What is Bile Duct Cancer?
Bile duct cancer is also called cholangiocarcinoma. Cancer develops within the bile duct system, a group of small tubes that transport bile fluid from the liver to the gallbladder. Cholangiocarcinoma occurs mainly in people older than 50, though it can occur at any age. Bile is discharged into the small intestine as food passes through the digestive system, which helps digestion and makes it easier for the body to absorb fats.
Types
Cholangiocarcinoma types are as follows:
- Intrahepatic cholangiocarcinoma
- Hilar cholangiocarcinoma
- Distal cholangiocarcinoma
Symptoms
Signs of bile duct cancer include:
- Yellow skin or eyes (jaundice)
- Pain in your belly or sides
- Upset stomach and vomiting
- Fever
- Loss of appetite or weight loss
- Weakness
- Itching
- Light-colored stools
- Dark urine
When To See A Doctor?
If you have persistent fatigue, stomach pain, jaundice, or other unpleasant symptoms, make an appointment with your doctor. If necessary, they could refer you to a digestive diseases specialist (gastroenterologist).
Causes
Experts don't know precisely what causes cholangiocarcinoma. But when bile duct cells encounter alterations in their DNA, cholangiocarcinoma develops. The instructions a cell needs to function are encoded in its DNA. The modifications instruct the cells to proliferate uncontrolled and accumulate into a mass of cells (tumor) capable of entering and damaging healthy body tissue.
Risk Factors
Factors that increase the risk of Bile Duct Cancer include:
- Primary sclerosing cholangitis Primary sclerosing cholangitis: This condition leads to scarring and hardening of the bile ducts.
- Chronic liver disease Chronic liver disease: A history of the chronic liver disease also increases the risk of Bile Duct Cancer.
- Bile duct problems present at birth Cholangiocarcinoma is more likely to develop in those born with choledochal cysts, resulting in dilated and irregular bile ducts.
- A liver parasite Cholangiocarcinoma is linked to liver fluke infection caused by consuming raw or undercooked seafood.
- Older age Adults over 50 are more likely to develop cholangiocarcinoma.
- Smoking Cholangiocarcinoma risk is linked with cigarette smoking.
- Diabetes Diabetes: Cholangiocarcinoma risk may be higher in those with type 1 or 2 diabetes.
- Certain inherited conditions Cholangiocarcinoma risk-raising circumstances are brought on by genetic abnormalities parents pass on to their children. Cystic fibrosis and Lynch syndrome are two examples of these conditions.
Complications
Bile duct cancer can cause a number of complications, including:
- Obstruction of the bile duct Cancer can block the flow of bile, causing jaundice and itching.
- Spread of cancer Cancer can spread to other body parts, such as the liver, lungs, and lymph nodes.
- Pain Bile duct cancer can cause abdominal pain and discomfort.
- Infection Bile can build up in the duct and cause infection.
- Weight loss Cancer and its treatments can cause a loss of appetite and weight loss.
- Anemia Anemia: Cancer and its treatments can cause anemia (low red blood cell count).
- Fatigue
Cancer and its treatments can cause fatigue and weakness.
It's essential to speak with a doctor about the specific risks and complications that may apply in a particular case and the best course of treatment.
- Maintaining a Healthy Lifestyle Bile duct cancer risk can be lowered by maintaining a nutritious diet, exercising frequently, and abstaining from unhealthy habits like smoking and binge drinking.
- Regular Medical Checkups Regular medical checkups, especially for those with a family history of bile duct cancer, can help in the early detection of the condition and boost the chances of a successful treatment plan.
- Early Detection and Treatment of Bile Duct Disorders Bile duct conditions such as gallstones and chronic inflammation can be treated early to reduce the risk of developing bile duct cancer.
- Avoiding Certain Risk Factors Avoiding risk factors, including consuming a diet high in animal fat and exposure to environmental pollutants, can help lower the chance of bile duct cancer.
- Vaccination People with hepatitis B or hepatitis C infections should get vaccinated to reduce their risk of bile duct cancer.
- Monitoring for Symptoms Monitoring symptoms, including jaundice, pain in the abdomen, and weight loss, can aid in the early detection of bile duct cancer and increase the chances of a successful treatment regimen.
- Lifestyle Changes Changes in lifestyle, such as reducing stress, getting enough rest, and avoiding toxins in the environment, can help lower the risk of bile duct cancer.
Diagnosis
Bile duct cancer is a relatively challenging medical condition to diagnose. The following tests may be recommended for a conclusive diagnosis:
- Blood Tests Blood Tests: Blood tests can detect tumor markers and chemical substances released by cancer cells. Therefore, if bile duct cancer is suspected, blood tests are recommended. These markers in studies do not necessarily indicate that the condition is bile duct cancer and vice versa. It is important to remember that these markers are also released in other conditions.
