Jane Doe
What is bile duct cancer?
Bile duct cancer is a cancer that starts in the bile duct. In order to understand this cancer, it helps to know about the normal structure and function of the bile duct.
Different parts of the bile duct system have different names. In the liver it begins as many tiny tubes (ductules) where bile collects from the liver cells. The ductules come together to form small ducts, which then merge into larger ducts and eventually the left and right hepatic ducts. The ducts within the liver are called intrahepatic bile ducts. These ducts exit from the liver and join to form the common hepatic duct at the hilum. About one-third of the way along the length of the bile duct, the gallbladder (a small organ that stores bile) attaches by a small duct called the cystic duct. The combined duct is called the common bile duct. The common bile duct passes through part of the pancreas before it empties into the first part of the small intestine (the duodenum), next to where the pancreatic duct also enters the small intestine.
Syptoms In bile Duct Cancer
The patient usually presents with the following symptoms
Causes of bile Duct Cancer
Abnormal bile ducts
If you are born with abnormal bile ducts, you might be at risk of developing cancer of the bile duct.
Inflammatory bowel disease
You might have an increased risk if you have ulcerative colitis. This is a type of inflammatory bowel disease.
Infection
In Africa and Asia, an infection caused by parasites is believed to cause bile duct cancer.
If you feel you might be at risk, talk to your family doctor (GP) about your concerns. He or she might refer you to a specialist.
Treatment for bile duct cancer
Many patients receive a few different treatments at the same time. For example, your doctor might use chemotherapy or radiotherapy to shrink your tumour before you have surgery. Your treatment will depend on the stage, grade and type of cancer cells that you have. The stage is based on the size of your cancer and if it has spread from where it started. The grade of your cancer can tell if your cancer grows quickly or slowly. You can have a low, moderate or high grade cancer.
Surgery
This is the most common form of treatment for bile duct cancer. The aim of surgery is to remove the part of the bile duct that contains cancer. If your cancer is causing a blockage, your doctor might put a stent in during an ERCP or PTC. A stent is a thin mesh wire that will keep the bile duct open and prevent blockages.
Chemotherapy
Chemotherapy uses drugs to cure or control your cancer. You might be given different chemotherapy drugs on their own or with each other. You might receive two or three chemotherapy drugs at the same time.
Chemotherapy can also be given before or after radiotherapy and surgery. The drugs are either injected into your bloodstream or given in tablet form.
Please see our booklet Understanding Chemotherapy (pdf5.35MB) for more about chemotherapy.
Radiotherapy
Radiotherapy uses high-energy rays to kill or shrink the cancer cells.
Advanced treatment
Advanced cancer means that your cancer has spread from the area where it started. If it spreads into the area around your bile duct, it is called local spread. If it spreads to other areas of your body, it is called secondary cancer or metastatic cancer. It is usually not possible to cure advanced cancer. Instead, treatment is given to control the cancer and relieve any symptoms you might have.
The palliative care team might visit you at this time. This team will help with any symptoms you have and support you and your family when you are having your treatment.
Lifestyle changes after treatment for bile duct cancer
You can't change the fact that you have had cancer. What you can change is how you live the rest of your life – making choices to help you stay healthy and feel as well as you can. This can be a time to look at your life in new ways. Maybe you are thinking about how to improve your health over the long term. Some people even start during cancer treatment.
Making healthier choices
For many people, a diagnosis of cancer helps them focus on their health in ways they may not have thought much about in the past. Are there things you could do that might make you healthier? Maybe you could try to eat better or get more exercise. Maybe you could cut down on the alcohol, or give up tobacco. Even things like keeping your stress level under control may help. Now is a good time to think about making changes that can have positive effects for the rest of your life. You will feel better and you will also be healthier.
Eating better
If treatment caused weight changes or eating or taste problems, do the best you can and keep in mind that these problems usually get better over time. You may find it helps to eat small portions every 2 to 3 hours until you feel better. You may also want to ask your cancer team about seeing a dietitian, an expert in nutrition who can give you ideas on how to deal with these treatment side effects.
One of the best things you can do after cancer treatment is put healthy eating habits into place. You may be surprised at the long-term benefits of some simple changes, like increasing the variety of healthy foods you eat. Getting to and staying at a healthy weight, eating a healthy diet, and limiting your alcohol intake may lower your risk for a number of types of cancer, as well as having many other health benefits.
Rest, fatigue, and exercise
If you were sick and not very active during treatment, it is normal for your fitness, endurance, and muscle strength to decline. Any plan for physical activity should fit your own situation. An older person who has never exercised will not be able to take on the same amount of exercise as a 20-year-old who plays tennis twice a week. If you haven't exercised in a few years, you will have to start slowly – maybe just by taking short walks.
Keep in mind exercise can improve your physical and emotional health.
Bile duct cancer is a cancer that starts in the bile duct. In order to understand this cancer, it helps to know about the normal structure and function of the bile duct.
Different parts of the bile duct system have different names. In the liver it begins as many tiny tubes (ductules) where bile collects from the liver cells. The ductules come together to form small ducts, which then merge into larger ducts and eventually the left and right hepatic ducts. The ducts within the liver are called intrahepatic bile ducts. These ducts exit from the liver and join to form the common hepatic duct at the hilum. About one-third of the way along the length of the bile duct, the gallbladder (a small organ that stores bile) attaches by a small duct called the cystic duct. The combined duct is called the common bile duct. The common bile duct passes through part of the pancreas before it empties into the first part of the small intestine (the duodenum), next to where the pancreatic duct also enters the small intestine.
