Bile Duct Cancer

CANCER OF BILE DUCT

Cancer is an uncontrolled growth of cells in any part of the body. When it happens in common bile duct then it is called cancer of common bile duct. Medically it is called cholangiocarcinoma. As such it is very rare type of cancer and generally seen in patients over 50 years of age. Bile duct connects the liver with gall bladder and small intestine.

There are 3 types of cholangiocarcinoma or common bile duct cancer that are generally treated in India:

  1. Intrahepatic Cholangiocarcinoma – At times gastro cancer surgeons put this type of cancer in category of liver cancers as it occurs in the parts of bile duct inside liver.
  2. Hilar Cholangiocarcinoma – This cancer occurs in ducts just outside the liver.
  3. Distal Cholangiocarcinoma – This type of bile duct cancer occurs in the portion of the bile duct near to small intestine.

Causes

  • Scarring of bile duct tissue due to chronic inflamation
  • Stones in common bile duct
  • Choledocal cyst is also a reason that can lead to bile duct cancer
  • Liver Cirrhosis
  • Hepatitis B or C infection
SYMPTOMS & DIAGNOSIS

Though cancer of bile duct is rare but still patients from across the globe come to India for the treatment for the same. Following are the common symptoms of the bile duct cancer:

  • Jaundice
  • Itchy skin
  • White colored stools
  • Unexplained weight loss
  • Fatigue

Diagnosis

Diagnosis of bile duct cancer is a tricky affair and needs lot of skills of the GI cancer specialist to correctly diagnose it. If the GI cancer specialist in India suspects that the patient may have bile duct cancer then he may advise the following:

  • Liver Function Test – Thats the basic blood test to rule out any abnormality in liver function.
  • CA 19-9 blood test – An increased level of cancer antigen in blood also directs towards ductal carcinoma
  • MRCP – MRI of bile duct and pancreas is the best test for diagnosis of cancer in the area
  • ERCP with biopsy – ERCP is an endoscopic procedure and is done to internally examine the bile duct and take the tissue in case required by the GI cancer surgeon.
TREATMENT & COST

In most of the cases surgery is the best way to start the treatment. However it again comes down to staging of the cancer.

Surgery – If possible cancer surgeon in India would opt for the removal of the part of bile duct. In case of little advanced cases surgery may involve removal of part of bile duct along with part of liver, pancreas and surrounding lymph nodes.

Liver Transplant – Liver transplant can be done for patients with Hilar Cholangiocarcinoma. However there is always chance of recurrence of cancer in such cases. Hence the choice of right patient is very important for getting the best results.

Chemotherapy – Chemotherapy plays a very important role where surgery is not the option. Chemotherapy uses special medicine to kill the cancer cells and slow down the progress of disease.

Radiation Therapy – Most of the times radiation therapy is used in conjunction with chemotherapy. The aim is to slow down the disease and reduce the spread.

Palliative Care – Palliative care in simple words means symptomatic treatment for the patients who are in very advanced stage of cancer and not treatment is working. The main aim of this treatment is to improve the quality of life of the patient.

Cost of the treatment for Common Bile Duct Cancer in India would be approximately INR 4,00,000 to 5,00,000 for surgery and approximately INR 22,00,000 to 25,00,000 for a liver transplant.

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