1. A Most Rare Type of Cancer
Bile ducts are a part of the body's system known as the biliary system. These ducts join the gall bladder and liver to the small intestine, delivering bile for the digestion of fats. Bile duct cancer (medical name, cholangiocarcinoma) is one of the most uncommon types of cancers. Between 2,000 and 4,000 new cases arise in the United States each year. Star running back Walter Payton of the Chicago Bears raised public awareness of the disease after being diagnosed in February 1999. He died in November of that year at the age of 45.
2. The Many Faces of Bile Duct Cancer
Bile duct cancer is divided into three groups, depending on where the cancerous tumor is located in the branches of the duct. Cancer that grows inside the smaller branches of the bile duct found inside the liver is referred to as intrahepatic. Tumors in the duct nearest the intestine are called distal bile duct cancers. The most rare type are tumors found where the bile ducts leaves the liver; these are called either perihilar cancers or Klatskin tumors (named after Dr. G. Klatskin, who first described this type of cancer).
3. The Silent Killer
Bile duct cancer is considered one of the "silent killer" diseases. No symptoms of this type of cancer are exhibited until the tumor or tumors have blocked the bile duct, backing bile up into the liver and subsequently into the bloodstream, resulting in jaundice (yellowing of the skin). Weight loss, fatigue, poor appetite and abdominal pain may accompany this jaundice. Urine may become dark yellow, and stools may become pale as fats are no longer being properly digested in the small intestine.
4. Getting the Bad News
Bile duct cancer can be confirmed by a few medical tests. To start, your physician will take blood tests to determine if your liver is working properly. Ultrasound and a CT scan or MRI of the abdomen will be performed. These will show doctors the condition of the liver and bile duct and any tumors present will then be presented. In many cases, a diagnosis of bile duct cancer outside the liver results in a life expectancy of about 11 months.
5. Don't Take Bile Duct Cancer Lying Down
Treatment for bile duct cancer depends on where the tumors are located. In some cases, if the cancer has not spread beyond the bile duct, removal of the bile ducts and, if the liver is affected, part of the liver as well is a surgical option. A liver resection might be performed for cancers contained to the liver. Chemotherapy, radiation therapy and photodynamic therapy might be used for cancer that cannot be operated on, though the effectiveness of chemotherapy on bile duct cancer is debated. A liver transplantation is also a surgical option if the cancer has not spread outside the bile duct.
