Bile duct cancer

November 12, 2012

Bile duct cancer

Bile duct cancer is relatively uncommon – around 4,000 new cases are reported annually in the US, it usually affects those in the over 65 year old category. The bile duct connects the liver to the intestine at the duodenum and is involved with transport of bile from the liver to the intestine – should the bile duct become blocked bile will build up in the blood stream and cause yellowing of the skin. Other than age there are few risk factors for bile duct cancer however those who have experienced inflammation of the bile duct due to colitis or stones may be at higher risk of bile duct cancer.

Another risk factor maybe Caroli’s syndrome which increases the risk of infection and stones. Hazardous chemicals as found in rubber plants and the automotive industries may also pose a risk. Symptoms of bile duct cancer will usually include -

  • Fatigue.

  • Poor appetite

  • Yellowing of skin.

  • Weight loss

  • Abdominal pain

  • Abnormalities in liver function tests.

There are two types of bile duct cancer tumours which present in two different locations and require different treatment – Distal bile duct cancer tumour occurs in the bottom half of the bile duct and can be removed via Whipple surgery. The bottom half of the bile duct is closely associated with the pancreas. Complete removal of the tumour is the only effective treatment leading to cure – complete removal then generally gives a survival rate of over 5 years for around 49% of patients. However if the tumour is not able to be removed surgically the only option for treatment may well be palliative care – particularly the relief of jaundice, a stent may be inserted to facilitate bile drainage.

Klatskins tumours affect the top half of the bile duct which is associated with the liver; a surgical cure for the bile duct cancer will be attempted by removal of the tumour together with a liver re-section. The bile duct divides into the liver – being the left and right hepatic ducts, as a klatskin tumour grows it may invade the blood vessels in the liver. Once the diagnosis of klatskins tumour has been made preparations will be made for surgery – the liver consists of two lobes and one lobe can be safely removed via surgical procedure. However the possible involvement of blood vessels means that exploratory surgery is required before a decision is made on how to proceed. Again complete removal of the tumour is the desired outcome in order for recovery from the bile duct cancer to take place. Tumours which are affecting the blood supply to both sides of the liver do not generally respond well to treatment.

Whilst there is no one preventative measure against any cancer there are some steps which can be taken in order to give some measure of protection -

  • Have the hepatitis B vaccine

  • Avoid exposure to hazardous chemicals

  • Avoid heavy drinking

  • When travelling in areas known to have liver flukes be sure to drink bottled water and properly cooked food.

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