Bile duct cancer is a rare cancer that starts in one of the bile ducts. These ducts are the thin tubes that connect the liver and gallbladder to the small intestine. They work to move the fluid the liver makes (called bile) to the gallbladder, where it is stored until food reaches the small intestine. It also helps break down fats found in food and helps get rid of waste. Cancer may also involve the gallbladder and behaves similarly to bile duct cancer.
Types of Bile Duct Cancer We Treat
The WVU Cancer Institute specializes in evaluating and treating cancerous and noncancerous tumors. We work to ensure your treatment is specific to your type of tumor and your needs.
The most common bile duct cancers are adenocarcinomas, which start in the mucous gland cells that line the bile duct.
Our team has expertise in diagnosing and treating all types of bile duct tumors, including:
Extrahepatic bile duct cancer
This type of bile duct cancer is found outside the liver.
Intrahepatic bile duct cancer
This cancer is found inside the liver within the smaller bile duct branches.
Perihilar (hilar) bile duct cancer
This type of cancer is found in the bile ducts that lead out of the liver and join the gallbladder.
Diagnosing Bile Duct Cancer
If your doctor suspects you have bile duct cancer, they may order tests to help make a diagnosis. These tests include:
- Advanced imaging — Doctors use abdominal ultrasound, computed tomography (CT), magnetic resonance image (MRI), and positron emission tomography (PET) scans to detect signs of disease and see whether cancer has spread to other areas of the body, such as the lymph nodes.
- Biopsy — During a biopsy, a doctor removes a small sample of tissue at the tumor site to analyze in a lab. Biopsy results help oncologists plan the best treatment for you. There are several different biopsy types, including image-guided biopsy, biopsy using endoscopic retrograde cholangiopancreatography (ERCP), and lab or genetic testing.
- Blood tests — Doctors use a blood test called a complete blood count to measure the number of different types of blood cells in your body. Doctors also use cytogenetic analysis, a blood test that looks at fluid, tissue, and cells to see if any chromosome changes might be caused by cancer. Other blood tests doctors may perform to detect cancer include blood tests to detect high levels of CA 19-9 tumor marker or to look for elevated chemicals in the blood, such as CA 125.
- Liver function test — This is a blood sample that doctors use to examine liver function. We collect a blood sample and measure the amounts of certain substances released into your blood by your liver. Sometimes, a higher-than-normal amount of a substance can be a sign of liver cancer.
- Physical exam — Doctors use a physical exam to look for signs of something going on in your body, such as the presence of a tumor. These can include skin color changes, enlargement of an organ, or lumps in your lymph nodes.
- Serum tumor marker test — Doctors perform this procedure to collect a blood sample and measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells (called tumor markers). An increased level of alpha-fetoprotein (AFP) in the blood may be a sign of liver cancer. Other cancers and certain noncancerous conditions, including cirrhosis and hepatitis, may also have increased AFP levels.
Treatment for Bile Duct Cancer
From your first visit, our team works with you to address your specific condition and needs. Your care plan may include:
- Medical oncology — Medical oncology includes chemotherapy, immunotherapy, targeted therapy, and hormone therapy. Our doctors use the latest in anti-cancer medicine to destroy cancer cells. We also use medicines to slow cancer growth and shrink tumors before surgery. Sometimes, we use medication alongside other treatments such as radiation or after surgery to destroy any cancer cells that might remain. We also use targeted therapy, such as Tyrosine kinase inhibitors, to treat specific liver cancer cells.
- Radiation oncology — We use radiotherapy treatments to target, destroy, and shrink many types of cancers. Our radiation oncologists may use this type of therapy after surgery to kill any tiny cancer cells that might remain. Radiation oncologists use external beam radiation therapy, 3D conformal radiotherapy, image-guided radiation therapy, stereotactic radiation therapy, intensity-modulated radiation therapy, and brachytherapy.
- Surgery — Surgery is used to diagnose, stage, and treat many tumors. Surgical options for bile duct cancer include a biliary bypass, stent placement, and partial hepatectomy where surgeons remove the part of the liver where cancer is found. Our surgeons have expertise removing these cancers with minimally invasive approaches. In distal bile duct cancers, surgeons may perform a robotic Whipple procedure where the surgeon removes part of the pancreas and small intestine along with the bile duct and nearby lymph nodes.
Resources for Bile Duct Cancer
We believe cancer care goes beyond diagnosis and treatment. Many resources are available to answer questions and connect you with others, including: