How is cholangiocarcinoma (CCA) managed?

Treatment options

Common approaches that may be used to manage CCA:^1,2

Surgery

Your healthcare team will first decide if the cancer can be removed surgically. This is known as resection. People who have this surgery may also receive treatment before the surgery, to shrink the tumour(s) as much as possible, or after the surgery, to try to kill any remaining cancer cells

Chemotherapy

Chemotherapy drugs circulate in your bloodstream to slow or stop the growth of rapidly dividing cancer cells. Chemotherapy is not specific and will target both dividing cancer cells and healthy cells. As cancer cells divide faster than most normal cells, they are more likely to be killed by the chemotherapy

Best supportive care

This includes treatments to help with symptoms and pain related to CCA. For example, people with CCA may have blocked bile ducts, leading to jaundice, pain or infections. Draining the bile ducts using a thin flexible tube (catheter) can help clear blockages and is considered a form of best supportive care

Radiation therapy

A type of cancer treatment that uses high-energy X-rays or other types of radiation to kill some cancer cells or stop them from growing. It is usually a localised treatment that targets just the area(s) where cancer cells are found

Targeted therapy

A more specific type of drug treatment that targets the genes and proteins that help cancer cells to grow and survive. Your doctor can use molecular profiling to learn more about your CCA and assess whether targeted therapy is an option for you

Other ways you can manage your CCA

You may find that making lifestyle changes and taking up self-care routines have a positive impact on your treatment journey

Self-care routines can be beneficial in improving physical, mental and emotional health³

Eat a balanced diet

Aim to eat a wide selection of different types of food that provide a variety of nutrients, including carbohydrates, proteins, fruit and vegetables; try to limit sugar and salt intake⁴

Drink water

Drink lots of water (approximately 6–8 glasses [1.2–1.5 litres] per day) and try to limit the consumption of alcohol and fizzy drinks that have added sugar⁴

Regular exercise

Adopt light exercise routines such as walking, cycling, swimming, yoga, tai chi, pilates and chair-based exercises³

Maintain a healthy weight

People with CCA may experience loss of appetite or weight loss and may need to eat extra calories and protein to maintain weight⁵

Nutritional status

Early symptoms of CCA can include nausea, loss of appetite, weight loss and general tiredness.⁵ This can mean your diet does not offer enough nutrients or offers a poor balance of nutrients. Your doctor may recommend nutritional therapy to improve your health and help optimise benefits from treatment. Nutritional therapy may include oral supplements⁵

Relaxation techniques

Relaxation techniques may include meditation, breathing exercises, massage and reflexology.³ Reports suggest that relaxation techniques may offer physical and psychological benefits, such as improvements in self-esteem,⁶ sleep quality,⁷ pain, fatigue and quality of life⁸

Speak to your doctor or nurse for more information and advice on lifestyle changes and self-care routines. You can also learn more using our Nutrition Guide.

Download our Nutrition Guide

Ongoing research and development

Researchers are continuously looking for new treatments that may be more effective at treating cancer, have fewer side effects and improve quality of life compared with existing treatments. Clinical trials help researchers and doctors to better understand how potential new treatments may work

What is a clinical trial?

A clinical trial is a type of scientific research study that tests how effective and safe possible new medicines are

If you’re eligible, being part of a clinical trial may offer certain benefits:
- Potential access to investigational medicines that are being developed but are not yet approved in Europe for doctors to prescribe
- You can help make a difference for other people in the future who have your specific type of cancer

However, there are important risks to consider for participating in clinical trials:
- The investigational approach being studied may not provide a benefit to you, the participant
- As clinical trials investigate safety and side effects, sometimes these are not fully known at the time of study. Therefore, in some rare cases there may be an increased risk of harm

You can ask your doctor or a patient organisation if they know of any clinical trials that you may be eligible to join. You can also search for information online and register your interest in taking part in clinical research

If you are interested in learning more about clinical trials please speak to your doctor who will be able to provide you with further advice

Learn more about the terms used in this website

More resources

What is CCA?

What are the main symptoms of CCA?

How is CCA diagnosed?

Download our information leaflet

References: 1. Bañales JM, et al. Nat Rev Gastroenterol Hepatol. 2020;17:557–88; 2. Valle JW, et al. Ann Oncol. 2016;27(suppl 5):v28–37; 3. Penny Brohn UK. https://www.pennybrohn.org.uk/resources/ (accessed 19 October 2022); 4. Public Health England. The Eatwell Guide. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/528193/Eatwell_guide_colour.pdf (accessed 19 October 2022); 5. O’Connor G. Presented at AMMF 2020. https://ammf.org.uk/wp-content/uploads/2020/11/Nutrition-in-Cholangiocarcinoma-AMMF-29.10.20.pdf (accessed 19 October 2022); 6. Harorani M, et al. Support Care Cancer. 2020;28:405–11; 7. Samuel SR, et al. J Cancer Surviv. 2021;15:799–810; 8. Dikmen HA, Terzioglu F. Pain Manag Nurs. 2019;20:47–53.