Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred come back.
These tests are sometimes called follow-up tests or check-ups. For information about the treatments listed below, see the Treatment Option Overview section. A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer , there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you. Treatment of resectable intrahepatic bile duct cancer may include:. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients.
You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. Treatment of unresectable , recurrent , or metastatic intrahepatic bile duct cancer may include the following:. Treatment of resectable perihilar bile duct cancer may include the following:. Treatment of unresectable , recurrent , or metastatic perihilar bile duct cancer may include the following:. Treatment of resectable distal extrahepatic bile duct cancer may include the following:.
Treatment of unresectable , recurrent , or metastatic distal extrahepatic bile duct cancer may include the following:. For more information from the National Cancer Institute about bile duct cancer, see the following:. For general cancer information and other resources from the National Cancer Institute, see the following:. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language.
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Cholangiocarcinoma (bile duct cancer) - Diagnosis and treatment - Mayo Clinic
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Show details Bethesda MD: Having colitis or certain liver diseases can increase the risk of bile duct cancer. Signs of bile duct cancer include jaundice and pain in the abdomen. Tests that examine the bile ducts and nearby organs are used to detect find , diagnose, and stage bile duct cancer.
Different procedures may be used to obtain a sample of tissue and diagnose bile duct cancer. Certain factors affect prognosis chance of recovery and treatment options. Bile duct cancer is a rare disease in which malignant cancer cells form in the bile ducts. There are two types of bile duct cancer: Intrahepatic bile duct cancer: This type of cancer forms in the bile ducts inside the liver.
Only a small number of bile duct cancers are intrahepatic. Intrahepatic bile duct cancers are also called intrahepatic cholangiocarcinomas. Extrahepatic bile duct cancer: The extrahepatic bile duct is made up of the hilum region and the distal region. Cancer can form in either region: Risk factors for bile duct cancer include the following conditions: Primary sclerosing cholangitis a progressive disease in which the bile ducts become blocked by inflammation and scarring.
Cysts in the bile ducts cysts block the flow of bile and can cause swollen bile ducts, inflammation, and infection. Infection with a Chinese liver fluke parasite. Check with your doctor if you have any of the following: Jaundice yellowing of the skin or whites of the eyes. Pain in the abdomen. The following tests and procedures may be used: Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A procedure in which a blood sample is checked to measure the amounts of bilirubin and alkaline phosphatase released into the blood by the liver.
A higher than normal amount of these substances can be a sign of liver disease that may be caused by bile duct cancer. Medical procedures that test samples of tissue , blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitor the disease over time. A procedure in which a sample of blood, urine, or tissue is checked to measure the amounts of certain substances made by organs , tissues, or tumor cells in the body.
Bile Duct Cancer
Certain substances are linked to specific types of cancer when found in increased levels in the body. These are called tumor markers. Higher than normal levels of carcinoembryonic antigen CEA and CA may mean there is bile duct cancer. A procedure in which high-energy sound waves ultrasound are bounced off internal tissues or organs, such as the abdomen, and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later. CT scan CAT scan: A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen, taken from different angles.
The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. MRI magnetic resonance imaging: A procedure that uses a magnet, radio waves , and a computer to make a series of detailed pictures of areas inside the body.
This procedure is also called nuclear magnetic resonance imaging NMRI. MRCP magnetic resonance cholangiopancreatography: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body such as the liver, bile ducts, gallbladder, pancreas, and pancreatic duct. Types of biopsy procedures include the following: A surgical procedure to look at the organs inside the abdomen, such as the bile ducts and liver, to check for signs of cancer. Small incisions cuts are made in the wall of the abdomen and a laparoscope a thin, lighted tube is inserted into one of the incisions.
Other instruments may be inserted through the same or other incisions to perform procedures such as taking tissue samples to be checked for signs of cancer. Percutaneous transhepatic cholangiography PTC: A procedure used to x-ray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an x-ray is taken.
A sample of tissue is removed and checked for signs of cancer. If the bile duct is blocked, a thin, flexible tube called a stent may be left in the liver to drain bile into the small intestine or a collection bag outside the body. This procedure may be used when a patient cannot have surgery. Endoscopic retrograde cholangiopancreatography ERCP: A procedure used to x-ray the ducts tubes that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine.
