Bile duct cancers may arise in many locations in and around the liver. Bile duct cancer tends to spread into the liver, along the bile duct surface and through the lymph system to lymph nodes in the region of the liver. Tumors in the bile duct leading from the gall bladder to the common bile duct (cystic duct) can spread to involve the gall bladder. Ultimately, other lymph nodes as well as other organs within the abdomen may become involved.
Bile duct cancers are quite rare, affecting some 16,600 people in the United States per year at the time of writing.
The cause is unknown.
People with chronic inflammatory processes such as ulcerative colitis or parasitic infections of the bile ducts, or with congenital abnormalities of the bile ducts are at higher risk for developing this cancer. No one cause has been clearly demonstrated.
The most common symptoms of bile duct cancer include jaundice and itching (the most common signs), abdominal pain, poor appetite, bloating, weight loss, fever, nausea, or an enlarging abdominal mass. Jaundice is caused by the accumulation in the skin of a component of bile (bilirubin) that normally empties into the intestines after traveling through the bile ducts. Pain usually signifies advanced disease.
There are no signs or symptoms unique to bile duct cancer; even if the findings associated with bile duct cancer are present, other explanations – such as gallstones – are far more likely. Symptoms generally develop slowly and are often subtle.
In addition to a complete medical history and medical examination, diagnostic procedures for bile duct cancer may include:
Treatment may include surgery or chemotherapy. If the cancer cannot be entirely removed, the principal goals of therapy become the relief of symptoms caused by the accumulation of bile, and relief from pain.
If the tumor is fairly small, it may be treated with radiation without much damage to the surrounding liver. It may also apply to patients with small or microscopic deposits of tumor following surgery.
Studies have not shown that chemotherapy prolongs survival. Even when tumor shrinkage occurs, patients may not be better off as the tumor ultimately regrows and treatment has side-effects.
Several studies have noted a reduction in the risk of esophageal, gastric and biliary cancers among regular aspirin users.
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