Bile duct cancer, also known as cholangiocarcinoma, is a rare form of cancer that affects the narrow tubes which carry bile (a digestive fluid) through the liver. This form of cancer most often occurs in individuals aged sixty-five or older, and there are fewer than 20,000 cases diagnosed annually in the United States. Symptoms of bile duct cancer include jaundice (yellowing of the skin and eyes), stomach pain, unintended weight loss, intense skin itching, white-colored stools, fever, fatigue, and vomiting.
Obesity, liver disease, smoking, bile duct inflammation, and a family history of the disease are the major risk factors for this type of cancer. Cancer can also be caused by infection from the liver fluke, a parasite that lives in waters throughout Asia and the Middle East. Bile duct cancer can be diagnosed following a thorough history and physical examination, blood tests, biopsies, and imaging studies.
Surgery can be performed to remove as much of the cancerous tissue as possible. If the tumors are very small, it may be possible for doctors to remove all of them. This may be done by removing part of the bile duct and joining the remaining ends together. For larger or more advanced cancers, doctors may also need to remove lymph nodes and a part of the liver or pancreas. For patients with hilar cholangiocarcinoma, a liver transplant may be an option. This procedure would completely remove the cancer, curing the patient. However, there is a risk that the cancer could return following the transplant.
Depending on the location, size, and number of tumors present, surgery may be recommended as the first stage of treatment. This is often the case for less advanced cancers. If tumors are larger, patients may need to have other treatments first to shrink the tumors prior to any operations. Operations for cancer require general anesthesia and are usually performed in hospitals. A stay of at least one night in the hospital is often required.