Bile duct cancer treatment at GenesisCare

Bile ducts are part of the digestive system and are the tubes that link the liver and gallbladder to the small bowel. They transport bile, which helps break down the fat in our food. Bile duct cancer is rare. You are more likely to get it if you’re aged over 65.¹

Extra-hepatic bile ducts are split into two areas:

• Hilar – where the right and left ducts meet, below the liver
• Distal – the lower section of the ducts, near the bowel

Causes of bile duct cancer

Doctors don’t yet know what causes bile duct cancer, but some things can make it more likely. These include:¹

• Abnormal bile ducts
• Bile duct stones
• Hepatitis B or C
• Infection with a parasite called liver fluke (most common in Africa and Asia)
• Liver disease (cirrhosis)
• Long-term inflammatory conditions such as ulcerative colitis or primary sclerosing cholangitis

Symptoms of bile duct cancer

• Jaundice (skin and whites of eyes becoming yellow) Dark urine and pale stools
• High temperature (fever) Itchy skin
• Loss of appetite
• Pain in your abdomen Unexplained weight loss Extreme tiredness

Having these symptoms does not mean you have bile duct cancer, but it is best to get them checked by a doctor.

Your doctor will discuss your specific symptoms with you. You may need tests including:^1,2

• Biopsy – where a tiny sample of tissue is taken for analysis
• Blood tests
• Scans including ultrasound, CT and MRI
• ERCP (endoscopic retrograde choangio-pancreatography) – a test carried out under general anaesthetic where a camera is passed down your throat, beyond your stomach to take X-ray images of the pancreatic and bile ducts, looking for any blockages
• PTC (percutaneous transhepatic cholangiography) – a test carried out under sedation, where an injection of dye is put into your bile ducts within the liver, and then X-rays are taken, looking for any blockages
• Standard X-rays.

Treatment for bile duct cancer will depend on the location and extent of the cancer, whether the cancer can be removed with surgery, likely side effects of treatment and your overall health.² Your doctor (oncologist) will discuss the treatment options with you. They may include:

• Surgery
• Chemotherapy
• Radiation therapy
• Photodynamic

Radiation therapy for bile duct cancer

Radiation destroys cancer cells in a targeted site in your body. Treatment is carefully planned, and with the developments in technology, very little harm is done to normal body tissue surrounding the tumour.³

You may have internal radiation therapy (brachytherapy) – high dose brachytherapy is a specialised treatment for selected patients with biliary cholangiocarcinoma. It is undertaken with an interventional radiation therapist following percutaneous transhepatic cholangiogram. Other patients with cholangiocarcinoma may be more suited to external beam radiation.

Radiation therapy can be delivered independently or alongside chemotherapy. Your doctor will discuss your specific treatment plan with you.

Chemotherapy for bile duct cancer

Chemotherapy is medication that treats your cancer by disrupting the cell cycle. The drugs kill cancer cells, preventing them from dividing and spreading further.

A cancer diagnosis is life changing. Even before your initial encounter with us you will experience a wave of emotions. It’s natural to feel disbelief, anxiety, sadness, anger and loneliness. At GenesisCare we understand these emotions and strive to strengthen your confidence, settle your emotions and create care experiences for the best possible outcomes.

Our care team know your name and get to know who you are as a person. We don’t want you to feel alone when you’re at GenesisCare. Your nursing team and oncology team are here to support you before, during and after your cancer treatment. We are here to guide you to get the support you need which may include a psychologist, exercise physiologist, physiotherapist and dietitian.

Please contact your local GenesisCare centre for more details on services available. View a list of our centres.

Radiation therapy

General side effects:³

• Soreness and swelling around the treatment area
• Tiredness and lethargy for a few weeks after you finish

Specific side effects (depending on the area being treated):

• Digestive issues – reduced appetite, pain, discomfort or bloating
• Change in bowel habits
• Nausea or

Most of these side effects will ease shortly after treatment is finished. Your team will discuss any long-term considerations with you depending on the tumour type.

Chemotherapy

Side effects⁴

Whether you experience side effects and how severe they are, depends on the type and dose of drugs you are given and your reaction from one treatment cycle to the next.

• Most side-effects are short-term and can be managed
• They tend to gradually improve once treatment stops and the normal, healthy cells recover

You may worry about the side effects of chemotherapy. If you feel upset or anxious about how long treatment is taking or the impact of side effects, let your doctor or nurse know.

What can I do to help my treatment go smoothly?

• Get as much rest as possible
• Eat a wholefood, varied diet
  • Appetite changes are common, and you may experience taste changes or nausea – help manage this by eating small, frequent snacks, avoiding smells that make you feel nauseous, eating foods that interest you rather than what you think you ‘should’ eat
• Keep up your water intake
• Reach out to support groups and others who have had
• Ask your team about topical treatments for skin if you are getting irritation or pain
• Stay out of the sun as much as possible throughout your treatment
• Record your side effects in a diary or journal
• Take some gentle exercise, such as walking, if you feel up to it. Light to moderate exercise can reduce treatment-related fatigue and improve
  • It is important to acknowledge when you are fatigued, and rest when you need to. Plan your exercise for times in the day when you know you have more energy

• Ask for, and accept, help from family, friends and neighbours
• Be open with employers about your treatment and discuss flexible working options where needed

1. Patel Nat Rev Gastroenterol Hepatol 2011; 8(4):189-200.
2. Cancer Council Australia. Gall bladder cancer. Available at: https://www.cancer.org.au/cancer-information/types-of-cancer/rare-cancers/gall-bladder-cancer. Accessed on: 13/05/21
3. Cancer Council Australia. Radiation therapy. Available at: https://www.cancer.org.au/cancer-information/treatment/radiation-therapy. Accessed on: 13/05/21.
4. Cancer Council Victoria. Chemotherapy side effects. Available at: https://www.cancervic.org.au/cancer-information/treatments/treatments-types/chemotherapy/side_effects_of_chemotherapy.html Accessed o: 13/05/21.