About Bile Duct Cancer

Uncontrolled growth of cells in the body results in cancer. Bile duct cancer or cholangiocarcinoma is rare cancer that begins in the bile ducts. Bile ducts carry digestive juices to the gall bladder and small intestine from the liver. To understand how to treat bile duct cancer, we must know about the bile duct system. The bile duct system begins in the liver as tiny tubes called ductules. These ductules come together as ducts, which merge to form the larger right and left hepatic ducts. The ducts within the liver are called intrahepatic ducts. Bile duct cancer treatment options depend upon where cancer begins in the ductal system. Based on this, bile duct cancers can be of three types– intrahepatic, hilar and distal (extrahepatic). It occurs more commonly in older adults, usually over 50 years. Bile duct cancer life expectancy or its 5-year survival rate is around 9% for intrahepatic cancer, and if diagnosed early, the 5-year survival rate is 25%.

Symptoms

Bile duct cancer usually gets diagnosed in the advanced stages, making cure and treatment challenging. Some signs and symptoms of bile duct cancer to watch out for are:

 

  • Yellowing of skin and whites of the eyes
  • Intense itchiness on the skin  
  • Clay or pale coloured stools
  • Dark urine
  • Abdominal pain (especially on the right side)
  • Persistent fatigue
  • Night sweats
  • Fever
  • Sudden weight loss

 

Though these symptoms may be observed in other conditions as well, visit your doctor if they are persistent.

Diagnosis

Early diagnosis of bile duct cancer allows more treatment options. If your doctor suspects bile duct cancer based on your medical history, signs and symptoms, and physical evaluation, they may recommend you to undergo the following diagnostic tests:

 

  • Liver function tests
  • Tumour marker tests
  • Endoscopic Retrograde Cholangiopancreatography (ERCP)
  • Imaging tests: X-rays, MRIs, CT scan      
  • Ultrasound
  • Biopsy

 

To determine bile duct cancer treatment options, your doctor needs to know if cancer can be removed using surgery or requires additional(or adjuvant) treatments. Biopsy also enables cancer staging, provides information about cancer’s extent and likely response to treatment.

Treatment

Treatment of bile duct cancer depends upon its location and extent, patient’s age and overall health, and possible side effects. Standard treatment options for bile duct cancer include surgery, radiation therapy and chemotherapy.

 

Localised or resectable cancers are confined to a small part of the bile duct and can be entirely removed by surgery. Unresectable cancers like stage 3 and stage 4 bile duct cancer are characterised by the spread of cancer to other parts of the body and cannot be removed entirely by surgery. These cases require additional treatments to reduce symptoms and improve prognosis.

 

Newer bile duct cancer treatment options include:

  • Immunotherapy
  • Radiofrequency ablation
  • Photodynamic therapy
  • Biliary drainage
  • Liver transplant

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