Bile duct tumors - Cholangiocarcinoma

1. What is Cholangiocarcinoma?
2. What Causes Cholangiocarcinoma?
3. What will I experience if I have Cholangiocarcinoma?
4. How is Cholangiocarcinoma diagnosed?
5. What is the treatment for a Cholangiocarcinoma?

1. What is Cholangiocarcinoma?

• Cholangiocarcinoma is cancer of the bile ducts
• The bile ducts are the tubes connecting the liver and gallbladder to the small intestine
• They transport bile, a fluid that is important for fat digestion
• Cancer is classified according to the type of cell it originates from
• Cholangiocarcinomas usually arise from glandular cells and are therefore known as
  adenocarcinomas

2. What Causes Cholangiocarcinoma?

• The cause of most bile duct cancers is unknown but they are more likely to occur in people with inflammatory bowel conditions such as ulcerative colitis
  
  
• They may also present in people with congenital biliary duct abnormalities
  

3. What will I experience if I have cholangiocarcinoma?

• If cancer develops in the bile ducts it may block the flow of bile from the liver to the intestine
  
  
• This causes the bile to stay in the body and leads to the skin and whites of the eyes becoming yellow (known as jaundice)
  
  
• The urine also becomes a dark yellow colour and stools (bowel motions) are pale
  
  
• The skin may become 'itchy'
  
  
• Mild discomfort in the abdomen, loss of appetite, high temperatures and weight loss may also occur
  
  
• Other conditions can also result in these symptoms and so if you experience these symptoms, see your doctor and try to understand that there are much more common causes for these symptoms including common duct stones (link)

4. How is a Cholangiocarcinoma diagnosed?

• After completing a physical examination your doctor can do a number of tests to identify the cause of your symptoms. A blood test is the usual first step
  
  
• As for many other biliary diseases, an ultrasound will be able to find the problem in almost all cases
  
  
• It may be necessary to progress to a CT or MRI scan
  
  
• The diagnosis is usually made after an ERCP (link). An ERCP allows the doctor to visualise the biliary ducts and if needed take a biopsy of any lesions. A biopsy involves inserting a small needle into the lesion and sending it away to pathology to be examined under a microscope to identify the type of cells involved
  

5. What is the treatment for a Cholangiocarcinoma?

• The type of treatment you are given will depend on a number of factors, including your age, your general health, the position and size of the cancer in the bile duct and whether the cancer has spread to other areas
  
  
• There are a range of treatments available including surgery, stent insertion, radiotherapy and chemotherapy