Sometimes bile duct cancer causes these ducts to narrow and block or slow the flow of bile, causing jaundice. An endoscope is passed through the mouth and stomach and into the small intestine. Dye is injected through the endoscope thin, tube-like instrument with a light and a lens for viewing into the bile ducts and an x-ray is taken. If the bile duct is blocked, a thin tube may be inserted into the duct to unblock it. This tube or stent may be left in place to keep the duct open. A procedure in which an endoscope is inserted into the body, usually through the mouth or rectum.
An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves ultrasound off internal tissues or organs and make echoes. This procedure is also called endosonography. The prognosis chance of recovery and treatment options depend on the following: Whether the cancer is in the upper or lower part of the bile duct system. The stage of the cancer whether it affects only the bile ducts or has spread to the liver, lymph nodes , or other places in the body. Whether the cancer has spread to nearby nerves or veins.
Whether the cancer has just been diagnosed or has recurred come back. Cancer may spread from where it began to other parts of the body. Stages are used to describe the different types of bile duct cancer. The results of diagnostic and staging tests are used to find out if cancer cells have spread. There are three ways that cancer spreads in the body. Cancer can spread through tissue , the lymph system , and the blood: The cancer spreads from where it began by growing into nearby areas.
The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor metastatic tumor in another part of the body. The cancer gets into the blood, travels through the blood vessels, and forms a tumor metastatic tumor in another part of the body. Intrahepatic bile duct cancer Stage 0: In stage 0 intrahepatic bile duct cancer, abnormal cells are found in the innermost layer of tissue lining the intrahepatic bile duct. These abnormal cells may become cancer and spread into nearby normal tissue.
Stage 0 is also called carcinoma in situ. In stage II intrahepatic bile duct cancer, either of the following is found: In stage IV intrahepatic bile duct cancer, cancer has spread to other parts of the body, such as the bone, lungs , distant lymph nodes , or tissue lining the wall of the abdomen and most organs in the abdomen.
Perihilar bile duct cancer Stage 0: In stage 0 perihilar bile duct cancer , abnormal cells are found in the innermost layer of tissue lining the perihilar bile duct. Stage 0 is also called carcinoma in situ or high-grade dysplasia.
In stage I perihilar bile duct cancer , cancer has formed in the innermost layer of tissue lining the perihilar bile duct and has spread into the muscle layer or fibrous tissue layer of the perihilar bile duct wall. In stage II perihilar bile duct cancer , cancer has spread through the wall of the perihilar bile duct to nearby fatty tissue or to liver tissue.
Distal extrahepatic bile duct cancer Stage 0: In stage 0 distal extrahepatic bile duct cancer , abnormal cells are found in the innermost layer of tissue lining the distal extrahepatic bile duct. In stage I distal extrahepatic bile duct cancer , cancer has formed and spread fewer than 5 millimeters into the wall of the distal extrahepatic bile duct.
Cancer has spread 5 millimeters or more into the wall of the distal extrahepatic bile duct. Cancer may have spread to 1 to 3 nearby lymph nodes. In stage IV distal extrahepatic bile duct cancer , cancer has spread to other parts of the body, such as the liver , lungs , or tissue lining the wall of the abdomen and most organs in the abdomen. The following groups are used to plan treatment: Resectable localized bile duct cancer The cancer is in an area, such as the lower part of the common bile duct or perihilar area, where it can be removed completely by surgery.
Unresectable, metastatic, or recurrent bile duct cancer Unresectable cancer cannot be removed completely by surgery. Patients can enter clinical trials before, during, or after starting their cancer treatment. There are different types of treatment for patients with bile duct cancer. Three types of standard treatment are used: Surgery The following types of surgery are used to treat bile duct cancer: Removal of the bile duct: A surgical procedure to remove part of the bile duct if the tumor is small and in the bile duct only. Lymph nodes are removed and tissue from the lymph nodes is viewed under a microscope to see if there is cancer.
A surgical procedure in which the part of the liver where cancer is found is removed. The part removed may be a wedge of tissue, an entire lobe , or a larger part of the liver, along with some normal tissue around it. A surgical procedure in which the head of the pancreas , the gallbladder , part of the stomach , part of the small intestine , and the bile duct are removed.
