A uncommon kind of cancer called cholangiocarcinoma begins in the bile ducts. The small intestine receives bile (a fluid that aids in fat digestion) through the bile ducts, which are tiny tubes that travel from your liver and gallbladder.
Because cholangiocarcinoma is an aggressive cancer, it spreads quickly. Most cases of cholangiocarcinoma are diagnosed when the cancer has already progressed outside the bile ducts. Currently, there is little prospect of recovery from bile duct cancer, and treatment is challenging.
What kinds of cancers affect the bile ducts?
Cholangiocarcinoma comes in three different forms:
- Bile duct cancer within the liver is known as intrahepatic cholangiocarcinoma.
- In your hilum, perihilar cholangiocarcinoma is a type of cancer of the bile duct. The region immediately outside of the liver known as the hilum is where the tiny bile ducts from inside the liver combine to produce the larger duct known as the common hepatic duct. This type of cholangiocarcinoma is the most prevalent. A Klatskin tumor is another term for perihilar cholangiocarcinoma.
- Bile duct cancer that originates in the ducts nearer to your small intestine rather than your liver is known as distal cholangiocarcinoma.
Because perihilar cholangiocarcinoma and distal cholangiocarcinoma originate outside of the liver rather than inside of it, they are often referred to as extrahepatic bile duct cancers.
Signs and Origins
What signs of cholangiocarcinoma are present?
Symptoms of cholangiocarcinoma typically appear when the malignancy has progressed and obstructed a bile duct. Bile duct cancer symptoms include:
- Stomach ache.
- High temperature.
- Weary.
- Skin irritation.
- Jaundice (yellowing of the skin and eye whites).
- Dark urine.
- Greasy or light-colored stools.
- Vomiting as well as nausea.
- Unaccounted-for weight loss.
Early-stage cholangiocarcinoma is typically painless. However, discomfort from a large tumor may feel localized under your ribs on the right side of your abdomen. Some people may experience pain in different areas of their back or abdomen.
However, this kind of pain is not unique to bile duct cancer; it is typical of many illnesses. It’s critical to consult a medical professional to ascertain the cause of any odd stomach ache.
Diagnoses and Examinations
How does one diagnose cholangiocarcinoma?
A medical professional will assess your symptoms, look over your past medical records, and perform a physical examination.
Exams for cholangiocarcinoma could consist of:
Tests for liver function: These tests look for abnormal levels in your blood, such as higher liver enzymes, which could mean your liver isn’t functioning properly. Elevated levels could potentially indicate a blockage in your bile duct.
Tests for tumor markers: These examine your blood or urine for compounds that may indicate you have cancer. Elevations of either carcinoembryonic antigen (CEA) or carbohydrate antigen (CA) 19-9 could be indicators of bile duct malignancy.
Imaging tests: If your doctor thinks you may have bile duct cancer, an abdominal ultrasound is typically the first imaging test you’ll need. A CT scan or an MRI, particularly magnetic resonance cholangiopancreatography (MRCP), may also be necessary for you.
Endoscopic tests: These examinations look at your bile ducts using an endoscope, which is a thin, flexible tube equipped with a camera. The purpose of the endoscope is to allow your healthcare professional to have a close-up look at your bile ducts while you are sedated (in a light sleep). Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography (EUS) are among the tests.
Percutaneous transhepatic cholangiography (PTC): PTCs are used to see and drain bile duct obstructions associated with cholangiocarcinoma. Your doctor will inject a contrast dye straight into your liver and bile ducts throughout the procedure. Blockages are made more visible on an X-ray by the dye. To allow the bile duct to empty, a tube will be inserted.
