Our Approach & Expertise
Memorial Sloan Kettering has a longstanding commitment to improving the treatment of gallbladder and bile duct cancer, with the goal of developing more effective, targeted therapies.
A common type of bile duct cancer is intrahepatic cholangiocarcinoma, which begins in the bile ducts within the liver. (For information about primary liver cancer (hepatocellular carcinoma), visit the Liver Cancer information.)
Team Approach to Care
Memorial Sloan Kettering takes a multidisciplinary team approach to providing the best possible diagnosis, treatment, and palliative care for patients with gallbladder and bile duct cancer. Our team includes:
- medical oncologists, who treat cancer with chemotherapy and novel biologic therapy
- radiation oncologists, who use radiation therapy to shrink tumors
- gastroenterologists, who diagnose and treat disorders of the digestive system
- diagnostic radiologists, who use imaging to diagnose diseases
- interventional radiologists, who deliver nonsurgical, minimally invasive therapies
- pathologists, who identify diseases by studying cells and tissues under a microscope
- social workers
- complementary medicine specialists
Members of our team meet weekly to discuss the treatment of patients with these cancers, bringing a variety of clinical perspectives and extensive experience to the development of an individualized treatment plan. The team also participates in a weekly meeting to share clinical trial results, review information from surgical pathology reports, and plan future research studies.
Visit PubMed to read journal articles from our gallbladder and bile duct cancer experts
Our doctors are active members of several national and international medical organizations, including the American Society of Clinical Oncology (ASCO), Cancer and Leukemia Group B (CALGB), the American College of Surgeons Oncology Group (ACOSOG), the Radiation Therapy Oncology Group (RTOG), and Society of Interventional Radiology (SIR). Our doctors lead and participate in most national clinical trials to improve the treatment of gallbladder and bile duct cancer. Their research also contributed to the development of the staging classification system for these cancers that is now used by the American Joint Committee on Cancer.
At Memorial Sloan Kettering, we have a dedicated team of nurses who specialize in caring for patients with gallbladder and bile duct cancer during outpatient visits and inpatient hospital stays. Each nurse works in collaboration with one primary physician to oversee every patient’s care. This allows our nurses to asses a patient’s needs, triage any symptoms, and if necessary, make referrals to other departments within Memorial Sloan Kettering, such as integrative medicine, nutrition, and social work. Nurses also help patients understand the details of the treatment plan and what to expect throughout the course of treatment. They are actively involved with teaching patients and their families and provide educational materials as needed.
As the liaison between patients and physicians, nurses play an important role in the team approach to care offered at the Center.
Communication with patients and their caregivers is a priority at Memorial Sloan Kettering. We believe that treating the whole person, not just the disease, is best for both patients and their families. Memorial Sloan Kettering offers a broad range of emotional support programs designed to help patients and family members cope with the range of issues related to life during and after cancer treatment. For more information about the services we offer, please visit the After Treatment section.
If gallbladder or bile duct cancer is suspected, the diagnosis may be confirmed through a biopsy, in which a small sample of bile duct or gallbladder tissue is removed and examined under a microscope. Once a diagnosis has been established, additional tests may be required to determine the extent (stage) and precise location of the tumor, which can affect the choice and outcome of treatment. (For more information about the risk factors for developing gallbladder or bile duct cancer, visit the Risk Factors section.)
Multidisciplinary input is an important aspect of the treatment plan, since many patients will receive more than one type of treatment. For bile duct and gallbladder cancer, this may include some combination of surgery and nonsurgical treatments such as ablation (removal or destruction), embolization (blockage of blood flow to the tumor), novel biologic therapy, chemotherapy, and radiation therapy. Having a team of specialists collaborating on treatment from the very beginning optimizes patient care.
Our Surgical Experience
Memorial Sloan Kettering’s surgeons have extensive experience in gallbladder and bile duct cancer surgery. Our surgeons are continuously working to improve the effectiveness and safety of these procedures, and we routinely offer surgical treatment to many patients of all ages whose tumors are considered inoperable at other hospitals.
Gallbladder cancer is often discovered during laparoscopic removal of the gallbladder to treat gallstones, when the tumor is only partly removed. This greatly complicates the situation and makes curative therapy more difficult. Surgeons at Memorial Sloan Kettering have found that additional, aggressive surgical treatment can improve long-term survival and cure for patients with gallbladder cancer discovered during laparoscopy, including large tumors that have spread to the liver. (1), (2)
Some patients with inoperable bile duct or gallbladder cancer may experience severe abdominal pain. Memorial Sloan Kettering’s doctors were among the first to use a minimally invasive technique known as neurolytic celiac plexus block, which involves injecting an anesthetic directly into the nerves that cause abdominal pain. This therapy has been shown to relieve pain level and boost a patient’s mood, and life expectancy. It can be performed either during laparoscopic staging of the disease or during evaluation by endoscopic ultrasound — with fewer side effects than conventional approaches to pain management. To learn more about this palliative procedure, visit the Treatment section.
In addition, Memorial Sloan Kettering’s interventional radiologists and gastroenterologists are experienced in identifying patients who can benefit from minimally invasive procedures that allow bile to drain out of the gallbladder or through a bile duct that is blocked by a tumor. These procedures are not curative, but can relieve debilitating symptoms caused by a blocked bile duct, such as jaundice, itching, nausea, vomiting, and infection.
Multimodal Therapy for Patients with Advanced Disease
Many patients with gallbladder or bile duct cancer cannot be treated with surgery because their cancer is too advanced. Memorial Sloan Kettering offers a number of treatments aimed at extending survival and improving quality of life for patients with gallbladder and bile duct tumors. Treatment plans may include one or a combination of treatments, including minimally invasive procedures to relieve symptoms, biologic therapy, chemotherapy, and radiation therapy.
Our team of physician-scientists is working to develop novel, targeted therapies that stop cancer cells from replicating or target the blood vessels that nourish gallbladder and bile duct tumors. One study currently underway is evaluating the potential benefits of combining gemcitabine, cisplatin, and sorafenib (a novel biologic drug that disrupts blood supply to the tumor).