Cholangiocarcinoma

Symptoms of Cholangiocarcinoma

The following are the most common symptoms of cholangiocarcinoma. However, each individual may experience symptoms differently. Symptoms may include:

  • Jaundice (yellowing of the skin and eyes)
  • Abdominal pain
  • Poor appetite
  • Weight loss
  • Itching
  • Pale stools
  • Dark urine
  • Fever

The symptoms of cholangiocarcinoma may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

Diagnosing Cholangiocarcinoma

In addition to a complete medical history and physical examination, a number of diagnostic procedures may be used for cholangiocarcinoma.

Ultrasound

What Is an Ultrasound?

Ultrasonography, which is sometimes called sonography, uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. The sound waves bounce off body parts and send back an image, like sonar on a submarine. A computer then looks at the signals sent back by the sound waves and creates an image of the body using those signals.

Ultrasounds are used to view internal organs as they function, and to assess blood blow through various vessels. Ultrasound procedures are often used to examine many parts of the body such as the abdomen, breasts, female pelvis, prostate, scrotum, thyroid and parathyroid, and the vascular system. During pregnancy, ultrasounds are performed to evaluate the development of the fetus.

CT Scan

MRI

Biopsy

What Is a Biopsy?

A biopsy is a procedure in which tissue samples are removed from the body by a needle or during surgery, for examination under a microscope to determine if cancer or other abnormal cells are present.

By examining and performing tests on the biopsy sample, pathologists and other experts can determine what kind of cancer is present, whether it is likely to be fast or slow growing, and what genetic abnormalities it may have. This information is important in deciding the best type of treatment. Open surgery is sometimes performed to obtain a biopsy, but in most cases, tissue samples can be obtained without open surgery using interventional radiology techniques.

Some biopsies can be performed in a doctor’s office, while others need to be done in a hospital setting. Most biopsies require use of an anesthetic to numb the area and may require sedation.

ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography is a procedure that allows the doctor to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. The procedure combines X-ray and the use of an endoscope—a long, flexible, lighted tube. The scope is guided through the patient’s mouth and throat, then through the esophagus, stomach, and duodenum. The doctor can examine the inside of these organs and detect any abnormalities. A tube is then passed through the scope and into the bile duct, and a dye is injected which will allow the internal organs to appear on an X-ray.

TNM Staging System

The TNM System is a standard system for describing the extent of a cancer’s growth. This system was developed by the American Joint Committee on Cancer (AJCC) and is the most common system used to stage anal cancer. Here’s what the letters stand for in the TNM System.

  • T (tumor) refers to the size of the original tumor and whether or not it has invaded nearby organs.
  • N (node) refers to whether the lymph nodes in the area of the original tumor have become cancerous.
  • M (metastasis) refers to whether the cancer has spread to other, distant organs in the body, such as your bones, liver, or lungs.

Stage Groupings of Bile Duct Cancer

Once your T, N, and M stages have been determined, your doctor puts them together in a stage grouping. This is used to determine your overall cancer stage. Stage grouping is shown in Roman numerals going from 0 (the earliest stage) to IV (the most advanced stage). The following are the stage groupings used for extrahepatic bile duct cancer—the most common type of bile duct cancer, which occurs in the part of the bile duct outside the liver.

  • Stage 0
    The cancer is only in the innermost layer of the bile duct. It has not spread to lymph nodes or distant sites in the body. This is also called carcinoma in situ.
  • Stage IA
    The cancer is in the bile duct wall, but has not grown all the way through it. It has not spread to lymph nodes or distant sites in the body.
  • Stage IB
    The cancer has grown through the bile duct wall but has not spread anywhere else.
  • Stage IIA
    The cancer invades nearby structures, such as the liver, pancreas, or gallbladder. Or it may have spread to smaller branches of the hepatic artery or portal vein, but not into the larger vessels. It has not spread to lymph nodes or distant sites.
  • Stage IIB
    The cancer is in the bile duct and has spread into lymph nodes but not to distant sites. It may or may not have spread to nearby structures.
  • Stage III
    The cancer invades the main vein or arteries or part of the small intestine, gallbladder, colon, or stomach. It may or may not have spread to lymph nodes but has not spread to distant sites.
  • Stage IV
    The cancer has spread to distant sites, such as the bones or lungs.

Your doctor considers the stage and your health to recommend a treatment plan. Staging information helps doctors compare your individual situation with other people who have had bile duct cancer. Based on clinical studies done on people in similar stages of the disease, a doctor can make some predictions about how the cancer may act and how different treatments may work.

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