Types of bile duct cancers
Cancers can develop in any part of the bile duct and, based on their location (see picture below), are divided into 3 groups:
- Intrahepatic bile duct cancers
- Perihilar (also called hilar) bile duct cancers
- Distal bile duct cancers
Intrahepatic bile duct cancers
These cancers develop in the smaller bile duct branches inside the liver. They can sometimes be confused with cancers that start in the liver cells, which are called hepatocellular carcinomas, and are often treated the same way. Only about 1 out of 10 bile duct cancers are intrahepatic.
Perihilar (also called hilar) bile duct cancers
These cancers develop at the hilum, where the hepatic ducts have joined and are just leaving the liver. They are also called Klatskin tumors. These are the most common type of bile duct cancer. These cancers are grouped with distal bile duct cancers as extrahepatic bile duct cancers.
Distal bile duct cancers
More than 95% of bile duct cancers are carcinomas and most are adenocarcinomas. Adenocarcinomas are cancers of glandular cells that can develop in several organs of the body. Bile duct adenocarcinomas develop from the mucous glands that line the inside of the duct. Cholangiocarcinoma is another name for a bile duct carcinoma. Other types of bile duct cancers are much more rare. These include sarcomas, lymphomas, and small cell cancers. This document does not discuss these other types of bile duct cancer, and uses the term bile duct cancer to mean cholangiocarcinoma.
Syptoms In bile Duct Cancer
The patient usually presents with the following symptoms
- jaundice (yellowness of the skin)
- abnormal liver tests
- weight loss
- abdominal pain
- poor appetite
- weakness and fatigue.
Causes of bile Duct Cancer
Abnormal bile ducts
If you are born with abnormal bile ducts, you might be at risk of developing cancer of the bile duct.
Inflammatory bowel disease
You might have an increased risk if you have ulcerative colitis. This is a type of inflammatory bowel disease.
Infection
In Africa and Asia, an infection caused by parasites is believed to cause bile duct cancer.
If you feel you might be at risk, talk to your family doctor (GP) about your concerns. He or she might refer you to a specialist.
Treatment for bile duct cancer
Many patients receive a few different treatments at the same time. For example, your doctor might use chemotherapy or radiotherapy to shrink your tumour before you have surgery. Your treatment will depend on the stage, grade and type of cancer cells that you have. The stage is based on the size of your cancer and if it has spread from where it started. The grade of your cancer can tell if your cancer grows quickly or slowly. You can have a low, moderate or high grade cancer.
Surgery
This is the most common form of treatment for bile duct cancer. The aim of surgery is to remove the part of the bile duct that contains cancer. If your cancer is causing a blockage, your doctor might put a stent in during an ERCP or PTC. A stent is a thin mesh wire that will keep the bile duct open and prevent blockages.
Chemotherapy
Chemotherapy uses drugs to cure or control your cancer. You might be given different chemotherapy drugs on their own or with each other. You might receive two or three chemotherapy drugs at the same time.
Chemotherapy can also be given before or after radiotherapy and surgery. The drugs are either injected into your bloodstream or given in tablet form.
Please see our booklet Understanding Chemotherapy (pdf5.35MB) for more about chemotherapy.
Radiotherapy
Radiotherapy uses high-energy rays to kill or shrink the cancer cells.
Advanced treatment
Advanced cancer means that your cancer has spread from the area where it started. If it spreads into the area around your bile duct, it is called local spread. If it spreads to other areas of your body, it is called secondary cancer or metastatic cancer. It is usually not possible to cure advanced cancer. Instead, treatment is given to control the cancer and relieve any symptoms you might have.
The palliative care team might visit you at this time. This team will help with any symptoms you have and support you and your family when you are having your treatment.
Lifestyle changes after treatment for bile duct cancer
You can't change the fact that you have had cancer. What you can change is how you live the rest of your life – making choices to help you stay healthy and feel as well as you can. This can be a time to look at your life in new ways. Maybe you are thinking about how to improve your health over the long term. Some people even start during cancer treatment.
Making healthier choices
For many people, a diagnosis of cancer helps them focus on their health in ways they may not have thought much about in the past. Are there things you could do that might make you healthier? Maybe you could try to eat better or get more exercise. Maybe you could cut down on the alcohol, or give up tobacco. Even things like keeping your stress level under control may help. Now is a good time to think about making changes that can have positive effects for the rest of your life. You will feel better and you will also be healthier.
Eating better
If treatment caused weight changes or eating or taste problems, do the best you can and keep in mind that these problems usually get better over time. You may find it helps to eat small portions every 2 to 3 hours until you feel better. You may also want to ask your cancer team about seeing a dietitian, an expert in nutrition who can give you ideas on how to deal with these treatment side effects.
One of the best things you can do after cancer treatment is put healthy eating habits into place. You may be surprised at the long-term benefits of some simple changes, like increasing the variety of healthy foods you eat. Getting to and staying at a healthy weight, eating a healthy diet, and limiting your alcohol intake may lower your risk for a number of types of cancer, as well as having many other health benefits.
Rest, fatigue, and exercise
If you were sick and not very active during treatment, it is normal for your fitness, endurance, and muscle strength to decline. Any plan for physical activity should fit your own situation. An older person who has never exercised will not be able to take on the same amount of exercise as a 20-year-old who plays tennis twice a week. If you haven't exercised in a few years, you will have to start slowly – maybe just by taking short walks.
Keep in mind exercise can improve your physical and emotional health.
- It improves your cardiovascular (heart and circulation) fitness.
- Along with a good diet, it will help you get to and stay at a healthy weight.
- It makes your muscles stronger.
- It reduces fatigue and helps you have more energy.
- It can help lower anxiety and depression.
- It can make you feel happier.
- It helps you feel better about yourself.