The bile duct is a small tube that goes from the liver to the small intestine and transports bile, which helps the body digest fats. There are numerous smaller bile ducts that come together to form the main duct, some in the liver and some outside of the liver. When cancer forms in any of these tissues or ducts, it is called bile duct cancer, or cholangiocarcinoma.
Significance
The American Cancer Society estimates that between 2,000 and 3,000 bile duct cancers are diagnosed yearly in the United States. It is more common in the Middle East and Asia due to a parasitic infection of the bile duct. Bile duct cancer can be diagnosed at any age, but the American Cancer Society says that two out of three of these cancers are diagnosed in individuals older than 65 years old.
Diagnosis
Diagnosing bile duct cancer is typically done in a variety of ways, including a physical examination, ultrasounds, CT scans and MRI. A procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, involves x-raying the bile ducts between the liver and gallbladder and between the gallbladder and small intestine, according to the National Cancer Institute. An endoscope is then threaded down the esophagus into the small intestine, and a dye is released into the ducts. When an x-ray is taken, the dye will illuminate any blockages that may occur due to tumors. If there are tumors, a biopsy will be taken for further evaluation.
Treatment
Two standard types of treatment are typically used to treat bile duct cancer, states the National Cancer Institute: surgery and radiation therapy. Surgery may include removal of the bile duct, removal of the part of the liver where the cancerous duct is or a more involved surgical procedure called a Whipple procedure. The type of surgery depends on how big the tumor is and if the cancer has spread anywhere. Palliative surgery may also be performed to ease symptoms if the tumor is too large to be removed. Radiation therapy can be given alone or in addition to surgery. The American Cancer Society lists other treatments for bile duct cancer, including chemotherapy and tumor ablation.
Clinical Trials
New treatments for bile duct cancer are being tested in clinical trials with the hope of finding an effective treatment that will prolong survival. Treatments being tested, as listed by the National Cancer Institute, include radiation sensitizers, which work to improve the effects of radiation therapy, new chemotherapy drugs and biologic therapy, which works with the immune system to help fight cancer.
Prognosis
According to The Cholangiocarcinoma Foundation, the five-year survival rate for the disease when diagnosed at an early stage is approximately 30 percent. The majority of diagnoses of this cancer, approximately 80 percent, are diagnosed at later stages, which carries a lower five-year survival rate.
