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Biliary Cancer

Overview

What is Biliary cancer?

Bile duct cancer is a rare type of cancer that starts in the bile duct. Bile ducts are slender tubes that connect the liver, gallbladder and small intestine. The primary function of the bile duct is to allow the bile juice to flow from the liver to the small intestine, where it aids fat digestion and absorption.

Risk Factors

A risk factor is anything that affects your chance of getting a disease like cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed.Smoking

  • Chronic pancreatitis (long-term inflammation of the pancreas)
  • Infection with HIV (the virus that causes AIDS)
  • Exposure to asbestos
  • Exposure to radon or other radioactive chemicals
  • Exposure to dioxin, nitrosamines, or polychlorinated biphenyls (PCBs)

Diagnosis

Bile duct cancer is a relatively challenging medical condition to diagnose. If bile duct cancer is suspected, the following tests may be recommended to get a conclusive diagnosis:

a. Blood Tests

b. Imaging Tests or Scans

c. Endoscopic Retrograde Cholangiopancreatography (ERCP)

d. Biopsy

Treatment

The treatment plans for bile duct cancers are devised based on multiple factors such as the type of the tumour, stage of the disease, size, age and overall condition of the patient. In stage 1 and stage 2 cases, the tumour may be surgically removed along with some portions of the liver and gallbladder. In advanced-stage cancers, the treatment plan will be made based on how many lymph nodes and organs have been affected. For a few cases, radiotherapy, chemotherapy and surgery are performed to relieve symptoms and help patients have a better quality of life.

Surgery

Surgery is considered to be the main line of treatment for bile duct cancers. Depending on the stage and the extent of cancer, the surgery may involve the removal of the following.

  • The part of the bile duct that is affected by cancer
  • The gallbladder
  • Surrounding lymph nodes
  • Part of the liver
Unblocking the Bile Duct

If the tumour is blocking the bile duct, the doctor may recommend a procedure to unblock the duct. This procedure may help in addressing the disease symptoms such as jaundice, itchy skin and abdominal pain. The bile duct is unblocked using a small metal or plastic tube called a stent. This stent is used to widen the bile duct and restore the bile flow. It can be inserted through endoscopic retrograde cholangiopancreatography (ERCP).

Radiotherapy

Radiotherapy and chemotherapy may be administered as adjuvant therapies after the surgery in order to reduce the risk of relapse. This treatment is also used to relieve the symptoms and delay the progression of the disease in bile duct cancer patients.

Chemotherapy

Just like radiation therapy, chemotherapy may also be administered as adjuvant therapy to reduce the recurrence risk, or as palliative therapy to delay the disease progression and relieve the symptoms associated with the disease.

Photodynamic Therapy (PDT)

Photodynamic therapy is a unique approach to shrink the tumour in bile duct cancer patients. This procedure helps control, but not cure, the symptoms associated with the disease. It makes the cancerous cells more sensitive to light, and later, the laser is passed through an endoscope in order to shrink the tumour.

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