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Bile duct cancer, also known as cholangiocarcinoma, develops in the bile ducts, which transport bile fluid between gastrointestinal organs and facilitate digestion. It is considered as one of the most common advanced cancer diseases.
A curative resection and prognosis can be extremely bad for more than half of patients with advanced bile duct cancer who are diagnosed with unresectable cancers. Although early detection of bile duct cancer has been necessary, this has been a challenging objective to accomplish because of our limited understanding of this disease entity. The liver’s extrahepatic and intrahepatic ducts may be affected.
Diagnosis for bile duct cancer
There are several endoscopic procedures that can help in diagnosing bile duct cancer at an early stage.
A topical anaesthetic, along with painkillers and sedatives, if necessary, can be used during a gastrointestinal endoscopic treatment. The physician will insert the endoscope into the oesophagus through the mouth. A camera on the endoscope captures images that are then displayed on a monitor.
Endoscopic retrograde cholangiopancreatography (ERCP)
An endoscope with side viewing is used during an ERCP. With the use of this endoscope, the physician can inject contrast medium into the bile ducts. When X-ray images are taken, the contrast brings any abnormalities to light. A biopsy and the removal of bile duct tissue for testing can be done by the physician during an ERCP.
The doctor puts a particular kind of endoscope called a cholangioscope inside the bile duct. The tumour is immediately viewed and sampled using the cholangioscope. During an ERCP, a patient may undergo a cholangioscopy.
Endoscopic ultrasound (EUS)
To obtain images of the gastrointestinal tract, this treatment is coupled with an endoscope and an ultrasound. The process is similar to an upper endoscopy. Bile duct cancer can be detected using EUS.
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Treatment for bile duct cancer
1. Surgical treatment
Whether they can be entirely removed determines what type of bile duct cancer they are. Depending on the type, size, and location of the tumour, surgery may be performed to remove the malignancy. Cancers that are surgically treatable fall into one of two categories: resectable and incurable.
2. Radiation therapy
By utilizing advanced radiation treatment delivery systems, doctors are better able to target difficult-to-reach bile duct tumours and give bile duct cancer cells more intense radiation doses while minimizing exposure to healthy, normal tissue. A number of radiation therapy may be recommended for the treatment of bile duct cancer, depending on the state of the patient and the location of the tumour.
3. Interventional radiology
The medical specialty of interventional radiology uses the least invasive procedures to identify and treat cancer. It has the ability to treat bile duct cancer. Anesthesia is needed for this outpatient treatment. In order to gain access to the bile duct during this treatment, the doctor makes a very small incision. When the needle reaches the bile ducts, an X-ray is taken. Stents can also be inserted using this technique to do biopsies on the bile duct. If required, bile can be removed externally via a tube.
4. Palliative care through stenting
Palliative care is a type of assistance. It seeks to avoid and treat problems or signs brought on by bile duct cancer. Palliative care is utilized in conjunction with every type of cancer treatment at every stage of bile duct cancer. It covers things like painkillers, nausea preventatives, and maintaining bile flow by placing stents, when a tumour may be preventing it. Palliative care is used to improve your quality of life rather than to treat the cancer.
5. Liver transplant
A liver transplant may be used to treat some unresectable intrahepatic or perihilar bile duct tumours (after total resection of the liver and bile ducts). Chemotherapy and radiation therapy could be the first courses of treatment. Although it can be difficult to find a liver donor who matches, a transplant may be able to offer a cure.
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In some cases bile duct cancer cannot be cured as cancer is diagnosed in an advanced stage and becomes lethal. As stressful as this news is, some people find it challenging to talk about advanced cancer. To ensure prompt treatment, it is crucial to get diagnosed at an early stage.
Bile duct cancer can now be detected early with the help of modern innovations and technologies, preventing the spread of this disease.