Advanced Treatment for Biliary Cancers
Cancers of the bile duct (cholangiocarcinoma) and gallbladder—collectively called biliary cancers—are rare and complex diseases that can be challenging to treat. At NewYork-Presbyterian Queens, our cancer experts have exceptional experience caring for people with biliary cancers. We offer advanced surgical, medical, and interventional endoscopic treatments—including those not widely available elsewhere—to treat these cancers, relieve obstructed bile ducts, and improve your quality of life.
Our Approach
We will put together a team of healthcare professionals to provide the care you need. Our biliary cancer surgeons, hepatologists (liver doctors), gastroenterologists, medical oncologists, radiation oncologists, genetic counselor, oncology navigator, oncology nutritionist, physical therapist, and other specialists are known for providing leading medical, surgical, and supportive care for people with bile duct and gallbladder cancers. If you have primary sclerosing cholangitis, ulcerative colitis, or gallstones—diseases which raise the risk of biliary cancer—we treat those disorders, too.
When planning your treatment, our physicians consider the type, location, and stage of your cancer, as well as your age and physical health. Your team meets regularly to discuss your care and make sure you are receiving the most effective therapies. Our doctors are also on the biliary cancer care team at NewYork-Presbyterian/Weill Cornell Medical Center.
Diagnosing Biliary Cancers
Biliary cancer diagnosis requires sophisticated examinations that are not widely available at all hospitals. We use these techniques at NewYork-Presbyterian Queens.
Imaging tests
CT scanning and magnetic resonance imaging (MRI)—including liver MRI and magnetic resonance cholangiopancreatography (MRCP)—are useful for seeing how close biliary cancers are in relation to nearby biliary ducts and blood vessels.
Endoscopic retrograde cholangiopancreatography (ERCP) with the Spyglass® direct visualization system
This advanced procedure combines x-rays and the use of a specialized endoscope to obtain a tissue sample to analyze it for cancer cells. Our interventional endoscopists routinely perform this procedure and are highly experienced in its use.
Endoscopic ultrasound (EUS) with fine-needle aspiration to biopsy tissue
EUS involves the use of a special endoscope with high-energy sound waves ("echoendoscope") to see your digestive tract and nearby organs.
Biliary Cancer Surgery
If your gallbladder or biliary cancer was found early enough, you might be able to have surgery to remove it. During cancer surgery, surgeons will perform open surgery to remove cancer and surrounding lymph nodes. For gallbladder cancer, surgeons will remove gallbladder-containing cancer with a piece of adjacent liver, and may need to reconstruct bile duct to the small intestine to allow biliary drainage. For biliary cancer that is contained within the duct but outside of liver and pancreas, surgeons will remove the bile duct containing cancer and reconstruct bile duct to the small intestine to allow biliary drainage. For biliary cancer that is in the distal bile duct inside of pancreas, surgeons will generally perform a Whipple procedure—removing the bile ducts, a part of the stomach, part of the duodenum (a part of small bowel), the pancreas, gallbladder, and the surrounding lymph nodes. This is an extensive operation best performed by experienced surgeons at major medical centers. NewYork-Presbyterian Queens surgeons are skilled in these surgeries.
Interventional Endoscopic Therapies
Interventional endoscopy is a way to treat biliary blockage caused by biliary cancers without surgery. It can be especially useful for inoperable cancers and those causing pain and infection. Our interventional endoscopists are highly proficient using Endoscopic Retrograde Cholangiopancreatography (ERCP) to open a narrowed bile duct with balloon dilation and stent. This innovative technique can improve the comfort and quality of life of people with advanced biliary cancers.
ERCP with stent placement
Our interventional endoscopists are highly proficient in using this approach to open a narrowed bile duct with balloon dilation and stent and improve the comfort and quality of life of people with advanced biliary cancers.
Chemotherapy, Immunotherapy, and Targeted Therapy
Gemcitabine and cisplatin are the anticancer drugs most commonly used to treat biliary cancers. Some people with biliary cancers receive immunotherapy to boost the immune system's power to find and kill cancer cells. We may also check your genes in your tumor and in your blood for mutations that could be targeted by targeted therapy. If these medications are part of your treatment plan, you can receive them in our modern, comfortable Therapeutic Medicine Center. This center is directed by medical oncologists and staffed by experienced oncology nurses who monitor your comfort and attend to your needs during your infusion.
Radiation Therapy
You may receive radiation therapy if your cancer is not operable or as part of a clinical trial. People who need radiation therapy for biliary cancer benefit from the advanced radiation oncology techniques available at NewYork-Presbyterian Queens. You can receive radiation therapy in our state-of-the-art Radiation Oncology Center.
Clinical Trials for Biliary Cancers
At New York Presbyterian Queens, we participate in clinical trials with our fellow NewYork-Presbyterian centers to evaluate new therapies to advance the care of people with bile duct and gallbladder cancers, especially those whose disease does not respond well to standard therapies. Our goal is to develop better treatments that relieve symptoms and help people with biliary cancers to live longer. You may have the opportunity to participate in a clinical trial of a promising treatment.
Why Choose Us
The treatment of biliary cancers is highly complicated and can be challenging to do successfully. When you come to NewYork-Presbyterian Queens for your care, you will receive advanced therapies based on the latest medical research and also have access to clinical trials of treatments that may not be widely available elsewhere. We understand that biliary cancers can cause pain and impair your quality of life, so we are sure to provide palliative care to enhance your comfort and well-being at all stages of the treatment process. We also offer nutritional counseling and psychosocial support so your life can be the best it can be during this difficult time.
As part of one of the country's largest medical centers, you'll have access to specialists from all areas who collaborate with our cancer experts to provide you with comprehensive care. Contact our team to make an appointment.