Bile Duct Cancer (Cholangiocarcinoma)

Types of Bile Duct Cancer

• Intrahepatic cholangiocarcinoma: It forms inside the bile duct in the liver.
• Perihilar (hilar) cholangiocarcinoma or Klatskin tumor: It occurs in the hilum, an area just outside the liver where small bile ducts merge to form a common hepatic duct.
• Distal cholangiocarcinoma: It forms outside the liver, where ducts from the liver and gall bladder join to form the common bile duct that passes through the pancreas and ends in the small intestine.

Symptoms of Bile Duct Cancer

• Unexplained weight loss
• Yellowing of the skin and white of the eyes(jaundice)
• Light-colored greasy stools
• Nausea and vomiting
• Dark urine
• Fever
• Night sweats
• Intensely itchy skin
• Fatigue

Causes of Bile Duct Cancers

• Structural abnormalities in the area where the bile duct and pancreatic duct meet
• Choledochal cyst disease or bile duct stones
• Cirrhosis of the liver
• HIV
• Inflammatory bowel diseases
• Hepatitis B or Hepatitis C
• Primary sclerosing cholangitis
• Metabolic dysfunction associated with steatotic liver disease
• Clonorciasis(infection from Chinese liver fluke parasite)

• Smoking
• Obesity
• Diabetes
• Alcohol use disorder
• Exposure to toxins in automotive factories and rubber plants

Diagnosis of Bile Duct Cancer

• Liver function tests: It checks for elevated liver enzymes.
• Blood tests: CEA, CA-19-9, and Alpha-fetoprotein (AFP)are blood tests to check for underlying gastrointestinal malignancies.
• Tumor marker tests: They check your blood or urine for tumor markers.
• Imaging tests: Tests like an abdominal ultrasound, CT scans, and MRI, including a specialized MRI called magnetic resonance cholangiopancreatography (MRCP).
• Endoscopy tests: These include endoscopic ultrasound and endoscopic retrograde cholangiopancreatography(ERCP).
• Percutaneous transhepatic cholangiography(PTC): A procedure used to view blockages in the bile duct related to cholangiocarcinoma.
• Biopsy: Where tests indicate cancer, a biopsy is done to confirm the diagnosis.

Treatment of Bile Duct Cancer

• Surgery: Surgery is done to remove all or part of the bile duct or part of the affected organs.
• Liver transplant: Surgery is done to remove the liver and replace it with one from a donor.
• Chemotherapy: They are drugs used to kill cancer cells or shrink tumors.
• Radiation therapy: It uses high-powered radiation to kill cancer cells.
• Targeted drug therapy: They block abnormal proteins that fuel the cancer cells.
• Immunotherapy: It disables protein cells that prevent protein cells from attacking cancer cells.
• Photodynamic therapy: Laser light is used to trigger chemical reactions in cancer cells, killing them.
• Biliary drainage: Where the bile duct is blocked, a stent is placed into the duct to keep the bile moving.
• Clinical trials: Studies that test new cancer treatments.

Sources

• 1
  cancer.gov/types/liver/bile-duct-cancer#:~:text=Bile%20duct%20cancer%20is%20a,%2C%20gallbladder%2C%20and%20small%20intestine
• 2
  mayoclinic.org/diseases-conditions/cholangiocarcinoma/symptoms-causes/syc-20352408
• 3
  cancer.org/cancer/types/bile-duct-cancer/about/what-is-bile-duct-cancer.html
• 4
  my.clevelandclinic.org/health/diseases/21524-cholangiocarcinoma
• 5
  hopkinsmedicine.org/health/conditions-and-diseases/bile-duct-cancer-cholangiocarcinoma
• 6
  mayoclinic.org/diseases-conditions/cholangiocarcinoma/diagnosis-treatment/drc-20352413
• 7
  medlineplus.gov/genetics/condition/cholangiocarcinoma/
• 8
  cancer.org/cancer/types/bile-duct-cancer.html
• 9
  webmd.com/cancer/bile-duct-cancer