Radiation oncologist Josh Yamada talks about a technique called IGRT that delivers high doses of radiation precisely along the contours of a tumor.
Chemotherapy uses chemical substances to destroy cancer cells wherever they are in the body. Depending on your particular situation, we may recommend chemotherapy before surgery to help shrink your liver tumor. This is called adjuvant therapy.
Chemotherapy can also help in lowering the risk that the cancer will come back. This is called neoadjuvant therapy.
For cholangiocarcinoma, we usually prescribe a combination of the chemotherapy agents gemcitabine and cisplatin. Our team also has experience in using other targeted agents, which we may offer to you as part of a clinical trial.
Chemotherapy with Hepatic Arterial Infusion
With this technique, we deliver a high dose of chemotherapy drugs to your hepatic artery (the main source of blood and nutrients for liver tumors) through a small pump that we implant under your skin in the lower abdomen. We can inject more chemotherapy as you may need it through this pump on an outpatient basis.
At MSK, we can use hepatic arterial infusion (HAI) therapy strategically to shrink your tumors before your surgery or afterward to help prevent them from coming back.
Although it’s a bit different than primary liver cancer, we’ve seen that HAI chemotherapy combined with chemotherapy given in the usual way can dramatically increase how long people live with colon cancer that has spread to the liver, for example. And more recent evidence suggests that HAI chemotherapy alone can lengthen survival in people with primary liver cancer.
A benefit of HAI is that the drugs are delivered to just a part of the body (regionally) rather than system-wide, so it’s less toxic and causes fewer side effects.