Cancer: Initial symptoms of bile duct cancer

Bile duct cancer, also known as cholangiocarcinoma, is a rare but fatal cancer that affects the bile duct system. A network of tubes that originates in the liver and travels to the small intestine makes up the bile duct. This cancer's initial signs and symptoms are normal. However, early detection of this cancer may improve the effectiveness of treatment for this condition. If there are any signs of bile duct cancer, they are typically brought on by a blocked bile duct. The presence of intrahepatic or extrahepatic ductal carcinoma is typically characterised by specific symptoms, which may include:

The most common sign of bile duct cancer is jaundice, yet in most cases, this condition is not cancer related. Bile is usually produced by the liver and released into the intestine. Jaundice is caused when bile, which contains the greenish-yellow chemical bilirubin, cannot be excreted by the liver.

Dr. Vishnu Abhishek Raju, Consultant Gastroenterologist, Gleneagles Global hospital city, Chennai says, “Most bile duct cancer patients suffer itching because having too much bilirubin in the skin might cause a person to scratch.”

Bilirubin is responsible for the brown hue of bowel movements, so if it does not make it all the way to the intestines, a person's stool colour may be lighter or oilier.

A high blood bilirubin level can cause the urine to be dark in colour, which may be an indication of bile duct cancer. Early-stage bile duct cancer may produce minor abdominal pain, but larger tumours may cause more severe pain, particularly on the right side below the ribs.

Those who have bile duct cancer may not feel hungry and may shed pounds without consciously intending to do so. Bile duct cancer patients frequently have fever.

These are not usual symptoms of bile duct cancer, but they may occur in those who develop cholangitis as a result of a bile duct obstruction. These symptoms typically coexist with a fever.

Bile duct cancer diagnosis can be difficult; however, it can be confirmed with a number of tests, including blood tests, CT scan of the abdomen, MRCP, gastrointestinal endoscopy, endoscopic retrograde cholangiopancreatography (ERCP), cholangioscopy, and endoscopic ultrasonography (EUS). During EUS precision ultrasound scan of the bile duct and its problems can be studied by endoscopy in a sedated patient. During ERCP patients may be given an injection of a specialised dye that makes the bile ducts and the cancer more noticeable. Cholangioscopy is an advanced investigation wherein a small scope is passed into the bile duct to directly visualise the cancer.

"Biopsy confirmation of cancer can be done during EUS, ERCP or cholangioscopy. Staging of the cancer is done by imaging. Based on the stage, surgery or chemotherapy may be offered. In an advanced stage of the disease, endoscopic procedures can relieve jaundice and give the patient a good quality of life," says Dr. Raju.