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School of Medicine
Patients with cancers of the liver, bile duct and gallbladder have access to the world's leading experts at the Johns Hopkins Liver Tumor Center.
Liver, Bile Duct and Gallbladder Cancer Experts
Multidisciplinary teams of experts specializing in liver, bile duct and gallbladder cancers offer patients comprehensive evaluations and exceptional care. A a one-day clinic with a range of specialists, held weekly, is available.
About Liver, Bile Duct and Gallbladder Cancer
Cancers of the liver, bile duct and gallbladder account for approximately 20,000 new cancer cases per year. Liver cancer can originate in the liver (primary liver cancer) or from some other point in the body and spread to the liver.
Patients throughout the nation are referred to the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, where physicians have been providing highly advanced diagnoses and treatments for decades. A team of experts, including hepatologists, liver and transplant surgeons, medical and radiation oncologists and diagnostic and interventional radiologists, has been assembled to provide comprehensive, state-of-the-art care.
There are several risk factors for liver cancer. People who have hepatitis B or C or cirrhosis of the liver are more likely than others to get adult primary liver cancer.
Our physicians use spiral CT scans (computerized tomography tests) and MRIs (magnetic resonance imaging studies) to determine accurately the type and stage of the tumor. Radiologic studies have evolved so rapidly that some tests that were performed routinely just a few years ago are no longer necessary.
Our physicians can screen patients whose exposure to hepatitis may have put them at greater risk for developing liver cancer. Patients with rare bile duct disorders are at higher risk of developing bile duct cancer. These patients can have their bile tested for carcinoembryonic antigen (CEA), a marker that reveals tumor activity. The test for CEA originally was developed for colon cancer.
Please consult a physician if the following symptoms occur:
- a hard lump just below the rib cage on the right side where the liver has swollen
- discomfort in the upper abdomen on the right side
- pain around the right shoulder blade
- yellowing of the skin (jaundice)
For tumors of the liver, bile duct and gallbladder, surgical removal of the tumor remains the treatment of choice. However, not all tumors are operable. For some patients, a combination of radiation and chemotherapy has been successful in shrinking the tumors so that surgery can be performed. A procedure called portal vein embolization can be done to help grow the liver before surgery.
Laparoscopic removal of liver tumors also is available for certain patients, which offers a smaller incision area and potentially less recovery time.
For other patients with liver tumors, a team of interventional radiologists, radiation oncologists and medical oncologists works together to perform chemoembolization or chemoradiation. Chemoembolization delivers chemotherapy directly to the tumor at the same time that its blood supply is interrupted. Radiofrequency ablation, using heat to destroy tumors, also is performed by expert physicians at Johns Hopkins.
For patients with bile duct cancer, Kimmel Cancer Center medical oncologists and radiation oncologists work together to insert tubes into the bile ducts, then deliver irridium 192, a radioactive isotope, through the tubes. This treatment usually is performed along with traditional radiation and chemotherapy. These physicians have been using this treatment for many decades.
Chemotherapy can be given during any stage of treatment for liver, bile duct and gallbladder cancers. New biologic agents that target the tumor specifically are employed at Johns Hopkins in addition to standard chemotherapies.
New Treatment Approaches
Physicians at the Kimmel Cancer Center have remained at the forefront of the diagnosis and treatment of liver, bile duct, and gall bladder cancers through extensive research. New studies track the role environmental factors play in the development of bile duct and gallbladder cancers. Other studies continue to examine the role that estrogen plays in the development of these tumors. Physicians research the cause and prevention of gallstones, a major risk factor for gallbladder cancer and the reason this tumor occurs more often in women. New robotic methods of delivering treatments and biologic therapies are on the horizon.