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How We Treat Biliary Cancer

  • Our approach to care

    The Pancreas and Biliary Tumor Center at Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC) brings together a team of experts who specialize in treating biliary cancer. We offer patients the most advanced treatments and clinical trials.

    Because biliary cancer is usually diagnosed in the later stages, once symptoms occur, the disease is considered to be advanced and can be challenging to treat. It is important to choose a treatment center with a team that specializes in this kind of cancer and has treated many patients with the disease.

    Personalized treatment plans

    We treat the whole person, not just the disease.

    Our highest priority is providing our patients and their loved ones with exceptional medical and supportive care. A team of medical specialists, nurses specializing in biliary cancer, and other support staff (dietitians, integrative therapists, and many others) collaborate in the management of your care.

    Your health care team will take the time to connect with you one-on-one, listen, and understand your needs and preferences. We offer the most advanced therapies possible, while also helping you maintain your quality of life during treatment. We encourage you to be actively involved in the decision-making process.

    Our multidisciplinary approach

    Your team of specialists — gastroenterologists, medical oncologists, radiation oncologists, surgical oncologists, pathologists, radiologists, palliative care physicians, and dedicated nursing, nutrition and social work staff — works closely together from your initial diagnosis through your entire treatment, ensuring that your care is coordinated.

    Clinical trials and genetic screening

    Our specialists are actively involved in research, and apply the latest knowledge to your care. Genetic screening is available to all our patients. Our targeted therapies through clinical trials are a part of our treatment approach, and many of our patients choose to participate.

    Supportive resources

    To address all of your physical and emotional needs, we provide a comprehensive range of support services and complementary and integrative therapies. We offer individual and family counseling, rehabilitation and physical therapy, pain and symptom management, acupuncture, massage, Reiki, and support groups.

    If you would like a second opinion, or to have our team consult on your care plan...

    If you have been diagnosed with biliary cancer and would like a second opinion or to meet with us about your care plan, please contact us. It is important that you get a second opinion before you start treatment.

    Reasons to consider a second opinion may include:

    • To confirm your diagnosis
    • To determine the optimal sequence for your therapies
    • To learn more about your biliary cancer from a knowledgeable specialist who has treated other patients just like you
    • To better understand your options for treatment
    • To learn if you are eligible for a clinical trial

    Phone: 877-442-DFCI or 877-442-3324
    Online: Complete the Appointment Request Form

    Treatment for biliary cancer

    The main types of treatment for biliary cancer include:

    • Surgery
    • Chemotherapy
    • Radiation therapy
    • Palliative therapy

    Surgery

    At the Pancreas and Biliary Tumor Center, our surgical team is one of the most experienced in the United States. Dedicated biliary surgeons use a variety of innovative techniques including:

    • Minimally-invasive and robotic surgery using laparoscopic techniques
    • Bile duct resection and reconstruction, often with removal of a portion of the liver
    • Newer surgical procedures to remove larger tumors that previously were considered inoperable

    Surgery for tumors of the bile duct and gallbladder differ, depending on where the tumor is located:

    • Gallbladder: For all except superficial tumors of the gallbladder, surgery consists of removing the gallbladder with a portion of the surrounding liver, as well as nearby lymph nodes to be sure that no tumor cells are present.
    • Bile duct: Surgery can vary depending on where a tumor is located in the bile duct. Some tumors will require removal of the distal (far) end of the bile duct, which requires the Whipple procedure, or removal of the head of the pancreas and duodenum. Tumors of the more proximal (near) bile duct might be removed without removal of a portion of the pancreas, but could require removal of a portion of the liver to ensure that all of the tumor has been removed.

    Medical oncology and chemotherapy

    We work with our large multidisciplinary team to direct your care. Because of our close integration with other specialists in our Center, our team offers you their collective expertise when formulating and executing an optimal care plan. When chemotherapy is indicated, our 20 medical oncologists are national leaders in improving the use of chemotherapy for biliary cancer through clinical trials and basic research.

    Medical oncologists administer chemotherapy, a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Our medical oncologists are highly experienced in optimizing chemotherapy and reducing side effects, and your oncologists will use their extensive expertise to determine the most appropriate treatment regimen for you.

