Inroads are being made in the treatment of gallbladder and bile duct cancers, and seeking medical care at a comprehensive cancer center provides the experience and options necessary to successfully attack these rare but serious diseases.
First, catching gallbladder and bile duct cancers early — before they have a chance to grow and spread — is crucial to successful treatment.
Although there are no screening guidelines for either of these cancers, Fong said, they can be detected during a patient’s annual physical exam. If blood tests reveal abnormal liver enzymes, positive results on follow-up tests — and ruling out other diseases — may indicate gallbladder or bile duct cancer.
In between exams, people should contact their physician if they experience any of the following, which may be symptoms of these cancers:
Light-colored or greasy stools
Abdominal pain or discomfort
Loss of appetite
Experience and expertise matters in treatment
Because both gallbladder and bile duct cancers are rare, few physicians have experience treating them. Patients who seek treatment or second opinions at a comprehensive cancer center, such as City of Hope, will have the most experienced doctors and therapy options not available elsewhere, such as clinical trials of promising drugs or minimally invasive surgical techniques that can reduce side effects and recovery time.
Being treated at a comprehensive cancer center can improve outcomes, Fong said, offering the example of the decreased risk of complications patients experience after bile duct cancer surgery performed at such centers.
Therapies are continually improving
Over the past three decades therapies for gallbladder and bile duct cancers have improved greatly, said Fong, extending patients’ survival and giving them a better chance at a cure. One important advance over the past decade is the improvement in chemotherapy. In some cases, Fong said, newer and better uses of cancer-fighting drugs can allow patients with inoperable disease to become eligible for surgery.
At City of Hope, treatments being explored to attack these cancers include:
Novel surgical approaches: Surgeons are constantly working to develop procedures to improve a patient’s clinical outcome and quality of life. These include expanding the use of minimally invasive procedures and stimulating liver regeneration, so more suspicious tissue can be removed during surgery.
Targeted therapy: Scientists are researching drugs that target cancer cells, attacking tumors while sparing normal cells. They’re currently studying the effectiveness of pembrolizumab (Keytruda), an immunotherapy drug, against gallbladder and bile duct cancers.
Precise radiation: Improved radiation technology and techniques can allow tumors to be treated while reducing exposure to surrounding normal tissue. Current developments include coupling advanced imaging with external beam radiation delivery, allowing real-time adjustments to focus the beams precisely on tumor sites.