Enough of the pancreas is left to make digestive juices and insulin. If cancer is blocking the bile duct and bile is building up in the gallbladder, a biliary bypass may be done. During this operation, the doctor will cut the gallbladder or bile duct in the area before the blockage and sew it to the part of the bile duct that is past the blockage or to the small intestine to create a new pathway around the blocked area. If the tumor is blocking the bile duct, surgery may be done to put in a stent a thin tube to drain bile that has built up in the area.
Cancers can develop in any part of the bile duct and, based on their location, are classified into three types:. Signs and symptoms may not be present until the later stages of bile duct cancer, but in some cases they may lead to an early diagnosis. The following are some symptoms associated with bile duct cancer:. Bile duct cancer is uncommon. However, certain factors and conditions may put you at greater risk of developing this type of cancer. Long-standing Inflammation Long-standing inflammation is a key risk factor in developing bile duct cancer.
Conditions that are associated with this kind of inflammation include:. Liver Fluke Infection Flukes are parasitic worms that can enter your body if you eat undercooked freshwater fish that contains parasites. Once they have entered the body, liver flukes go and inhabit the bile ducts. The species of fluke connected to bile duct cancer is mostly found in Southeast Asia. Other Risk Factors Family history of bile duct cancer, smoking, diabetes and pancreatitis may also play a role.
General Information About Bile Duct Cancer
Bile duct cancer can be a challenging condition to diagnose. If cancer is suspected, the patient is referred to a specialist for tests. Some of the tests are described below:. Most cases of bile duct cancer cannot be cured. Instead, treatment is most commonly used to relieve symptoms. The treatment plan will be determined by the stage the cancer has reached. In stage 1 and stage 2 cases of bile duct cancer, a cure may be possible by surgically removing the affected part of the bile duct, and possibly some of the liver or gallbladder.
In a stage 3 case, the chances of achieving a successful cure will depend on how many lymph nodes have been affected. A cure may be possible if only a few nodes have cancerous cells in them or it may be possible to slow the spread of the cancer by surgically removing the lymph nodes. In cases of stage 4 bile duct cancer, achieving a successful cure is highly unlikely.
However, chemotherapy, radiotherapy and surgery can often be used to help relieve symptoms. If it is possible to cure bile duct cancer, surgery will be needed to remove any cancerous tissue. Depending on the extent of the cancer, it may be necessary to remove:. Unfortunately, due to the aggressive nature of bile duct cancer, fewer than one-third of patients are suitable for surgery. After surgery, it is usually possible to reconstruct what remains of the bile duct so that bile can still flow into the intestine. Unblocking The Bile Duct: If the bile duct becomes blocked as a result of cancer, a treatment to unblock the duct is recommended.
This will help resolve symptoms such as:. Unblocking the bile duct is sometimes necessary if the flow of bile back into your liver starts to affect the normal functioning of your liver.
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The bile duct can be unblocked in several ways. During the procedure, a surgeon will guide a long, flexible tube with a light and video camera on the end endoscope into the bile duct and pass down a small metal or plastic tube called a stent. The stent is used to widen the bile duct, which should help to get the bile flowing again.
Alternatively, a stent can be placed in the bile duct using a variation of the Percutaneous Transhepatic Cholangiography PTC procedure. This involves placing the stent in the bile duct through a small incision in the stomach. Radiotherapy cannot cure bile duct cancer but can help to relieve the symptoms, slow the spread of cancer and prolong life. Two types of radiotherapy are used to treat bile duct cancer:. Radiotherapy works by damaging cancerous cells. However, it can also damage healthy cells and cause side effects. Side effects of radiotherapy include:.
Chemotherapy is used in a way similar to radiotherapy to relieve the symptoms of cancer, slow down the rate at which it spreads and prolong life. It is sometimes used in combination with radiotherapy. As with radiotherapy, medicines used in chemotherapy can sometimes damage healthy tissue as well as cancerous tissue, and adverse side effects are common. Side effects of chemotherapy can include:. Photodynamic Therapy is a new technique that can help to control — but not cure — the symptoms of bile duct cancer. A special chemical is injected into the bile duct, which makes the cancerous cells more sensitive to light.
A laser is then passed through an endoscope and used to shrink the tumour. Appointment already booked for this date and time.
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