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What to Know About Radiation Therapy for Bile Duct Cancer

Radiation therapy uses high-energy rays to kill cancer cells. Radiation can be used before surgery to try to shrink the size of a tumor. This may make surgery easier and more effective. It may also be used after surgery to try to kill any cancer cells that were missed or could not be removed during surgery. If surgery is not possible, you may have radiation to help ease symptoms.

There are two main types of radiation treatment--external and internal. Either may be used to treat bile duct cancer. In addition, you are likely to receive chemotherapy combined with radiation.

External radiation treatment

When the radiation comes from a machine outside the body, it is called external beam radiation therapy. For this treatment, you see a radiation oncologist. This doctor specializes in the use of radiation to kill cancer cells. He or she decides how often you need radiation and at what dose.

Typically, you will have radiation for five days a week, excluding weekends. Your treatment will usually last several weeks.

The experience is somewhat like getting an X-ray, but it takes longer.

Internal radiation treatment

You may get radiation inside your body. This is also called brachytherapy. With the help of an interventional radiologist, a radiation oncologist inserts radiation seeds into the bile duct. The seeds are placed as closely as possible to the tumor or into the tumor itself so that fewer normal cells are exposed to radiation. With internal radiation, you may get a higher total dose of radiation in a shorter amount of time.

To have brachytherapy for bile duct cancer, you need to have a small tube, called a percutaneous transhepatic bile duct stent, put in place. The doctor places radioactive seeds on the end of a long wire. Using X-rays to guide him or her, the doctor carefully inserts the wire through your skin and down the stent to the area where the cancer is located. The wire that extends outside your body is secured to your skin. The wire is left in place for 24 to 72 hours. Then the doctor carefully removes it using X-rays again as a guide. You will need to stay in the hospital during the time the radioactive seeds and wire are in place. 

Questions to ask your doctor about radiation therapy

You may be often overwhelmed with the information you receive from your doctor. It is important that you take the time to gather as much information as possible. To help deal with the medical information and remember all of your questions, it is helpful to bring a family member or close friend with you to doctor's appointments. Here are some questions you may want to ask your doctor about radiation therapy:

  • What is the goal of this treatment?

  • What will happen if I don't have radiation therapy? 

  • Are there other treatment options? 

  • Do I need a second opinion?

  • How will I get radiation?

  • How many treatments will I get?

  • Over what period of time will the treatment be?

  • When will the treatment begin?

  • When will it end?

  • How will I feel during radiation therapy?

  • What can I do to take care of myself during radiation therapy?

  • What kind of side effects should I tell you about?

  • Where can I get more information?

What to expect after radiation therapy

Radiation affects both normal cells and cancer cells. This means it can cause side effects. What the effects are depends on what part of your body is treated and what type of radiation you receive. If you have internal radiation therapy, you will be less likely to have side effects. These are some common side effects of external radiation:

  • Skin irritation

  • Fatigue

  • Nausea

  • Diarrhea

These often go away when your treatment ends. Always tell your doctor or nurse about side effects you have. They may be able to help ease them. 


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