Late Stages of Bile Duct Cancer

The bile duct is a small tube that connects the liver with the small intestine. This tube transports bile, a liquid produced by the liver and stored in the gallbladder, from the liver and gallbladder to the small intestine, where it helps in the digestion of food. Any cancer that originates in the bile duct is known as bile duct cancer. There are several different types of bile duct cancer, and these types are important to know so that the correct stage is diagnosed and therefore the correct treatment is offered.

Types

• The rarest type of bile duct cancer is intrahepatic bile duct cancer. This cancer begins in the portion of the bile duct that is inside the liver. This type is sometimes confused with liver cancer and is actually staged the same way as liver cancers. The most common type is hilar (or perihilar) bile duct cancer, which begins where the left and right ducts leaving the liver come together. These tumors are also known as Klatskin tumors. The third type is distal bile duct cancer, which begins in the portion of the bile duct near the small intestine.

Staging

• Bile duct cancers are diagnosed into seven stages; stage 0, stage IA, stage IB, stage IIA, stage IIB, stage III and stage IV. Stages III and IV are considered late-stage cancer. To determine the patient's prognosis (outlook), the doctor determines whether the cancer is resectable, meaning if it can be completely removed through surgery. In general (although not 100 percent of the time) the late-stage cancers are considered nonresectable.

Symptoms

• The early stages of bile duct cancers usually are not accompanied by any notable symptoms. The earliest symptom is jaundice which is the buildup of bilirubin, a greenish-yellow chemical found in bile. The accumulation of bilirubin can cause the skin and the whites of the eyes to look yellow and cause the skin to feel itchy. Jaundice, however, is a symptom of many less severe conditions, including hepatitis and gallstones.

  The most notable symptom of late-stage bile duct cancers is abdominal pain, usually below the ribs on the right side.

Diagnosis

• A variety of tests can help to diagnose bile duct cancer, including blood tests to look for specific tumor markers (substances released by cancer cells) or liver and gallbladder function, and imaging tests such as X-rays and ultrasounds that can performed internally. However, the best diagnostic test, which can not only make the initial diagnosis of bile duct cancer but also help to stage the cancer, is a CT (computed tomography) scan. Once the diagnosis is made, other tests may be performed to determine the exact location and blockage and extent of the cancer.

Survival Rates

• Cancer survival rates are based on the stage, location and extent of the cancer as well as the patient's general health. A five-year survival rate is the percentage of people who live at least five years after their diagnosis. For late-stage bile duct cancers which are nonresectable, the survival rate is less than 10 percent. This is because these cancers are hard to treat, since surgery is not an option. However, those patients with intrahepatic bile duct cancer can increase their survival rate if they receive a liver transplant.