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Intrahepatic Cholangiocarcinoma

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Around 10 to 20 percent of cancers that start in the liver are called intrahepatic cholangiocarcinomas — cancers that begin in the cells lining the liver's small bile ducts, which are tubes that carry bile to the gallbladder

Most cholangiocarcinomas start outside the liver, in the bile ducts. Cholangiocarcinomas are often treated the same way as hepatocellular cancers.

Why Choose Sylvester Comprehensive Cancer Center?

Advanced radiation options like ViewRay (one of just five centers nationwide) and RapidArc®, offering intensity modulated external radiation therapy (IMRT). We offer more efficient and effective treatments, shorter treatment times, pinpoint accuracy in targeting tumors, and less damage to surrounding healthy tissue.

More cancer clinical trials than any other South Florida hospital. If appropriate for your cancer and stage, our clinical trials provide you with the very newest ways to treat and potentially cure your cancer.

The only designated Cancer Center of Excellence in South Florida. We treat cancer, and only cancer, giving you the best potential outcomes. The likelihood of surviving cancer at least five years following treatment is 17 percent higher when treated at a Dedicated Cancer Center than at other hospitals. 

Multidisciplinary care teams with nationally recognized expertise. Collaboration saves lives. Your care team is made up of experts in your exact type of cancer, and every single aspect of it.

Questions? We're here to help.

Our appointment specialists are ready to help you find what you need. Contact us today.

Tests


Determining treatment options and the best chances  of recovery depend on the stage of cancer. This means whether the cancer is confined to the liver or has spread. Choices are also based on recurrence/cancer returning after a past initial treatment program; and your general health. Besides a careful medical history and physical examination, procedures for diagnosing liver cancer may include the following:                            

  • Serum Tumor Marker Test 

    A blood sample is checked to gauge the levels of specific substances released into the blood, such         as alpha-fetoprotein (AFP). Elevated levels of this protein may be a sign of liver cancer or a noncancerous condition. In some cases, the AFP level is normal even when there is liver cancer.

  • Liver Function Tests

    Also called liver enzyme tests, this group of blood tests detects inflammation and damage to the liver. They can also check how well the liver is working.

  • CT Scan (CAT Scan) of the Abdomen 

    A series of detailed pictures of areas inside the abdomen, taken from different angles. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly.

  • PET Scan (Positron Emission Tomography Scan) 

    The purpose of this procedure is to find malignant tumor cells in the body using radioactive glucose (sugar) injected into a vein. Cells that are malignant appear brighter in the picture because they are more active and take up more glucose than normal cells do.     

  • MRI (Magnetic Resonance Imaging) 

    An MRI combines the use of a magnet, radio waves, and a computer to produce a series of elaborate pictures of the liver. Dye is also injected into a vein to create pictures of blood vessels in and around the liver. 

  • Ultrasound Exam

    Using high-energy sound waves, called ultrasound, these are bounced off internal tissues or organs to form a picture of body tissues.

  • Biopsy 

    Often a sample of suspicious cells is surgically removed for viewing under a microscope. Tissue can be obtained using fine-needle aspiration, core needle, or laparoscopy (a minimally invasive procedure).  


Treatments


Intrahepatic cholangiocarcinoma has a variety of treatments that can be used alone or with other treatments to produce the best outcome for your specific cancer. That’s why careful diagnosis and staging are so important. Your specialist will explain your treatment choices, how successful they expect them to be, and the risks and side effects with each option.         

  • Surgery 

    Surgery is performed for primary tumors that start in the liver and secondary tumors (called metastatic) that have traveled to the liver from a different organ such as the colon, lung, or breast.

    • Partial hepatectomy: This procedure removes part of your liver The remaining liver tissue functions as if it were whole and will regrow in most cases to the size of the original liver.

    • Staged partial hepatectomy:  When tumors are large, or there are more than one, the surgery can be performed in two stages. A multi-disciplinary team that includes a surgeon and an interventional radiologist works together.

    • Liver transplantation: For certain patients with primary liver cancer that originated in the liver (and is confined to the liver), your   surgeon may recommend removing the whole liver and replacing with a healthy donor liver.
       
