Bile Duct Cancer (Cholangiocarcinoma): Risk Factors, Symptoms, and Diagnosis

Bile ducts (tubes) transport bile from liver into small bowel. There are 2 bile ducts that emerge from liver and 1 from gallbladder. And they all connect together for the formation of one bile duct. This link to small bowel and there, it joins pancreatic duct. Bile is required for food digestion. The main role of the bile is breaking down fat in the food. Now, let’s discuss about the Bile Duct Cancer in detail.

What is Bile Duct Cancer?

The Bile Duct Cancer (BDC) initiates in bile duct. This type of cancer can form its roots anywhere alongside bile ducts. Depending on the origin of beginning, it may have different names. The symptoms of this cancer type rest on where is the growth of the cancer in bile duct. The BDC has different types. Some begin inside bile ducts that are inside liver, known as intrahepatic cancers. While, the other types start outside liver that are known as extrahepatic cancers.

  • Klatskin Tumours: Also known as perihilar cancers, they begin at the point where left side hepatic duct meets the right side hepatic duct. Approximately 50% of the BDC are found to be the Klatskin tumours.
  • Intrahepatic BDC: These cancers start in bile ducts in liver. These tumours are treated as the same way primary liver cancers are treated.
  • Common BDC: These cancers initiates in common bile duct.
  • Multifocal BDC: It shows that there are multiple tumours present in the bile duct’s different sections.

The BDC is rare. According to a survey, there are approximately 92 cases reported in a year in Victoria.

Bile Duct Cancer Causes and Risk Factors

It is not clear that what causes the most BDC. However, there are a few factors that can increase the BDC risks. People who are experiencing irritation or swelling in the long-term in bile ducts are most probable to hit by this cancer. People with the bowel disease (ulcerative colitis) would also be prone to higher risk. In Asia and Africa, the infection with liver fluke parasite is imagined as a cause for most numbers of the bile duct cancers.

You cannot ‘catch’ the BDC: it isn’t infectious and cannot pass on to the others.

Bile Duct Cancer Symptoms

In most cases, the primary symptom of this cancer type is jaundice. Jaundice is when the whites of the eyes and the skin turn yellow. Here are the other symptoms of bile duct cancer:

  • Dark yellow urine
  • Light colored bowel motions
  • Feeling of extreme itchiness
  • Upset stomach
  • Appetite loss
  • High temperatures
  • Weight loss

If you experience any of the above discussed symptoms, then you must consult with your doctor. If bile duct cancer isn’t diagnosed, then the symptoms may be because of something else. However, if the symptoms stay for 2+ weeks, you must see your doctor.

Diagnosis

After examining you, the doctor will suggest you some tests to find out whether or not you have cancer. You will go through some blood tests for checking your liver function and general health. You may also go through the blood test to examine a chemical that is sometimes found high in the people with the BDC. This chemical is called ‘tumour market’ by the doctors. Here are the different tests that you may go through for diagnosing bile duct cancer:

  • ERCP (endoscopic retrograde cholangio-pancreatography(
  • PTC (percutaneous transhepatic cholangiography)
  • Biopsy

The doctor might also advise you some other tests, like MRI, CT scan, or bone scan, if they believe that the cancer might have been spread in other body parts

Staging

The results derived from the tests will tell whether or not you have the cancer. Results will identify the origin of primary cancer and whether or not it has spread to the other parts. This will help the doctor in staging the cancer and after that the doctor will be able to find the best possible treatment for the patient. The bile duct cancer staging is done through different ways. For BDC, there’s a TNM system and number system. TNM means Tumour, Node, and Metastasis. For example:

  • T1, T2, T3, and T4: It shows how far cancer has been spread into the bile duct. T1 indicates least and T4 indicates the highest damage.
  • N0, N1, and N3: It indicates whether or not cancer has been spread to the lymph nodes and what is the cancer amount present in nodes. N0 shows that the cancer hasn’t spread to the lymph nodes. N3 shows maximum damage.
  • M0, M1: It indicates whether or not the cancer has been spread to lymph nodes or other organs. M0 means it hasn’t spread and M1 shows it has.
Treatment

The treatment for the BDC depends on the cancer type you have, your general health, whether or not and how far it is spread, and the treatment preference of you. The treatment options that your doctor may advise you include:

  • Chemotherapy
  • Surgery
  • Photodynamic therapy
  • Radiotherapy

The information available in this article is for general information purpose only. You must take advice from your doctor and must see a doctor if you ever experience the symptoms of bile duct cancer in the long term.

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