Bile Duct Cancer

 

 

OVERVIEW

Bile duct cancer is a rare type of cancer of the gastrointestinal system (digestive system). It is found in the tissues of the bile duct, a tube that connects the liver and gallbladder to the small intestine. Even though it is rare, our gastroenterologists and surgical onoclogist who specialize in treating gastrointestinal cancers at The Cancer Center at Hackensack University Medical Center are skilled in treating bile duct cancer. Our Cancer Center features these unique and innovative services:

  • board-certified gastroenterologist, surgical oncologist and medical oncolofists who are highly skilled in the latest technologies and techniques to diagnose, treat, and manage bile duct cancer
  • state-of-the-art diagnostic technology and imaging studies
  • clinical trials to investigate new medications and treatment methods
  • a full range of suport services

 

DIAGNOSTIC SERVICES

The Cancer Center features state-of-the-art diagnostic services for bile duct cancer. A diagnosis is usually made by using several different approaches, which may include:

  • blood chemistry test (to determine if there is a blockage of the bile ducts)
  • tumor markers (substances produced by cancers and found in the blood)
  • ultrasound
  • CT scan
  • MRI
  • PET scan
  • tissue biopsy
  • cholangiography (X-rays of the bile ducts using a contrast dye)
  • ERCP (endoscopic retrograde cholangiopancreatography, an endoscopic test to view the small intestines and bile ducts)
  • PCT (percutaneous transhepatic cholangiography, whereby dye is injected through a small needle placed into the liver to show bile duct blockages)
  • angiogram (to show surgeons where blood vessels are located near the cancer so that surgery can be planned with as little bleeding as possible)

 

RISK FACTORS

Risk factors for bile duct cancer include:

  • chronic infections of the bile ducts
  • stones in the bile ducts
  • a history of diseases of the liver and bile ducts, such as polycystic liver disease, choledochal cysts, Caroli's syndrome, and cirrhosis of the liver

 

SYMPTOMS

Symptoms of bile duct cancer include:

  • yellowing of the skin (jaundice)
  • pain in the abdomen
  • fever
  • itching

 

TREATMENT SERVICES

The main treatment for bile duct cancer is surgery. Radiation therapy and chemotherapy may be used if the cancer cannot be removed surgically or as a palliative treatment to ease pain.

Surgery

Surgery for bile duct cancer is complicated and should only be performed by an experienced surgeon. The Cancer Center has several surgical oncologist on staff who are highly experienced in treating cancers of the gastrointestinal system, including bile duct cancer. The type of operation you will need depends on the location of the cancer:

  • extrahepatic bile duct cancer (if the cancer is only in the bile duct, the surgeon may remove the duct and make a new one by connecting the openings to the intestine)
  • intrahepatic bile duct cancer (for cancer that has started within the liver, the surgeon removes the part of the liver that contains cancer)
  • perihilar bile duct cancer (for cancer that is near the liver, the surgeon removes part of the liver, the bile duct, gallbladder, and sometimes part of the pancreas and small intestine)
  • distal bile duct cancer (for cancers near the pancreas and small intestine, the surgeon removes part of these organs)
  • palliative surgery (if cancer cannot be removed because of its size or location, the surgeon bypasses the tumor blocking the bile ducts to reduce itching that accompanies the blockage. Or, a plastic tube may be placed through the bile duct to keep it open.)
  • liver transplantation (when the cancer can't be totally removed without also removing the entire liver)

Radiation Therapy

Your doctor may suggest radiation therapy to treat and palliate (ease) symptoms of advanced bile duct cancer, such as pain.

Chemotherapy

Your doctor may recommend chemotherapy to shrink the tumor or to relieve symptoms of advanced bile duct cancer.