment
Cancer treatments can cause side effects. Which side effects your child might have depends on the type of treatment they receive, the dose, and how their body reacts. Talk with your child’s treatment team about which side effects to look for and ways to manage them.
To learn more about side effects that begin during treatment, visit Side Effects.
Problems from cancer treatment that begin 6 months or later after treatment and continue for months or years are called late effects. Late effects of cancer treatment may include:
physical problems
changes in mood, feelings, thinking, learning, or memory
second cancers (new types of cancer)
Some late effects may be treated or controlled. It is important to talk with your child’s doctors about the long-term effects cancer treatment can have on your child. Learn more about Late Effects of Treatment for Childhood Cancer.
Follow-up care
As your child goes through treatment, they will have follow-up tests or check-ups. Some of the tests that were done to diagnose the cancer or to find out the treatment group may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child’s condition has changed or if the cancer has come back. To learn more about follow-up tests, visit Tests to diagnose childhood undifferentiated embryonal sarcoma of the liver.
Coping with your child's cancer
When your child has cancer, every member of the family needs support. Taking care of yourself during this difficult time is important. Reach out to your child’s treatment team and to people in your family and community for support. To learn more, visit Support for Families: Childhood Cancer and the booklet Children with Cancer: A Guide for Parents.
Primary liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver. Cancer that forms in other parts of the body and spreads to the liver is not primary liver cancer. The liver is one of the largest organs in the body. It has two lobes and fills the upper right side of the abdomen inside the rib cage. The main functions of the liver include the following:
to make bile to help digest fat that comes from food
to store glycogen (sugar), which the body uses for energy
to filter harmful substances from the blood so they can be passed from the body in stools and urine
EnlargeAnatomy of the liver. The liver is in the upper abdomen near the stomach, intestines, gallbladder, and pancreas. The liver has a right lobe and a left lobe. Each lobe is divided into two sections (not shown).
Most adult primary liver cancers are hepatocellular carcinomas. This type of liver cancer is the third leading cause of cancer-related deaths worldwide.
Primary liver cancer can occur in both adults and children. However, treatment for children is different than treatment for adults. For more information, see Childhood Liver Cancer.
Signs and symptoms of liver cancer
These and other signs and symptoms may be caused by adult primary liver cancer or by other conditions. Check with your doctor if you have any of the following:
a hard lump on the right side just below the rib cage
discomfort in the upper abdomen on the right side
a swollen abdomen
pain near the right shoulder blade or in the back
jaundice (yellowing of the skin and whites of the eyes)
easy bruising or bleeding
unusual tiredness or weakness
nausea and vomiting
loss of appetite or feelings of fullness after eating a small meal
This page describes the different types of treatment for bile duct cancer (cholangiocarcinoma). Which of these treatments a person receives will depend on whether the cancer can be completely removed with surgery (resectable) or not (unresectable). To learn more, see treatment of resectable and treatment of unresectable bile duct cancer.
Types of treatment
Surgery
The following types of surgery are used to treat bile duct cancer:
Removal of the bile duct: This surgical procedure is done to remove part of the bile duct if the tumor is small and is in the bile duct only. Lymph nodes are removed and tissue from the lymph nodes is viewed under a microscope to see if there is cancer.
Partial hepatectomy: This is a surgical procedure to remove the part of the liver where cancer is found. The part removed may be a wedge of tissue, an entire lobe, or a larger part of the liver, along with some normal tissue around it.
Whipple procedure: During this surgical procedure the head of the pancreas, the gallbladder, part of the stomach, part of the small intestine, and the bile duct are removed. Enough of the pancreas is left to make digestive juices and insulin.
After the doctor removes all the cancer that can be seen at the time of the surgery, some people may receive chemotherapy or radiation therapy to kill any cancer cells that are left. Treatment given after surgery to lower the risk that the cancer will come back is called adjuvant therapy. It is not yet known whether chemotherapy or radiation therapy given after surgery helps keep the cancer from coming back.
The following types of palliative surgery may be done to relieve symptoms caused by a blocked bile duct and improve quality of life:
Biliary bypass: If cancer is blocking the bile duct and bile is building up in the gallbladder, a biliary bypass may be done. During this operation, the doctor will cut the gallbladder or bile duct in the area before the blockage and sew it to the part of the bile duct that is past the blockage or to the small intestine. This type of surgery creates a new pathway around the blocked area.
Endoscopic stent placement: If the tumor is blocking the bile duct, surgery may be done to put in a stent (a thin, flexible tube) to drain bile that has built up in the area. The doctor may place the stent through a catheter that drains the bile into a bag on the outside of the body or the stent may go around the blocked area and drain the bile into the small intestine.