    Our medical oncologists:

    • Have experience with the latest therapies and have the expertise to tailor these therapies to each patient for the greatest likelihood of success. Our team will discuss these options with you to determine the appropriate care plan.
    • Address difficult symptoms you may be experiencing, such as pain, jaundice, nausea, weight loss, and emotional distress.

    Clinical trials

    The Pancreas and Biliary Tumor Center offers clinical trials for biliary cancer, providing you with the most innovative treatment options, which may not be available elsewhere. We have several clinical trials open at a time for patients with biliary cancer.

    As a research center, clinical trials are an important aspect of our program. Through these trials, we are able to study new cancer treatments and offer them at our Center. Most of today's standard treatments for cancer are based on earlier clinical trials.

    Some clinical trials include only patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not improved. There are also clinical trials that test new ways to stop cancer from recurring or reduce the side effects of treatment. Patients can enter clinical trials before, during, or after starting cancer treatment.

    Radiation oncology

    The approach we take to treating biliary cancer with radiation is unique, combining external beam with brachytherapy, a technically sophisticated way to give a higher dose radiation directly within the bile duct.

    We also offer stereotactic radiation therapy, which uses a highly focused, highly accurate x-ray beam to deliver a large dose of radiation in a single treatment to localized lesions that are unable to be removed surgically. This therapy has been able to treat patients without surgery.

    Our radiation oncologists are national leaders in the improvement of radiation therapy for biliary cancer. You will receive a carefully considered, customized plan for radiation therapy when it is determined to be part of your treatment plan.

    Sequencing the use of radiation therapy appropriately in your treatment plan is critical because the order in which you receive treatments makes a difference. We encourage patients who have been diagnosed elsewhere to see us for a second opinion before starting radiation therapy, since once you start on a path of treatment, we are often not able to adjust it.

    Radiation therapy is often recommended:

    • After surgery and chemotherapy to further decrease the chance of the cancer returning
    • To reduce the tumor prior to surgical resection and make it operable
    • To help control cancers that cannot be removed surgically

    Your hospital care

    If your treatment calls for a surgical procedure, or if you need to be admitted to the hospital for any reason, you will receive your care at Brigham and Women's Hospital. Post-surgical care and other inpatient care are provided by the Dana-Farber/Brigham and Women's Cancer Center team either at Brigham and Women's Hospital or at Dana-Farber's Inpatient Hospital located within Brigham and Women's Hospital.

    All outpatient infusion therapy is provided at the Yawkey Center for Cancer Care at Dana-Farber Cancer Institute, one of the most advanced outpatient cancer centers in the United States.

    Radiation Oncology has two separate units, one at Brigham and Women's Hospital and the other at Dana-Farber. Both are staffed by 25 radiation oncologists who work at both locations.

    For Referring Physicians

    Because you, the physician, are an integral part of your patient’s care team, we are committed to collaborating with you to ensure the best care for your patient.

    If you have a patient with a biliary cyst, or with diagnosed or suspected biliary cancer, we look forward to working with you and encourage you to contact us before starting your patient on a treatment regimen.

    Find out more about how to refer a patient to DF/BWCC.

    Biliary Cancer Support Services and Follow-up Care

    When you become a patient at the Pancreas and Biliary Tumor Center, you and your loved ones have access to our extensive array of support programs and services before, during, and after your treatment — connecting you to all the support services you need.

    Managing symptoms and side effects

    We understand that the symptoms from cancer, and the cancer treatment itself, can be physically and emotionally challenging. We can help you feel better by managing your symptoms with nutritional guidance, pain management, counseling, complementary and integrative therapies, and more.

    We provide a wide range of support groups, programs, and resources for our patients. These programs and resources can help you and your family address issues that you may face as a result of your cancer and its treatment, like fatigue or depression.

    Learn more about the support services we offer to our patients.

    Follow-up and survivorship care

    All patients in the Center receive comprehensive, personalized post-treatment follow-up care. We pride ourselves on providing each patient with a personalized follow-up care plan – including clear steps for monitoring your health after treatment ends.

    After completing your treatment, you will stay under close surveillance. Typically, this includes tumor marker and radiology tests every three months for at least the first few years after completing therapy. Patients travelling long distances for care may have follow-up and surveillance coordinated with physicians closer to their home.

    We also offer an extensive survivorship program to help our patients resume full lives after cancer.

    Explore additional information, resources, and support for living well beyond cancer.