Bile duct cancer also known as cholangiocarcinoma is a cancer which starts in the cells lining
one of the ducts of biliary system which carry bile from liver to intestine. It is a rare type
of cancer which is more common in men at the age of 50-70 years than women. Cholangiocarcinoma
accounts for 10-15% of all primary hepatobiliary malignancies that can occur in different
locations in the biliary system. When it affects the bile duct within the liver it is called
intra-hepatic cholangicarcinoma. When it affects the bile duct outside the liver it is called
extra hepatic.
Risk Factors
Exact cause of the disease is unknown; however most of the risk factors associated are
due to the inflammation and fibrosis of biliary tract.
Primary sclerosis cholangitis: It is a type of inflammation of the bile ducts
that causes hardening and scarring of bile ducts.
Recurrent (hepatolithiasis) Fibro polycystic disease like Caroli’s disease which is
a rare congenital disorder and choledochal cysts results in major complication i.e.
cholangiocarcinoma
Asian liver flukes: Liver flukes are the cause of major health problems.
There are three bile duct flukes which are acquired by humans who eat raw fish:
Clonorchis sinensis, Opisthorchis viverrini and O.felineus. The flukes are about one
cm in length and have a sucker that attaches to the intrahepatic bile duct
epithelium, which then lives in the biliary system for approximately ten years.
There is strong epidemiological evidence linking chronic biliary tract disease with
bile duct flukes and leading to the ultimate development of cholangiocarcinoma
Toxins: Few toxins like thorotrast, dioxin and polyvinyl chloride are also
linked with Cholangiocarcioma
Chronic liver disease: Scarring of the liver caused by a history of chronic
liver disease increases the risk of cholangiocarcinoma.
Other factors: There are few less established risk factors like Hepatitis C &
B virus, alcohol, smoking, ulcerative colitis, obesity and diabetes
Symptoms
Usually in cholangiocarcinoma, symptoms starts when the bile duct is blocked due to the
tumor. Obstruction occurs early when the tumor is in the common bile duct or common
hepatic duct as compared to perihilar or intrahepatic tumor. These symptoms are:
Jaundice
Pruritus
Dark yellow urine
Discolouration of the skin and eyes (yellow color)
Loss of appetite
Clay coloured stool
Vomiting/nausea
Abdominal pain
Weakness
Weight loss
Diagnosis:
Blood tests: Liver function tests helps to measure the level of bilirubin and
alkaline phosphatise which in turn help to assess the functioning of bile duct.
Tumor marker tests (CEA and CA19-9) Cholangiocarcinoma may cause high levels of
carcinoembryonic antigen (CEA) and CA19-9 in the blood. However, these tests are not
confirmatory but help to assess the progress of ongoing treatment
Ultrasound: An ultrasound uses sound waves to create a picture of the
internal organs. Any abnormality or tumor seen during USG is confirmed by further
investigations like CT SCAN
Biopsy: In cholangiocarcinoma biopsy is usually performed during a procedure
called a percutaneous transhepatic cholangiography (PTC) or endoscopic retrograde
cholangiopancreatography (ERCP) which is done to treat obstructive jaundice. At
times biopsy is not possible, in this situation people are treated for bile duct
cancer based on other test results and symptoms
CT scan: A CT scan is used to measure the tumor’s size and spread of the
disease. Sometimes, a special dye called a contrast medium is given before the scan
to provide better details of the image
MRI cholangiopancreatography(MRCP): A contrast medium may be injected into a
patient’s vein or given as a pill to swallow before the MRI to create a clearer
picture
Percutaneous transhepatic cholangiography (PTC): A contrast medium through a
thin needle is inserted into the bile duct which shows the blockage and its location
on the x-ray. This is important in planning the treatment ahead
Endoscopic retrograde cholangiopancreatography(ercp): It is a procedure that
helps examine the pancreas and bile ducts. A bendable, light tube about the
thickness of index finger is placed through the mouth into the stomach reaching the
top part of the small intestine (duodenum)
Prevention
There is no known way to prevent the disease as most of the risk factors are beyond our
control. However, there are few things that can lower the risk and these include:
Treat hepatitis infections which results in cirrhosis. Get vaccinated for hepatitis
B virus
Quit smoking
Avoid eating raw fish
If diagnosed with liver fluke infection, take proper medication
Include more of fruits and vegetables in your diet and less of processed food and
red meat
The extent of a bile duct cancer is an important factor in determining the treatment
options. As per the conventional methods, the best bile duct cancer treatment is
surgery.Treatment possibilities for Cholangicarcinoma depend upon the stage in which
cancer is diagnosed. Chances of recovery are always better when diagnosed in early
stages. At Cancer Healer Center, the team of highly trained professionals works together
to form the most appropriate treatment plan suitable for the stage and extent of the
disease. Immunotherapy at Cancer Healer Center helps to recover the cases even when the
disease is diagnosed in an advanced stage or in metastatic stage like liver metastasis.
The therapy helps to enhance the immune cells of the body which fight back against the
cancer cells and help to control the disease. It treats without causing any side effects
and this is the reason it can be given to the patients suffering from jaundice due to
destruction of bile duct. It is one of the most effective bile duct cancer treatment.
Medicines help to improve appetite and reduce weakness in patients suffering from
jaundice or impaired liver function due to metastasis. It helps to maintain a better
quality of life with better chances of survival. For better guidance, Kindly contact the
Cancer Healer Team!