  • Ablation

    When surgery may be too risky, ablation has different techniques to destroy abnormal liver tissue, including:

    • Radiofrequency ablation: High-energy radio waves heat the tumor, killing cancer cells.

    • Ethanol (alcohol) ablation: Also known as percutaneous ethanol injection (PEI). Concentrated alcohol is injected into a tumor to kill cancer cells.

    • Microwave ablation: Microwaves are applied directly to the tumor, producing heat that damages/kills cancer cells, or makes them more responsive to radiation or medical therapy.

    • Cryoablation: Freezes and destroys cancer cells under ultrasound guidance.
  • Embolization 

    Embolization is an option for some patients whose larger tumors cannot be removed by surgery or ablation. Embolization tries to block or reduce the blood flow to cancer cells in the liver.

    • Chemoembolization: Delivers concentrated chemotherapeutic drug(s) to the tumor along with a blood vessel blocking agent – starving the tumor of its blood supply.

    • Radioembolization: This procedure is similar to chemoembolization but with radiation instead of drugs.

    • Portal vein embolization: Often used for borderline liver resection candidates. The blood supply is blocked on one side of the tumor, allowing the other side to grow to a fully functional size for surgery.

  • Radiation Therapy 

    Advanced technology tools working for you include RapidArc®, an external beam (delivered from a machine outside the body) technology delivering intensity modulated radiation therapy (IMRT). IMRT shortens treatment times to one-half to one-eighth that of conventional radiation therapy, resulting in better tumor targeting and less damage to healthy tissue.

  • Chemotherapy (Systemic Medical Therapy)

    Chemotherapy can be administered intravenously (infusion needle) or by a pill and is usually a combination of cancer-fighting drugs.  Chemotherapy is also sometimes given to surgical patients, after the procedure, to eliminate remaining cancer cells and reduce recurrence.

    • If you require infusion chemotherapy, you can receive it at the Comprehensive Treatment Unit (CTU) at Sylvester's main location in Miami. It's a 12,000-square-foot unit that includes 33 recliners and 11 private rooms. You can also have your infusion treatments at the Kendall, Plantation, Hollywood, Coral Springs, or Deerfield Beach locations.          

  • Targeted Therapy 

    These therapies are designed to attack the molecular changes that make cancer cells grow and spread. Some of these medicines are delivered in combination, and others individually. The purpose is to prevent cancer from growing and spreading. It may also be used to help chemotherapy get inside the tumor and be more effective.                  