- Imaging Tests or Scans The precise location, shape, and size of the tumor are identified using scans like ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). Additionally, the results of these scans are significant for disease stages.
- Endoscopic Retrograde Cholangiopancreatography (ERCP) Endoscopic Retrograde Cholangiopancreatography (ERCP) : This unique imaging technique combines an endoscope with X-rays. A special fluid is injected during the procedure to help the X-ray technician see the bile duct area more clearly. The endoscopy (through the neck) is guided by the X-ray scanner, which helps detect blockages, tumors, or other abnormalities.
- Spyglass Spyglass is a more sophisticated ERCP test that enables the expert to insert a specialized endoscope into the bile duct to look for anomalies. Spyglass also allows the technician to collect samples precisely for biopsy.
- Biopsy Biopsy : The diagnosis of bile duct carcinoma often confirms with a biopsy. The process involves the removal of a tiny sample of bile duct tissue, which is examined under a microscope for the presence of cancerous cells. In rare instances, samples of the nearby lymph nodes may also be taken to assess whether cancer has spread to the lymphatic system.
Treatment
Bile duct cancer treatment strategies are designed based on a number of variables, including the type of tumor, stage of cancer, size, age, and general health of the patient. The tumor and a piece of the liver or gallbladder may be surgically removed in stage 1 and 2 patients.
The course of treatment for cancer in its advanced stages will depend on how many lymph nodes and organs have been impacted. Radiotherapy, chemotherapy, and surgery are occasionally used to treat symptoms and improve the quality of life for patients.
Surgery
Surgery is thought to be the main method of treatment for bile duct cancers. The removal of the following tissues may be necessary during surgery, depending on cancer's stage and extent:
- If the part of the bile duct that is affected by cancer
- The gallbladder
- Surrounding lymph nodes
- Part of the liver
Unblocking the Bile Duct
The doctor can suggest a procedure to clear the bile duct if the tumor is blocking it. The symptoms of this condition, such as stomach discomfort, itchy skin, and jaundice, may be treated with this therapy.
A stent, a small metal or plastic tube, is used to unclog the bile duct. The bile duct is dilated, and the flow of bile is restored using this stent. Endoscopic retrograde cholangiopancreatography can be used to introduce it (ERCP).
Stents are placed using a modified version of the percutaneous transhepatic cholangiography (PTC) method. During this procedure, small incisions are made in the stomach to place the stent and restore the bile flow.
Radiotherapy
To lower the chance of recurrence, radiation therapy and chemotherapy may be used as adjuvant treatments following the surgery. Additionally, individuals with bile duct cancer get this treatment to alleviate their symptoms and stop the spread of the disease.
Chemotherapy
Similar to radiation therapy, chemotherapy can also be given as an adjuvant therapy to reduce the risk of recurrence or as a soothing therapy to slow the progression of the condition and ease its symptoms.
Photodynamic Therapy (PDT)
In individuals with bile duct cancer, photodynamic treatment is a novel method for reducing tumor size. Although it does not treat the condition, this procedure helps manage the symptoms. A laser is later administered through an endoscope to shrink the tumor to make the cancerous cells more receptive to light. The symptoms of the condition are minimized by this treatment, which also enhances the patient's quality of life.
Do's and Don’ts
| Do’s | Don’ts |
| Seek medical attention if you experience unusual symptoms such as abdominal pain, jaundice, loss of appetite, and weight loss. | Ignore any symptoms or signs of bile duct cancer. |
| To lower the risk of developing bile duct cancer, keep a healthy body weight, exercise regularly, and stick to a healthy diet. | Smoke or drink excessive alcohol |
| Keep track of your medications and discuss any side effects with your doctor. | Skip or delay appointments or treatments recommended by your doctor. |
| Ask your doctor about regular screening and monitoring for bile duct cancer. | Take excessive amounts of vitamin supplements without checking with your doctor. |
| Stay informed about bile duct cancer, treatment options, and support resources. | Stop your treatment without discussing it with your doctor. |
Care at Medicover Hospitals
At Medicover Hospitals, we have the most renowned team of hepatologists, oncologists, gastroenterologists, and healthcare professionals who can offer our patients the best medical care while showing compassion and care. In our diagnostic division, we can carry out the necessary tests to detect Bile Duct Cancer thanks to modern methods and technology. The condition's diagnosis and treatment are approached systematically by our outstanding team of hepatologists, gastroenterologists, and oncologists. They deliver the necessary medical care and rehabilitative services to treat this illness effectively.
