Liver and Bile Duct Cancer Treatment, Side Effects and Support

At Banner MD Anderson Cancer Center, our liver and bile duct cancer experts build a customized treatment plan around your needs. We consider the type, location and stage of your cancer, as well as your personal preferences and overall health, to safely and effectively treat your cancer. Your expert team includes oncologists, pathologists and highly skilled support staff, working together to ensure you receive comprehensive care to treat your liver or bile duct cancer.

How Are Liver and Bile Duct Cancers Treated?

Liver and bile duct cancers are difficult to treat in later stages. If found early, cancer in the liver or bile duct has a much higher chance for successful treatment. Your treatment options will depend on your:

• Cancer stage
• Liver cirrhosis
• Overall health

Your doctor may recommend one or more of the following therapies to treat or manage your liver cancer or bile duct cancer symptoms:

• Surgery: Surgery is your best chance for successful liver cancer treatment. Surgeons will remove the cancer while leaving as much healthy liver as possible. If liver damage is too extensive, you may need a full liver transplant. For bile duct cancer, surgeons remove part of the bile duct and join the cut ends. In some cases, nearby liver tissue, lymph nodes or pancreas tissue may also be removed.
• Tumor ablation: Heat (radiofrequency ablation) or extreme cold (cryosurgery or cryotherapy) is used to freeze or burn the liver cancer or bile duct cancer away.
• Embolization: Tiny pellets are injected in the arteries that carry blood to the tumor to block blood flow, which makes it harder for liver cancer to grow.
• Radiation therapy: Radiation therapy may be used to shrink the tumor or relieve pain.
• Proton therapy: High radiation is delivered directly into the liver tumor.
• Chemotherapy: Standard chemotherapy is not effective in most patients with liver cancer; however, new treatments such as chemoembolization are starting to become available. For bile duct cancer, chemotherapy may be used before a liver transplant or to slow the disease and relieve symptoms in people with advanced bile duct cancer.
• Targeted therapy: Drugs block the growth and spread of cancer, limiting damage to healthy cells.
• Photodynamic therapy: A light-sensitive chemical is injected into a vein and builds up in fast-growing cancer cells. Laser light directed at cancer causes a chemical reaction in cancer cells that kills them.
• Immunotherapy: Immunotherapy uses your immune system to fight cancer by interfering with the process of cancer cells producing proteins that help them hide from immune system cells. Immunotherapy may be an option for advanced bile duct cancer when other treatments haven’t helped.
• Endoscopic therapy: A special side-viewing endoscope is inserted to access your biliary duct and endoscopic dilators or an inflatable balloon are inserted, using a guidewire to ensure proper placement.
• Biliary drainage: Biliary drainage involves placing a thin tube into the bile duct to drain the bile, placing stents to hold open a bile duct or performing a bypass surgery to reroute bile.
• Liver transplant: For some people with hilar cholangiocarcinoma, surgery to remove the liver and replace it with one from a donor (liver transplant) may be an option.
• Clinical trials: Talk to your doctor about clinical trials offered at Banner MD Anderson.

What Are Side Effects of Liver or Bile Duct Cancer Treatment?

Your body will need time to recover from liver or  bile duct cancer treatment. Talk to your doctor about any pain, issues or new symptoms you are feeling throughout your treatment process. Banner MD Anderson’s team of specialists can help relieve your symptoms and get you the care you need.

The following are the most common side effects of liver or bile duct cancer treatment:

• Percutaneous ethanol injection: Fever, pain
• Cryosurgery: Generally faster healing, low pain
• Hepatic arterial infusion: Infection and problems with a pump device
• Chemoembolization: Nausea, vomiting, fever, abdominal pain
• Radiation therapy: Nausea, vomiting, diarrhea, problems with digestion
• Chemotherapy: Hair loss, loss of appetite, nausea, vomiting, diarrhea, fatigue, mouth sores
• Liver transplants: Several weeks in the hospital to recover

When you undergo liver or bile duct cancer treatment, most doctors recommend you do not use acetaminophen to relieve pain as it can damage the liver.

Liver and Bile Duct Cancer Treatment Support

Liver and bile duct cancers take both a physical and emotional toll. Our Integrative Oncology Program provides patients compassionate support, resources and therapies to help take care of the whole person, not just the cancer.