Percutaneous transhepatic biliary drainage: This procedure is used to x-ray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an x-ray is taken. If the bile duct is blocked, a stent may be left in the liver to drain bile into the small intestine or a collection bag outside the body.
Radiation therapy
Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. These are the main ways radiation might be given to treat bile duct cancer:
External radiation therapy: A machine outside the body sends radiation toward the area of the body with cancer. Radiation is given in a series of treatments to allow healthy cells to recover and to make radiation more effective. The number of treatments is based on details about the cancer, such as the size and location of the tumor.
It is not known whether external radiation therapy helps in the treatment of resectable bile duct cancer. In unresectable, metastatic, or recurrent bile duct cancer, new ways to improve the effect of external radiation therapy on cancer cells are being studied:
Hyperthermia therapy: Body tissue is exposed to high temperatures to make cancer cells more sensitive to the effects of radiation therapy and certain anticancer drugs.
Radiosensitizers: Drugs called radiosensitizers make cancer cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more cancer cells.
Internal radiation therapy: A radioactive substance is sealed in needles, seeds, wires, or catheters that are placed directly into or near the bile duct.
External and internal radiation therapy are used to treat bile duct cancer and may also be used as palliative therapy to relieve symptoms and improve quality of life.
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. There are two main types of chemotherapy used to treat bile duct cancer.
Systemic chemotherapy: When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body.
Systemic chemotherapy is used to treat unresectable, metastatic, or recurrent bile duct cancer. The following chemotherapy drugs may be used:
Regional chemotherapy: When chemotherapy is placed directly into an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas.
Intra-arterial embolization is being studied in the treatment of unresectable, metastatic, or recurrent bile duct cancer. It is a procedure in which the blood supply to a tumor is blocked after anticancer drugs are given in blood vessels near the tumor. Sometimes, the anticancer drugs are attached to small beads that are injected into an artery that feeds the tumor. The beads block blood flow to the tumor as they release the drug. This allows a higher amount of drug to reach the tumor for a longer period of time, which may kill more cancer cells.
It is not known whether systemic chemotherapy helps in the treatment of resectable bile duct cancer.
To learn about the different ways chemotherapy works against cancer, what to expect when receiving chemotherapy, and how to manage chemotherapy side effects, see Chemotherapy to Treat Cancer.
Liver transplant
In a liver transplant, the entire liver is removed and replaced with a healthy donated liver. A liver transplant may be done in people with perihilar bile duct cancer. If the person has to wait for a donated liver, other treatment is given as needed.
Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Your doctor may suggest biomarker tests to help predict your response to certain targeted therapy drugs. Learn more about Biomarker Testing for Cancer Treatment.
The following targeted therapy drugs may be used to treat bile duct cancer:
For some people, joining a clinical trial may be an option. There are different types of clinical trials for people with cancer. For example, a treatment trial tests new treatments or new ways of using current treatments. Supportive care and palliative care trials look at ways to improve quality of life, especially for those who have side effects from cancer and its treatment.
You can use the clinical trial search to find NCI-supported cancer clinical trials accepting participants. The search allows you to filter trials based on the type of cancer, your age, and where the trials are being done. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Treatment of resectable (localized) bile duct cancer
If the cancer has not spread and is in a place where surgery can be safely done, the tumor and some of the tissue around it will be removed. This lowers the chance of the cancer coming back. Chemotherapy with or without radiation therapy may be given after surgery.
Treatment of resectable intrahepatic bile duct cancer may include surgery to remove the cancer. A partial hepatectomy with or without embolization may be done before the surgery.
Treatment of resectable perihilar bile duct cancer may include:
surgery to remove the cancer, which may include partial hepatectomy
stent placement or percutaneous transhepatic biliary drainage, as palliative therapy to relieve jaundice and other symptoms and improve quality of life
Treatment of resectable distal bile duct cancer may include:
surgery to remove the cancer, which may include a Whipple procedure
stent placement or percutaneous transhepatic biliary drainage, as palliative therapy to relieve jaundice and other symptoms and improve quality of life
Adjuvant therapy for resectable bile duct cancer may include:
chemotherapy
external-beam radiation therapy
a clinical trial of adjuvant therapy
Treatment of unresectable bile duct cancer (including metastatic or recurrent disease)
Most people with bile duct cancer cannot have their cancer completely removed with surgery. This may be the case if the cancer has spread too far, the cancer is in a place that is too difficult to completely remove with surgery, or the patient is not healthy enough for surgery.
Treatment of unresectable bile duct cancer (including metastatic or recurrent disease) may include:
stent placement or biliary bypass, as palliative treatment to relieve symptoms and improve quality of life
external or internal radiation therapy, as palliative treatment to relieve symptoms and improve quality of life
