What is bile duct cancer?
Bile is a fluid that aids in the digestion of foods by breaking down fats and making the digestive system’s job easier. The bile duct is what carries bile from the liver / gallbladder to the small intestine, allowing bile to breakdown fats in the food we eat.
Bile duct cancer (cholangiocarcinoma) is a rare form of cancer that starts in or around your bile duct. In the USA, it affects roughly 8,000 people per year, making up less than 0.5% of new cases.
Bile duct cancer occurs when cells begin to grow out of control, forming a tumour. There are several types of bile duct cancer. These include:
- Perihilar bile duct cancer – This starts in the hilum, which is next to the liver. The hilum contains many bile ducts and blood vessels.
- Intrahepatic bile duct cancer – This type of bile duct cancer starts in the small bile duct branches inside your liver.
- Distal bile duct cancer – This type of cancer begins further down the bile duct and closer to the small intestine.
Causes and risk factors of bile duct cancer:
A risk factor is something that increases the likelihood of you getting a disease such as bile duct cancer. Below are some of the most common risk factors associated with cholangiocarcinoma:
Previous liver or bile duct disease:
People who have suffered from the following diseases are at a higher risk of bile duct cancer:
- Primary sclerosing cholangitis (PSC),
- Gallstones and bile duct stones
- Cysts in bile ducts
- Cirrhosis – Damage to the liver caused by scar tissue
Inflammatory bowel diseases such as Crohn’s disease can increase the risk of bile duct cancer.
Southeast Asian countries:
Bile duct cancer is a lot more common in Southeast Asia and China. This is due to the higher rate of liver infections.
Most people who are diagnosed with bile duct cancer are in their 60s and 70s. The risks of bile duct cancer increase as you grow older.
People with a higher BMI are more at risk of bile duct cancer. This is because obesity increases the risk of gallstones and liver issues. Diabetes is also associated with an increased risk.
Symptoms of bile duct cancer:
There are several common symptoms associated with bile duct cancer. These symptoms range in severity depending on what stage the cancer is at. If you notice any of the following symptoms, we recommend that you see a doctor as soon as possible. An early diagnosis will allow doctors to begin treating your illness earlier, resulting in an increased chance of recovery.
Below are some of the most common symptoms associated with bile duct cancer:
- Jaundice – Jaundice occurs when your liver is unable to get rid of bile. This leads to a buildup of bile, which flows into the bloodstream. This results in yellowing of the skin.
- Dark coloured urine – Bile duct cancer can cause an increased bilirubin level, which can lead to dark coloured urine. Increased bilirubin can also cause itching of the skin.
- Lower abdominal pain – Larger tumours can lead to increased pain, which usually occurs below the ribs on the right side of your body.
- Reduced appetite and weight loss – Bile duct cancer can result in a decreased appetite, which can lead to weight loss.
You should keep in mind that these symptoms are not always due to bile duct cancer. In fact, most of the time, these symptoms will be attributed to another issue with your liver, bile duct or gallbladder. However, it is always best to get the issue checked out by a doctor. Other types of liver and bile duct issues can be dangerous, and require immediate treatment.
Treatment for bile duct cancer:
There are several different types of treatment for bile duct cancer. The ideal type of treatment will vary depending on several factors:
- The location of the cancer
- The size and sstage stage of the cancer
- Your overall health
- Whether the cancer is removable via surgery
Below are some of the most common treatments for bile duct cancer:
During a surgery, a surgeon will attempt to remove your bile duct cancer as well as a surrounding area of clean tissue called a margin. The aim of surgery is to remove all traces of cancer and prevent it from reocurring.
There are several common types of surgery for bile duct cancer. These include:
- Early stage bile duct removal – The surgeon will only remove the bile ducts that contain cancer. He/she will then join the remaining ducts to the bowel, allowing bile to flow correctly.
- Intrahepatic bile duct cancer removal – This method is ideal for bile ducts inside the liver. The surgeon will remove the affected part of the liver which includes these bile ducts.
- Perihilar bile duct cancer removal – This type of surgery consists of the surgeon removing the gallbladder, as well as the bile ducts and infected parts of the liver.
- Distal bile duct cancer removal – For this form of cancer, the surgeon may have to remove the gallbladder, part of the pancreas and part of the bowel.
Following the surgery, doctors may recommend chemotherapy or radiation therapy. This is done to reduce the chances of the cancer coming back.
Radiation therapy is when high energy rays are used to target and destroy cancer cells. It is often used:
- Before surgery to shrink the tumour, making it easier to operate on.
- After surgery to reduce the likelihood of cancer reoccurring.
- As an alternative to surgery for inoperable forms of cancer.
Radiation therapy is usually given externally via a machine (external beam therapy). However, it can also be given internally by placing radioactive sources inside the body. Throughout radiation therapy, the doctors will aim to shrink cancer cells while causing as little damage as possible to nromal cells. However, radiation therapy does usually come with side effects. These include:
- Sore or irritated skin
- Nausea and vomiting
- Increased risk of liver diseases and other cancers
Like radiation therapy, chemotherapy is often given alongside, or as an alternative to surgery. Chemotherapy is when drugs are used to destroy or limit the growth of cancer cells. The type of drugs used will depend on what type of cancer you have.
Chemotherapy is either given orally in the form of pills, or intravenously (via a drip). Chemotherapy does come with side effects, which include:
- Nausea and vomiting
- Extreme fatigue
- Loss of hair
- Increased chance of infection
What support can we give for bile duct cancer?
Bile Duct Cancer (Cholangiocarcinoma) is a rare cancer, meaning it is not as well known as other forms of cancer. Without a Ribbon is an Australian organisation that provides support for individuals who suffer from rare cancers. We provide a designated platform for Warriors to obtain information specific to their Rare Cancer. We also provide annual opportunities for our Warriors to meet and learn from each other.
If you suffer from a rare cancer such as bile duct cancer, we can help and support you through your journey thanks to the generous donations we receive. Click the link below to sign up and become a Warrior today!
You can help us with your donation:
Without a Ribbon is a charity that works hard to aid those who suffer from rare cancers. You can help our cause in a variety of ways:
Donations – Without a Ribbon is grateful for every donation received. Giving to Without a Ribbon helps us to provide ongoing support, organise the annual gathering and subsidise the costs of our Warriors attending these conferences.
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