Cholangiocarcinoma, commonly known as Bile Duct Cancer, is a rare and often fatal type of cancer that affects the bile ducts.
Bile Duct Function
The bile ducts are a series of tubes responsible for transporting digestive juices (bile) from your liver where it’s made, all the way to your gallbladder where it’s stored. From the gallbladder, ducts carry bile to your gut, where it aids in breaking down fats found in the food you eat.
In most cases, cholangiocarcinoma arises in the parts where bile is transported, which lie outside the liver. Rarely does the cancer develop in ducts that are located within the liver.
Types of Cholangiocarcinoma
Cancers may develop in any part of the bile duct system. Based on their location, they are classified into three types:
- Intrahepatic Bile Duct Cancers: These types of cancers develop in the smaller bile duct branches found inside the liver. Oftentimes, they are confused with cancers that start in the liver cells called hepatocellular carcinomas, which are often treated the same way.
- Perihilar (Hilar) Bile Duct Cancers: According to the American Cancer Society (ACS), these types of cancers “develop at the hilum, where the left and right hepatic ducts have joined and are just leaving the liver. These are also called Klatskin tumors. These cancers are grouped with distal bile duct cancers as extrahepatic bile duct cancers.”
- Distal Bile Duct Cancers: Found further down the bile duct, these cancers are much closer to the small intestine. Like perihilar cancers, they are extrahepatic bile duct cancers because they develop outside of the liver.
There are different symptoms associated with bile duct cancer. Your symptoms may vary depending on the location of the tumor, including the following:
- Probably the most common symptom is jaundice, which is the yellowing of the skin. This may develop at an early or later stage of cholangiocarcinoma, depending on the tumor location.
- Dark urine and pale stools.
- Skin itchiness may begin, which can be caused by jaundice or the cancer.
- You can experience moderate to severe pains in your abdomen that penetrates to your back. The tendency of this symptom accelerates as the cancer progresses.
- Additional rare, but health-hazardous side effects may include enlargement of your liver, spleen, and gallbladder.
You may also experience more general symptoms, such as:
- Sudden loss of appetite
- Significant weight loss
- Exhaustion and physical weakness
Are You at Risk?
If you are male or older than 65 years of age, you are more susceptible to develop cholangiocarcinoma. Certain conditions can also increase your risk for this type of cancer, which include:
- Bile duct infections or chronic inflammation
- Liver fluke
- Parasitic flatworm and infections
- Ulcerative colitis
- Rare conditions, such as primary sclerosing cholangitis, lynch syndrome, hepatitis, and biliary papillomatosis
According to the ACS, “We don’t know the exact cause of most bile duct cancers, but researchers have found several risk factors that make a person more likely to develop bile duct cancer. There seems to be a link between this cancer and things that irritate and inflame the bile ducts, whether it’s bile duct stones, infestation with a parasite, or something else.”
To diagnose the life-threatening disease, your doctor will perform a series of physical examinations along with taking blood samples since blood tests can determine how well your liver is functioning. Blood tests are also significant in finding substances called tumor markers. Most people with cholangiocarcinoma have high levels of tumor markers.
Your doctor may also suggest the need for imaging scans such as an ultrasound, MRI scan, and CT Scan. These technologies provide quality pictures of your bile ducts and the surrounding areas, which are highly reliable in revealing tumors. Imaging scans are also useful in guiding your surgeon’s movements — if they decide to conduct a biopsy and remove a sample tissue to check for cancer cells.
In addition, a procedure known as an endoscopic retrograde cholangiopancreatography (ERCP) is sometimes performed. This process is done via the insertion of a long tube equipped with a camera down your throat, going right into the part of your gut where the bile ducts open. Once in place, your surgeon may then inject dye into the bile ducts, which aids in revealing any blockages since the dye allows the tubes to show more clearly on an X-ray. In some cases, surgeons will also conduct an endoscopic ultrasound scan, the process of passing a probe that takes ultrasound pictures into the area of your bile ducts.
Depending on the location and size of your tumor, your treatment will vary accordingly. Other factors include how far the cancer has spread or metastasized, and the state of your overall health.
For early diagnosis of cholangiocarcinoma, surgical treatment is the only option that offers a cure since the tumor has not spread beyond your liver or bile ducts. Sometimes, if the cancer is still confined to the bile ducts, you may require the removal of infected ducts. On the other hand, if the cancer has spread beyond the tubes and into a section of your liver, that particle must be removed to prevent further infection. In cases when your entire liver must be removed, you will need a liver transplant since unlike the case of an appendix removal, the body cannot function without a liver.
If your cancer has invaded other organs around the liver, a Whipple procedure may be recommended by your surgeons. In this procedure, the following must be removed:
- Bile ducts
- Parts of your stomach and gut
Long-Term Outlook for Patients with Cholangiocarcinoma
If it’s possible to eradicate your tumor completely, then you have a high chance of being cured. Your outlook is generally better if the cancer is not in your liver. But not everyone is eligible for the surgical removal of some parts or the entirety of the liver and bile duct, primarily because the cancer is too advanced and has already metastasized, or is in an inoperable location. If you are looking for more conventional and alternative cancer treatments to combat your disease, contact us at 480-666-1403 today.