Bile duct cancer or termed medically as Cholangiocarcinoma can be defined as the proliferation of the cancer cells within the slender bile tubes. The bile duct connects the liver to the gall bladder and the small intestine and usually transfers the bile fluid into the gallbladder and finally into the small intestine where it facilitates the process of digestion. Cholangiocarcinoma is a rare type of cancer and is usually characterised in individuals ageing 50 years and above. Also Read: Gall Bladder Cancer: Causes, Symptoms And Treatment

Types

Depending upon the part where cancer occurs in the bile duct, cholangiocarcinoma is of the following types:

Hilar cholangiocarcinoma:

Also known as Perihilar cholangiocarcinoma, this type of bile duct cancer occurs in the part of the bile duct just outside the liver. Also Read: Liver Cancer: Causes, Symptoms And Treatment

Intrahepatic cholangiocarcinoma:

Considered as a type of liver cancer, this type of cancer happens in the part of the bile duct which is inside the liver.

Distal cholangiocarcinoma:

The distal cholangiocarcinoma occurs in the part of the bile duct which is nearer to the small intestine. 
bile duct cancer

Causes

Although the exact cause of cholangiocarcinoma is yet unknown recent researches show it usually happens when the DNA of the cells in the bile duct mutates causing a change in their instructions. These mutations make the cell grow abnormally and accumulate in large numbers to form a mass of tissue or tumour.

Risk factors

The various causative factors that aggravate the risk of cholangiocarcinoma include:

Age: It is commonly diagnosed in adults above the age of 50.

Infection: A liver fluke infection due to exposure to a liver parasite while consuming raw or undercooked food aggravates the chances of having bile duct cancer. 

Birth Abnormalities: People born with a choledochal cyst that causes dilated and irregular bile ducts are more prone to bile duct cancer in the later stages. 

Diseased Condition: Health conditions such as chronic liver disease or primary sclerosing cholangitis (i.e. scarring and hardening of the bile ducts) increases the risk of getting bile duct cancer.

Unhealthy habits: Habits such as smoking increases the risk of cholangiocarcinoma or bile duct cancer.

Symptoms

At the initial stages, bile duct cancer affects the process of bile fluid transfer from the liver into the gall bladder and small intestine, causing hepatitis or liver inflammation. Other common signs and symptoms include:

  • Jaundice (i.e. yellowing of the skin and the whites of the eyes)
  • Severe skin itching
  • White-coloured faeces
  • Fatigue
  • Bloating
  • Pain in the abdomen
  • Sudden weight loss
  • Low-grade fever
  • Dark-coloured urine

Diagnosis And Treatment

On noticing any of the above-mentioned signs and symptoms, do consult a specialised doctor right away to start the treatment at the earliest. The doctor usually does a thorough physical checkup followed by acknowledging the patients past medical history and carries out a few of the diagnostics including:

  • Liver function test: Blood tests to analyse the liver function.
  • Tumour marker test: A test to check the level of cancer antigen (CA) 19-9 in the blood.
  • Endoscopic Retrograde Cholangiopancreatography (ERCP): An endoscopy where a thin tube fitted with a miniature camera is passed down the food pipe, digestive tract and small intestine to the bile ducts to properly examine the interior of the bile duct.
  • Imaging tests: These include CT-scan, MRI-scan, and Magnetic Resonance Cholangiopancreatography (MRCP) etc.
  • Biopsy: A mass of tissue is scraped off and analysed to look for cancer cells and the spread of infection.

Treatment

Treatment options usually depend upon the type of bile duct cancer and its appropriate location to understand whether the tumour can be removed through a surgical procedure. The available treatment options include:

  • Surgery
  • Liver Transplant
  • Chemotherapy
  • Radiation therapy
  • Photodynamic therapy
  • Biliary drainage