Extrahepatic Bile Duct Cancer Treatment | We Care India
Extrahepatic Bile Duct Cancer Treatment | We Care India
Bile duct cancer
The bile ducts are the tubes connecting the liver and gall bladder to the small intestine (small bowel). Bile is a fluid made by the liver and stored in the gall bladder. Its main function is to break down fats during their digestion in the small bowel. In people who have had their gall bladder removed, bile flows directly into the small intestine. The bile ducts and gall bladder are known as the biliary system....
Cancer is classified according to the type of cell from which it starts. Cancer of the biliary system almost always starts in a type of tissue called glandular tissue and is then known as adenocarcinoma...
If the cancer starts in the part of the bile ducts contained within the liver it is known as intra-hepatic. If it starts in the area of the bile ducts outside the liver it is known as extra-hepatic. This information concentrates mainly on extra-hepatic bile duct cancers. Intra-hepatic bile duct cancers may be treated like primary liver cancer....
Signs and symptoms
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 flow back into the blood and body tissues, 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 (fevers) and weight loss may also occur...
These symptoms can be caused by many things other than bile duct cancer, but any jaundice or any symptoms which get worse or last for a few weeks should always be checked by your doctor...
Treatment overview
The type of treatment that you are given will depend on a number of factors, including your general health, the position and size of the cancer in the bile duct and whether the cancer has spread beyond the bile duct....
Consent
Before you have any treatment, your doctor will give you full information about what it involves and explain the aims of the treatment to you. They will usually ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent...
Surgery
There are different operations depending upon how big the cancer is and whether it has begun to spread into nearby tissues : -/
* Removal of the bile ducts If the cancer is small and contained within the ducts, then just the bile ducts containing the cancer are removed and the remaining ducts in the liver are joined to the small bowel, allowing the bile to flow again.
* Partial liver resection If the cancer has begun to spread into the liver, the affected part of the liver is removed, along with the bile ducts.
* Whipple's If the cancer is larger and has spread into nearby structures, then the bile ducts, part of the stomach, part of the duodenum (small bowel), the pancreas, gall bladder and the surrounding lymph nodes are all removed....
Stent insertion
There are two ways in which it may be possible to relieve jaundice without a surgical operation. These use the ERCP or PTC procedures described below.
The ERCP method involves the insertion of a tube, called a stent into the blocked bile duct. The stent is about as thick as a ball-point pen refill and about 5-10cm long (two to four inches). The stent clears a passage through the bile duct to allow the bile to drain away. The preparation and procedure is the same as for ERCP described above. By looking at the x-ray image the doctor will be able to see the narrowing in the bile duct. The narrowing can be stretched using dilators (small inflatable balloons), and the stent can then be inserted through the endoscope to enable the bile to drain........
Other treatments
Radiotherapy/ Radiotherapy is occasionally used to treat bile duct cancer. Radiotherapy treats cancer by using high-energy x-rays to destroy cancer cells while doing as little harm as possible to normal cells. It may be given either externally from a radiotherapy machine, or internally by placing radioactive material close to the tumour.
Chemotherapy
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy the cancer cells. They work by disrupting the growth of cancer cells. Occasionally, chemotherapy may be given in combination with radiotherapy for cancers that cannot be removed surgically. Researchers are still looking into how effective chemotherapy is for the treatment of bile duct cancer.
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