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bile duct cancer: do you know the signs?
4 minute read
bile duct cancer carries a poor prognosis and is difficult to treat. getty
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cholangiocarcinoma, better known as bile duct cancer, is a rare and often fatal form of disease that develops in the narrow tubes that transport bile throughout the digestive system. bile, a yellow-green fluid that helps break down food, is carried by these tubes from the liver (where it is created) to the gallbladder (where it is stored) and on to the gut where it helps digest the fat in the foods we consume.
sometimes, cells in the bile ducts undergo a change that causes them to stop behaving normally. if these changes are non-cancerous, according to canadian cancer society, they can result in bile stones, bladder inflammation or other issues. if they are cancerous, however, these cells can begin to multiply rapidly, form tumours and destroy surrounding tissue before spreading to other parts of the body.
this type of cancer, which generally affects people over the age of 50, is often divided into two main groups based on where it originates: intrahepatic (or inside the liver) and extrahepatic (outside the liver). the majority of cases of bile duct cancer are extrahepatic.
bile duct cancer carries a poor prognosis and is difficult to treat because by the time it is diagnosed it has often spread to other areas of the body.
symptoms of bile duct cancer
bile duct cancer often exhibits no signs in its early stages, only making itself known once tumours have spread to the liver or other surrounding organs. the most common symptom associated with the disease is jaundice, or a yellowing of the skin and the whites of the eyes. urine may also appear bright yellow and stools can be lighter in colour, greasy and float in the toilet. other symptoms can include:
- itchy skin (from the effects of jaundice)
- loss of appetite or weight loss
- nausea, vomiting or fever
- abdominal pain
- fatigue
- night sweats
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diagnosing bile duct cancer
a doctor will typically perform a physical exam and ask about symptoms when investigating a potential case of bile duct cancer. according to bc cancer, this involves looking for signs of jaundice and feeling around the abdomen for tenderness or evidence of an enlarged liver or the accumulation of fluid. other procedures may include:
- tumour marker tests. high levels of a certain protein (ca 19-9) in the blood may be indicative of bile duct cancer or other bile duct diseases
- imaging. ultrasounds, mris, ct scans and mrcps (magnetic resonance cholangiopancreatography) are all useful in determining if the cancer has spread. an endoscopic ultrasound (a long tube sent down the throat) may also be used to biopsy bile duct cells and search for evidence of tumours
- cholangiography. a dye that can help locate the cancer is injected into the bile ducts before x-rays are taken
- endoscopic retrograde cholangiopancreatography (ercp). a tube is put down the throat and sent into the bile ducts to check for blockages, extrahepatic bile duct cancer or take a biopsy
- laparoscopy. an incision is made in the abdomen to make room for a small camera that can look for the presence and spread of cancer
- surgery. to determine the presence of cancer or take a biopsy, surgery may be required
abdominal ultrasound imaging can be used to diagnose bile duct cancer. getty
treating bile duct cancer
treatment for this disease depends on a few factors, including the size and location of the tumour and whether or not it has spread to other parts of the body. healthline reports that surgery is the only form of treatment that offers a cure for bile duct cancer, particularly if it has been caught early. if the cancer has spread, all or part of the surrounding organs, including the liver, may need to be removed. if it is possible to completely remove the presence of tumours, patients may be able to make a full recovery.
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if it isn’t possible to completely remove the cancer, surgery may unblock a patient’s bile ducts to relieve jaundice and other symptoms of the disease.
how can i prevent bile duct cancer?
there is currently no known way to prevent bile duct cancer but there are a few possible risk factors for the disease, including obesity, heavy alcohol consumption, cirrhosis of the liver and smoking.
prevalence of bile duct cancer
in canada, the five-year net survival statistics for this disease are incorporated into a group known as “other digestive system cancers” (with net survival referring to the probability of surviving the cancer in the absence of other causes of death). the five-year net survival rate for other digestive system cancers is 21 per cent, meaning, on average, 21 per cent of patients diagnosed with these forms of cancers will survive for at least five years.
support for bile duct cancer
the canadian cancer society offers more information about bile duct cancer, a cancer information hotline and a community service locator to help you find support in your area.
dave yasvinski is a toronto-based writer.
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