Know More About Bile Duct Cancer
Bile duct cancer, also known as cholangiocarcinoma, occurs when the cells present in the bile duct undergo massive multiplication and lead to the formation of lumps or tumors. The bile ducts are responsible for carrying the fluid bile that aids in digestion. The bile duct connects the liver to both the small intestine and the gall bladder. It usually occurs in people aged above 50 years and is of various types depending on the area of origin of the cancer cells.
- The primary reason remains to be mutations in the DNA of the cell that lead to multiplication. The growth becomes uncontrollable and forms lumps or masses in the body. These cells hold the potential to attack and kill normal healthy cells.
- If an individual is born with some bile duct-related defects like a choledochal cyst, the chances of developing cholangiocarcinoma are increased. Also, the chronic liver disease contributes to the reasons.
- The disease, primary sclerosing cholangitis, causes scarring and hardening of the bile duct and increases the probability of bile duct cancer. Apart from this, liver fluke infection is also associated with the development of cancer.
- Smoking, old age, diabetes (type 1 or type 2), or certain genetic mutations are also among the risk factors for the development of bile duct cancer.
Types of bile duct cancer
Depending on the area of origin of the cancer cells, they have been divided into three types:
Intrahepatic bile duct cancer
The bile duct has been divided into numerous small ducts that join inside the liver to form the right and left hepatic ducts. The cancer cells start forming in the liver itself.
Distal extrahepatic bile duct cancer
The tumor cells begin forming in the perihilar region near the bowel.
Perihilar bile duct cancer
In this case, the cancer cells develop outside the liver, where the right and left hepatic ducts join. These are also known as hilar cancer or klatskin tumors.
Based on the types of cells that the tumor begins in, it can be squamous cell carcinoma, lymphoma, and sarcoma.
Signs and Symptoms
- Night sweats
- Dark urine
- Yellowing of the eye
- Itchy skin
- White-colored stools
- Unintentional weight loss
- Pain in the right side of the abdomen, below the ribs
The diagnosis methods are numerous:
These include processes like magnetic resonance imaging (MRI), computed tomography (CT) scan, and X-rays. With such techniques, the detection of tumors can be easy. These tests give the doctor detailed images of the body organs and their functioning.
Liver function tests
The liver function tests are done to check the functioning of the liver. The blood tests can help analyze the signs and symptoms as well.
Endoscopic retrograde cholangiopancreatography
During this procedure, a thin and flexible tube is passed down the throat with a camera at its tip to look clearly at what is happening inside the body. The doctor may also inject a dye while examination to see better pictures
Tumor marker test
The levels of carbohydrate antigen or CA antigen is checked through these tests. CA 19-9 is a protein that’s overproduced by bile duct cancer cells. However, its increased amounts may not necessarily indicate the presence of cancer. It also happens in the cases of bile duct inflammation and obstruction.
It is a common procedure that is performed to get the tissue samples and carry out laboratory testing. A fine thin needle is inserted into the bile duct to collect the cells and tissues that have been affected.
Side effects of such procedures
Targeted drug therapy may lead to
- Nail changes
- Wound healing and blood clotting
- Dry skin and rashes
- Changes in hair color
- High blood pressure
While getting radiation therapy, the normal healthy cells might also undergo damage, red and sore skin, fatigue, loss of appetite, uncomfortable swallowing, stiffness in muscles and joints, diarrhea, and fertility issues.
Photodynamic theory may lead to health problems like
- Painful breathing
- Trouble swallowing
- Stomach pain
- Skin issues like swelling, redness, itching, stinging
Biliary drainage can cause
- Vomiting or nausea
- Shaking chills
- Pain in abdomen
- Light or grayish white stools
- Redness or swelling around the tube site
With the help of surgery, the doctors remove as much cancer as they can. The affected area is removed along with some surrounding healthy tissues and cells to avoid its recurrence. In some complex cases, the lymph nodes and pancreatic tissue may also be removed.
If the person is suffering from hilar carcinoma, a liver transplant is done to eliminate the disease from the body. However, the possibility of recurrence does not go away completely.
The radiations act as a powerful source of destroying the cancer cells. The protons or X-rays are used to aim at the cancer cells to limit their spread and kill them.
Chemotherapy drugs can be provided through a vein so that they travel throughout the body. On the other hand, the drugs can be administered so that they are delivered directly to the cancer cells. The therapy helps to provide relief to the body and leads to a reduction in signs and symptoms.
It uses the body’s immune system to target the cancer cells and fight them. It interferes with the process where the cancer cells produce proteins that blinds the body’s immune cells. Also, it leads to strengthening immunity.
Heating of cancer cells
The cancer cells are provided with heat treatment to kill them. The electric current is passed through the cells to destroy them. This is also termed radiofrequency ablation. To perform this, incisions are made, and small needles are inserted through the abdomen.
During this therapy, a light-sensitive chemical is injected into the body that reaches cancer cells and accumulates there. Once this is done, the laser light is directed at the affected area, which causes a reaction inside them and leads to their destruction. To achieve the treatment, several sessions are needed. It is advised to avoid sun exposure after this treatment.
In the cases of biliary damage, a narrow tube is placed in the bile to drain it. Often, rerouting is done to make the duct stay open while it is being affected by the tumor. It helps to relieve the symptoms and provide some comfort.
Targeted Drug Therapy
The targeted drug therapy involves focusing on the malfunctions present in the cancer cells. Through this therapy, the abnormalities are blocked, which leads to destroying them.
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