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Treating Biliary Tract Cancer

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Understanding Biliary Tract Cancer

Medically Reviewed By William C. Lloyd III, MD, FACS
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There aren’t any screening tests for biliary tract cancer, which means this cancer is often found after it has already spread. Biliary tract cancer progression and life expectancy vary based on where the cancer is located and other factors that are unique to you.

an older patient is talking to a doctor in a clinic

Biliary tract cancers include bile duct cancer, gallbladder cancer, and ampullary cancer – cancers located in the biliary tract of your upper digestive system. The biliary tract consists of organs and ducts involved in producing, storing, and transporting the digestive fluid called bile. Your liver produces bile, which travels down through tubes, or ducts; about half of the bile flows into your small intestine, and the other half is stored in the gallbladder. When you eat, your gallbladder releases bile into the small intestine to help your body break down fats from food.

Biliary tract cancer can develop in the bile ducts located inside or outside your liver, in your gallbladder, or in the cells lining your ampulla of Vater, the small opening connecting your bile duct and pancreatic duct to your small intestine. From there it can spread to blood vessels, lymph nodes, and then to other organs. The speed and course of biliary tract cancer progression is different for each person.

What are biliary tract cancer symptoms?

There are no screening tests to detect biliary tract cancer. Most people don’t know they have this cancer until it has already spread and started to cause symptoms.

The sooner you start treatment, the better your chance of slowing or stopping biliary tract cancer progression. Let your doctor know if you have symptoms like these:

  • a yellow color to your skin and the whites of your eyes, called jaundice
  • pale-colored poop
  • itchy skin
  • dark urine
  • belly pain
  • appetite loss
  • unexplained weight loss
  • nausea and vomiting

These can also be symptoms of many other conditions. Only a full workup from your primary care doctor or an oncologist can show whether you have biliary tract cancer.

How is this cancer diagnosed?

Biliary tract cancer detection involves several different tests that show whether you have this cancer, and how far it has spread. The process usually starts with a discussion of your health history and risks, along with a physical exam to look for symptoms.

These are some of the most common tests doctors use to diagnose biliary tract cancer:

  • Blood chemistry tests: These tests measure levels of bilirubin and alkaline phosphatase, which your liver produces. High levels of these substances could be a sign of biliary tract cancer.
  • Tumor marker tests: Some biliary tract cancer cells release large amounts of carcinoembryonic antigen (CEA) and CA 19-9, which show up in blood tests.
  • Imaging scans: Ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) take detailed pictures of your internal organs to show where the cancer is in your body, and how large it has grown.
  • Percutaneous transhepatic cholangiography (PTC): The doctor places a thin needle into your liver and injects a dye through it. The dye highlights your bile ducts on an x-ray and reveals any blockages.
  • Biopsy: In this test, your doctor removes a small piece of tissue from your tumor and sends it to a lab for testing. A biopsy is the only way to confirm that you have biliary tract cancer. The tissue sample may undergo more tests to identify specific genes, proteins, or other factors that will help your doctor target treatment to your cancer.

What is the outlook?

Looking at the statistics for this cancer can be confusing or even scary. Biliary tract cancer life expectancy is based on where the cancer started and how far it has spread. People with early stage biliary tract cancer are more likely to live longer than people with late stage cancer. If you’re looking at 5-year survival rate data, keep in mind that these rates are based on the average percentage of people alive for five years after diagnosis or beginning treatment. These numbers don’t tell the whole story, though. Biliary tract cancer prognosis is unique to each person. Factors like your age, your health, and the treatments you receive affect your outlook. The studies that these statistics are based on were done many years ago. Newer treatments could improve biliary tract cancer life expectancy. Only your oncologists can tell you what kind of biliary tract cancer progression you can expect, and how treatments might affect your outlook. If you still have questions, you can always seek out a second opinion.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Aug 11
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