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

  • Aetna WC
  • Aetna Affiliates/Signature Adm (ASA)
  • Aetna Behavioral Health
  • Aetna Elect Choice (EPO)
  • Aetna Florida Healthy Kids
  • Aetna HMO
  • Aetna Medicaid HMO
  • Aetna Medicare HMO
  • Aetna Medicare PPO
  • Aetna POS
  • Aetna PPO
  • Aetna UM Employee HMO 1
  • Aetna UM Employee HMO 2
  • Aetna UM Employee POS HRA
  • Aetna/Coventry Institutes of Excellence (IOE)
  • Amerigroup Florida Healthy Kids
  • Amerigroup Medicaid HMO
  • Argus Vision
  • AvMed Choice
  • AvMed HMO/POS
  • AvMed MDC and JHS Groups
  • AvMed Medicare HMO
  • AXIS
  • BCBS Blue Options Network Blue PPO
  • BCBS BlueCare HealthOptions HMO
  • BCBS BlueChoice PPC/PPO
  • BCBS Miami Dade Blue PPO Limited Benefits Plan
  • BCBS of Florida (All products except "SELECT" Plans)
  • BCBS of Florida (Commercial plans exclude HIX Select)
  • BCBS Traditional PHS/PPO
  • Beacon Health (ValueOption)
  • Beech Street PPO
  • Broward Health Medical Center
  • CarePlus Medicare HMO
  • Catholic Hospice
  • CCP/CMS Title XIX (Medicaid Enrolled in South Florida)
  • CCP/CMS Title XXI (Non Medicaid Enrolled in South Florida)
  • CCP/MMA (Broward County residents)
  • Charlotte County Sheriffs Office PPO
  • Cigna Affiliates
  • Cigna Behavioral Health
  • Cigna Dental HMO/PPO
  • Cigna EPO
  • Cigna HMO
  • Cigna Life Source (Intracorp is part of Cigna Lifesource)
  • Cigna MDCPS Jackson Sr. High
  • Cigna POS
  • Cigna PPO
  • Cigna Shared Administration
  • Clear Health Alliance SNP Medicaid HMO
  • Concordia Behavioral Health
  • CorVel WC
  • Coventry First Health WC
  • Coventry Health Care of Florida (HIP) HMO/POS
  • Coventry Health Care of Florida (HIP) PPO
  • Coventry Health Plan of Florida (Foundation) HMO
  • Coventry Health Plan of Florida (Foundation) POS
  • Coventry National PPO
  • Coventry Summit Medicare HMO
  • Coventry Vista Medicare HMO
  • Coventry First Health PPO
  • Delta Dental PPO
  • DentaQuest (ADI)
  • DIKLA
  • Dimension WC
  • Dimension Plus PPO
  • EHN PPO
  • EQUIAN (Health Systems International)
  • Europe Assistance/Global Corporate Solutions (Care Management Network)
  • eyeQuest
  • FCCI WC
  • Florida Healthcare Plan (Affiliate of BCBSFL)
  • Florida PACE (FPC)
  • Freedom Health Medicaid HMO
  • Freedom Health Medicare HMO
  • Gallagher Bassett WC (MDCPS & FCSRMC)
  • Global Excel Mgt PPO
  • Great West (Cigna) HMO/POS
  • Guardian Life PPO
  • HAA Preferred Partners
  • Health First Health HMO/POS
  • Health First Health Medicare HMO
  • Health First Health PPO
  • Health Net Veterans Choice HMO
  • Heritage Summit Healthcare WC
  • Humana Behavioral Health (LifeSynch)
  • Humana Dental/CompBenefits/OHS
  • Humana EPO
  • Humana HMO
  • Humana Medicaid HMO
  • Humana Medicare HMO
  • Humana National Transplant
  • Humana PPO
  • Humana Premier
  • iCare Health Solutions
  • Interlink Health Services
  • International Kids Fund (IKF)
  • League Medical Concepts Federal Inmates
  • Life Trac
  • Magellan Behavioral Health
  • Magellan Complete Care SNP Medicaid HMO
  • MDAbroad
  • Medica Medicare HMO
  • Medical Development In't (MDI)-Federal Inmates
  • Medicus
  • Metlife Dental PPO
  • MHNet Behavioral Network (MHNet)
  • Molina
  • Molina Market Place
  • Molina Medicaid HMO
  • Molina Medicare HMO
  • Morgan White International
  • MultiPlan PPO
  • Naphcare (Federal Prisoners)
  • National Healthcare Solutions Inc.
  • Neighborhood HealthPlan HMO/POS
  • Neighborhood HealthPlan PPO
  • North Broward Hospital District PPO
  • Olympus Managed Healthcare
  • Optum
  • Positive Healthcare SNP Medicaid HMO
  • Positive Healthcare SNP Medicare HMO
  • Prestige Health Choice Medicaid HMO
  • Prime Health Services WC
  • Quality Health Management
  • Religious Order of Jehovah's Witnesses PPO
  • Rockport Healthcare Group WC
  • Royal Caribbean Cruises PPO
  • Sanus Health Corporation
  • Seasons Hospice
  • Simply Healthcare Medicaid HMO
  • Solstice Dental HMO/PPO
  • Start Healthcare Network
  • Sunshine
  • Sunshine AMBETTER
  • Sunshine Healthy Kids HMO
  • Sunshine Medicaid HMO
  • Sunshine Medicare HMO
  • Tricare South Prime HMO
  • Tricare South Standard PPO
  • United Behavioral Health (UBH)
  • UnitedHealthcare Affiliates
  • UnitedHealthcare Healthy Kids HMO
  • UnitedHealthcare HMO/POS
  • UnitedHealthcare Medicaid HMO
  • UnitedHealthcare Medicare Nursing Home Plan
  • UnitedHealthcare PPO
  • University of Miami Athletic Dept PPO
  • VUMI
  • Wellcare/Staywell Healthy Kids HMO
  • Wellcare/Staywell Medicaid HMO
  • Wexford Health State Inmates
  • Worldwide Managed Care