Cancer of the bile duct (cholangiocarcinoma biliary cancer)

• What is Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer)
• Statistics on Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer)
• Risk Factors for Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer)
• Progression of Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer)
• Symptoms of Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer)
• Clinical Examination of Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer)
• How is Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer) Diagnosed?
• Prognosis of Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer)
• How is Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer) Treated?
• Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer) References

What is Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer)

Cancer of the bile duct or cholangiocarcinoma is a cancer that arises from the bile ducts. There are the tubes that connect the liver and the gallbladder. The tubes transport bile to the small intestine.

Statistics on Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer)

Incidence of cholangiocarcinoma in Western countries ranges between 2-6 cases per 100 000 population. Incidence tends to be higher among those of Asian descent due to the increased risk of chronic parasitic infection in Asian countries. The male to female ratio is about 3:2, and peak incidence of cholangiocarcinoma occurs in the 50’s.

Risk Factors for Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer)

Most cases of cholangicarcinomas arise without a cause being found.
Some conditions which carry a higher risk of cholangiocarcinoma include:

• Chronic parasitic infection of the bile ducts (higher risk in some Asian countries due to dietary habits).
• The presence of cysts in the bile ducts.
• Inflammatory bowel disease.
• Certain autoimmune processes.
• Previous cancer.
• Prior treatment with Thorotrast.

Progression of Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer)

Cholangiocarcinomas arise from the cells that line the bile ducts. Typically cholangiocarcinoma progresses slowly, with spread via the local lymphatic system and into the liver and surrounding lymph nodes. Eventually cholangiocarcinoma metastasises and spreads into distant parts of the body.

How is Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer) Diagnosed?

Blood Tests:

• Liver function tests which will usually be abnormal.
• Tests for certain ‘tumour markers’ that correspond to the type of cancer.

 
Imaging:

• Ultrasound.
• CT.
• MRI scan.

 
A procedure called ERCP may also be performed to show the site of obstruction caused by a cholangiocarcinoma tumour.

Prognosis of Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer)

Cholangiocarcinoma prognosis is often poor as most tumours are unsuitable for resection. Long term prognosis is best for cholangiocarcinoma patients with completely resected tumours; patients who have cholangiocarcinoma tumours unsuitable for surgery but are suitable for chemoradiation have an average survival of about 1 year following treatment of the cholangiocarcinoma.

How is Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer) Treated?

Cholangiocarcinoma surgery offers the best chance of a cure, however as most cases of cholangiocarcinoma are not detected until a late stage, this may not be a suitable option.
In general, the use of radiotherapy and chemotherapy is limited with these tumours. Therefore treatment for the majority of cholangiocarcinoma patients aims to relieve symptoms and improve quality of life. This is done by relieving bile duct obstruction with stents – plastic or metal tubes which keep the ducts open, and supplying appropriate pain control if necessary.

Cancer of the Bile Duct (Cholangiocarcinoma Biliary Cancer) References

[1] Anand M, Nicholson D. Cholangiocarcinoma. eMedicine 2002.
[available online: http://www.emedicine.com/radio/topic153.htm] [2] Cotran, Kumar, Collins. Robbins Pathological Basis of Disease, 6th ed. WB Saunders, United States of America (1999).
[3] Kumar and Clark. Clinical Medicine, 5th ed. WB Saunders, Toronto (2002).
[4] The Merck Manual of Diagnosis and Therapy, Section 4. Hepatic And Biliary Disorders. [available online: http://www.merck.com/mrkshared/]