Bile Duct Cancer Treatment in Navi Mumbai

Bile Duct

The bile ducts are paired thin tubes that descend from the liver to the small intestine. Their main function is to allow a fluid called bile to descend from the liver and gallbladder towards the small intestine, where it aids the digestion of fats in food.

The bile duct system has different names for different parts. In the liver, it starts as many small tubes called ductules. The ductules together constitute small tubes called ducts. These join to form larger ducts and then merge into the left and right hepatic ducts. All of these ducts inside the liver are called intrahepatic bile ducts.

The left and right hepatic ducts leave the liver to join and form the common hepatic duct in an area called the hilum. The gallbladder is connected with the common hepatic duct with the help of a small duct called the cystic duct. The resulting duct is called the common bile duct. The common bile duct travels through part of the pancreas before it connects with the pancreatic duct and empties itself into the first part of the small intestine, called the duodenum at the ampulla of Vater.

Bile duct cancer, also called cholangiocarcinoma, can start in any part of the bile duct system. Based on where the cancers originate, they are classified into three types - intrahepatic bile duct cancers, perihilar or hilar bile duct cancers, and distal bile duct cancers.

  • Intrahepatic bile duct cancers
    These cancers originate from the smaller bile duct branches within the liver. They may often be confused with cancers that start in liver cells, such as hepatocellular carcinomas.
  • Perihilar or hilar bile duct cancers
    These cancers originate from the hilum, the point where the left and right hepatic ducts join and leave the liver. These are also called Klatskin tumors.
  • Distal bile duct cancers
    These cancers are found in the lower parts of the bile duct, close to the small intestine. These cancers are extrahepatic bile duct cancers like perihilar cancers because they originate from cells outside the liver.

Bile duct cancers are usually asymptomatic until later in the course of the disease. When bile duct cancer causes symptoms, it is usually because a bile duct is obstructed. The symptoms depend on whether the cancerous cells are in ducts inside the liver (intrahepatic) or ducts outside the liver (extrahepatic) and include:

  • Jaundice
  • Itching
  • Light-colored, greasy stools
  • Dark urine
  • Abdominal pain
  • Loss of appetite/weight loss
  • Fever
  • Nausea and vomiting

This is the most common type of cancer that starts from the liver cells or hepatocytes and is called hepatocellular carcinoma. It is much more common than cholangiocarcinoma. If you are looking for a comprehensive Liver Tumour treatment in Navi Mumbai, look no further! We are here to help you.

Cancers primarily located in other organs, such as the colon or rectum, can sometimes spread (metastasise) to the liver. For example, colorectal cancer has a tendency to metastasize to the liver. The treatment of such cancers is different from those originating primarily from the liver. Therefore, it is important to know whether a tumor in the liver started in bile ducts (cholangiocarcinoma), the liver tissue itself (hepatocellular carcinoma), or another organ and has metastasised to the liver.

The extent of the bile duct cancer spread is an important factor that needs to be considered while deciding the treatment modality. Surgery is the main treatment modality for bile duct cancers that offers the only realistic chance for a cure.

Some bile duct cancers classified as resectable cancers can be removed completely by surgery. Most bile duct cancers in their earlier stages are potentially resectable. The type of surgery chosen to remove cancer depends on its location and extent of spread. However, if cancer has spread too far or is in a location where it is too risky to be removed, surgery can't be considered an option. Most cancers of bile ducts are unresectable by the time they are diagnosed.

Before doing the surgery, a staging laparoscopy is done. This allows the doctor to visualise the internal organs of the abdomen and determine if cancer has spread to a location that renders it unpredictable. Kokilaben Dhirubhai Ambani Hospital, Navi Mumbai is equipped with all the instrumentalities and tools needed for delivering the best Bile Duct Cancer treatment making it the best Bile Duct Cancer hospital in Navi Mumbai.

If the patient has yellowing of the skin and eyes or jaundice before surgery, a stent or catheter is put in the bile duct first to allow the bile to flow the way it normally should. This helps relieve symptoms over a few days, making the patient fit for surgery.

After the surgery, adjuvant therapy in the form of chemotherapy or radiotherapy may be needed to prevent the recurrence of cancer. Adjuvant therapy is mostly used when there is a higher chance that the cancer wasn't completely removed. If test results make it clear that some cancer cells are left behind, a second surgery to remove the tissue may also be required in some cases. In case of large or difficult to remove cancers, neoadjuvant therapy with chemo and/or radiation is helpful to shrink the tumor. When the tumor shrinks, surgery can be done to try to remove it.

  • Liver transplant
    A liver transplant may be considered an option for some intrahepatic or perihilar bile duct tumors that are unresectable. Chemo and radiation may be given first. It is often challenging to find a compatible liver donor, but a liver transplant is sometimes the only option left.
  • Palliative care
    For most bile duct cancers, imaging tests and/or laparoscopy make it clear if they are resectable or not. For the cancers that cannot be removed, treatment is aimed at attempting to control the spread of cancer and relieve any symptoms associated with it. Radiation and/or chemo: Radiation and/or chemotherapy may help to shrink or slow the growth of cancer for a time.
  • Targeted therapy
    For intrahepatic bile duct cancers that have the FGFR2 gene mutation and have grown after at one of the chemotherapy treatments, targeted therapy drugs, such as pemigatinib (Pemazyre) and infigratinib (Truseltiq), may be considered.
  • Ablation
    For bile duct cancers limited to the liver, ablation using extreme heat called radiofrequency ablation or cold temperatures called chemotherapy may help control the tumors.

Palliative care is supportive treatment aimed at preventing and treating the symptoms of bile duct cancer. It includes giving medications for any discomfort like nausea, pain control, and maintaining the flow of bile where a tumor may obstruct it. Palliative care is aimed at helping you feel better, not necessarily treating cancer. Maintaining your quality of life is an important goal for us. So, don't hesitate to discuss pain, other symptoms, or any quality-of-life concerns with our cancer care team at any stage of the treatment. Kokilaben Dhirubhai Ambani Hospital, Navi Mumbai prioritizes the comfort and safety of the patient under all situations, delivering the best Bile Duct Cancer treatment in Navi Mumbai.