Bile Duct Cancer (Medicine Book 10)

A sharp pencil point is about 1 mm, a new crayon point is about 2 mm, and a new pencil eraser is about 5 mm. Cancer has spread into the wall of the distal extrahepatic bile duct and to 4 or more nearby lymph nodes. Cancer has spread to the large vessels that carry blood to the organs in the abdomen. Cancer may have spread to 1 or more nearby lymph nodes. 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 cancer cannot be removed completely by surgery.

Most patients with bile duct cancer cannot have their cancer completely removed by surgery.

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Metastasis is the spread of cancer from the primary site place where it started to other places in the body. Metastatic bile duct cancer may have spread to the liver, other parts of the abdominal cavity , or to distant parts of the body. Recurrent bile duct cancer is cancer that has recurred come back after it has been treated. The cancer may come back in the bile ducts, liver, or gallbladder.

Less often, it may come back in distant parts of the body. Different types of treatments are available for patients with bile duct cancer. Some treatments are standard the currently used treatment , and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. The following types of surgery are used to treat bile duct cancer:. After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left.

Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. It is not yet known whether chemotherapy or radiation therapy given after surgery helps keep the cancer from coming back. The following types of palliative surgery may be done to relieve symptoms caused by a blocked bile duct and improve quality of life:. Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:. External and internal radiation therapy are used to treat bile duct cancer.

It is not yet known whether external radiation therapy helps in the treatment of resectable bile duct cancer. In unresectable , metastatic , or recurrent bile duct cancer, new ways to improve the effect of external radiation therapy on cancer cells are being studied:. Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body systemic chemotherapy. When chemotherapy is placed directly into the cerebrospinal fluid , an organ , or a body cavity such as the abdomen , the drugs mainly affect cancer cells in those areas regional chemotherapy. Systemic chemotherapy is used to treat unresectable, metastatic, or recurrent bile duct cancer.

It is not yet known whether systemic chemotherapy helps in the treatment of resectable bile duct cancer. In unresectable, metastatic, or recurrent bile duct cancer, intra-arterial embolization is being studied. It is a procedure in which the blood supply to a tumor is blocked after anticancer drugs are given in blood vessels near the tumor. Sometimes, the anticancer drugs are attached to small beads that are injected into an artery that feeds the tumor.

The beads block blood flow to the tumor as they release the drug. This allows a higher amount of drug to reach the tumor for a longer period of time, which may kill more cancer cells.

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This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. In a liver transplant , the entire liver is removed and replaced with a healthy donated liver. A liver transplant may be done in patients with perihilar bile duct cancer. If the patient has to wait for a donated liver, other treatment is given as needed.

For information about side effects caused by treatment for cancer, see our Side Effects page. For some patients, taking part in a clinical trial may be the best treatment choice.

Bile Duct Cancer

Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Cholangiocarcinoma (bile duct cancer) - Symptoms and causes - Mayo Clinic

Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring coming back or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country.

Clinical trials supported by other organizations can be found on the ClinicalTrials. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. 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. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish. The PDQ summaries are based on an independent review of the medical literature.

The date on each summary "Updated" is the date of the most recent change. A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients.

During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard. PDQ is a registered trademark. The content of PDQ documents can be used freely as text.

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Questions can also be submitted to Cancer. Turn recording back on. National Center for Biotechnology Information , U. 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. 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. This content does not have an English version. This content does not have an Arabic version. Gallbladder and bile duct The gallbladder serves as a reservoir for bile, a yellow-green fluid produced in your liver. Request an Appointment at Mayo Clinic. Mayo Foundation for Medical Education and Research; Feldman M, et al.

General Information About Bile Duct Cancer

Tumors of the bile ducts, gallbladder and ampulla. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Rizvi S, et al. Current diagnostic and management options in perihilar cholangiocarcinoma. Zaydfudim VM, et al. Surgical Oncology Clinics of North America. Mayo Clinic, Rochester, Minn. Smoot RL expert opinion. Choi J, et al. Aspirin use and the risk of cholangiocarcinoma.

Doherty B, et al. Update on the diagnosis and treatment of cholangiocarcinoma. Borad MJ, et al. Integrated genomic characterization reveals novel, therapeutically relevant drug targets in FGFR and EGFR pathways in sporadic intrahepatic cholangiocarcinoma. Surgery on the extrahepatic bile duct, duodenum, papilla, or pancreas. Merck Manual Professional Version. Tumors of the gallbladder and bile ducts. Bergquist JR, et al. Implications of CA elevation for survival, staging and treatment sequencing in intrahepatic cholangiocarcinoma: A national cohort analysis.

Journal of Surgical Oncology.

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