Bile duct cancer occurs in the bile ducts, which are a series of tubes that move from the liver to the small intestines. These ducts work to move bile from the gallbladder and liver to the small intestine, where it is used to help digest fat in food. Cancer can happen in any part of the bile duct system and is classified depending on location.
Intrahepatic bile duct cancer occurs in the small bile duct branches found in the liver. Perihilar bile duct cancer develops in the hilum, where ducts from the left and right lobe of the liver join together. Distal bile duct cancer occurs closer to the small intestine.
There are many risk factors for bile duct cancer that cannot be changed, such as age, autoimmune diseases, and ethnicity. However, there are some things you can do to lower the risk. Being at a healthy weight is one way to reduce your chances. Quitting smoking is also helpful.
Often there are few symptoms of bile duct cancer until more advanced stages of the disease. However in some cases, you may experience symptoms. These include jaundice, which is the yellowing of the eyes and skin. Itching is also common as excess bilirubin in the skin causes itching. You may also experience light-colored and/or greasy stools. Other symptoms include dark urine, stomach pain, loss of appetite, fever, nausea, and vomiting.
The first thing a doctor will do is a comprehensive history and physical exam. If the doctor believes you may have bile duct tumors, they will do other tests. These might be imaging tests, lab tests, and other procedures. The gold standard test for sampling tissue from the bile ducts to diagnose bile duct tumors is an ERCP. This is a specialized endoscopic procedure that allows endoscopists to access and visualize the bile ducts to diagnose and treat multiple bile duct diseases. Occasionally an endoscopist may even need to used more advanced imaging such as spyglass inside the bile duct itself to get a diagnosis.
The treatment plan is primarily based on the extent in which the bile duct cancer has spread. Surgery is the primary treatment because it is the only possibility of a cure. However many bile duct tumors are not surgically removable at the time of diagnosis due to extensive disease. In these cases patients may only have the chance to get chemotherapy. ERCP also plays a significant role in keeping bile ducts open and draining properly by the placement of stents (plastic or metal tubes) into the bile duct across tumors. This allows patients to continue to receive therapy for their tumors and also prevent infection of the bile ducts as well. ERCP may also be used to treat bile duct tumors and destroy cancer cells from within the body itself.
Are you interested in learning more about bile duct tumors, or other GI conditions? We invite you to contact us to learn more. Dr. Prashant Kedia is a therapeutic endoscopist and gastroenterologist serving patients in the Dallas-Fort Worth area and beyond. Call today to schedule an appointment at (214) 941-6891.