How Fast Does Bile Duct Cancer Spread? A Shockingly Rapid Pace

How Fast Does Bile Duct Cancer Spread? Cholangiocarcinoma or Bile duct cancer is a sporadic form of cancer (cancer that occurs randomly or by chance, without any clear reason or family history) that occurs in the slender tubes that carry bile (fluid that helps us digest food), which is secreted by the hepatocytes(main cells of the liver). Bile is a yellow-greenish fluid that once secreted is stored in the gallbladder. This form of cancer is so rare that it occurs in fewer than 8000 people in the United States.

This cancer spreads very quickly, and most people receive a diagnosis after it has already spread outside of their bile ducts and becomes difficult to treat. The chances of recovery from this type of cancer are generally poor. But let’s not lose hope as more promising research and clinical trials are out to look for the best treatment for us. 

The cancer is generally diagnosed when the tumor is in the later stages known as metastasis, which indicates the spread of the cancer to other parts of the body. People most often have no symptoms until the last stage.

Types of Bile Duct Cancer

Bile duct cancer often affects adults in their 70s and it is known to spread aggressively but with the correct treatment which includes chemotherapy or radiation therapy it can be controlled. There are three types of bile duct cancers:

Intrahepatic Cholangiocarcinoma: This type of cancer occurs inside the liver(Intrahepatic), affecting the bile ducts within it.

Perihilar Cholangiocarcinoma(Klatskin Tumor): This is the most common type of bile duct cancer and it forms in the hilum, which is the area just outside the liver where smaller bile ducts inside the liver join together to create a larger duct which is known as the common hepatic duct.

Distal Cholangiocarcinoma: This cancer develops in the bile ducts outside the liver, closer to the small intestine.

How Fast Does Bile Duct Cancer Spread?

The bile ducts are located deep within the body, people most often have no symptoms until the last stage before the cancer is diagnosed. Bile duct cancer grows slowly at first and goes undetected due to a lack of symptoms in the early stages. Once it spreads rapidly the tumor breaks through the bile duct wall.

According to a 2019 study conducted at the Department of Medical Physiology, Texas A&M Health Science Center College of Medicine, Bryan, TX, United States, the average survival time for someone with intrahepatic bile duct cancer who has recently undergone surgery is approximately 12.4 months.

According to the American Cancer Society, the survival rates of bile duct cancer depend on where it’s growing and how far it’s spread in the body. Ideally, these cancers have been classified as localized, meaning the cancer is limited to bile ducts, regional, meaning the cancer is spread to nearby organs, and distant, meaning the cancer has already spread to far away organs, for instance, the lungs.

Risk Factors That Increase The Risk of Bile Duct Cancer

• Viral infections like Hepatitis B and C infections increase the risk of developing bile duct cancer.
• Long-term inflammation of the pancreas is linked to a higher risk of bile duct cancer.
• Also, cirrhosis, or the scarring of the liver is associated with an increased risk of bile duct cancer.
• The liver may also be affected by infections caused by liver flukes, parasites that invade the bile ducts, significantly heighten the risk of bile duct cancer.

Symptoms of Bile Duct Cancer

The symptoms mainly occur due to the disruption of the bile flow (fluid that helps us digest food) through the bile ducts. 

• Abdominal pain is often felt on the right side of the abdomen but can also be felt in other areas such as the back or the whole abdomen. People may experience pain because the tumor grows into surrounding nerves and organs, such as the liver, gallbladder, pancreas, or small intestine. The tumor can also block the bile duct and prevent bile from draining properly.
• Jaundice, or yellowing of skin and the whites in the eye.
• Dark Urine
• Itchy Skin
• Fever
• Fatigue and Nausea
• Loss of Appetite and weight loss

Precaution and Steps You Can Take To Prevent Bile Duct Cancer

While there is no guaranteed precaution to prevent bile duct cancer, you can lower its risks by taking steps to protect your liver and bile ducts from inflammation:

• Protect yourself from infections such as hepatitis B, hepatitis C, and  HIV by regular medical checkups, taking vaccines, and practicing safe sex.
• Drinking too much alcohol directly impacts your liver, try to avoid or drink in moderation.
• Being overweight can lead to liver problems, such as fatty liver disease which can increase the risk of Cholangiocarcinoma.
• Smoking is linked to many types of cancer, including bile duct cancer. Quitting smoking can significantly reduce your risk and improve your overall health.

Supportive Care for Bile Duct Cancer

Bile duct cancer is an extremely rare and aggressive cancer that affects the bile ducts carrying bile from the liver. With fewer than 8,000 cases in the United States annually, this cancer often presents symptoms only in advanced stages, making early diagnosis challenging. And since there is hardly any way to prevent it, here are the thing that may help soothe symptoms if any.

• Radiation Therapy: Helps shrink tumors in advanced bile duct cancer, especially when they press on nerves or organs.
• Palliative Surgery/Procedures: Used to relieve pain and restore bile flow if a tumor blocks the bile duct, including:
  • Biliary bypass: Creates a new route for bile to drain.
  • Biliary stent or catheter: Inserts a small tube to keep the bile duct open or drain bile.
• Pain Management:
  • Medications: Pain-relieving drugs, especially in advanced stages.
  • Alcohol Injection (Nerve Block): Injected into nerves to deaden them and relieve pain.
• Itch Relief:
  • Medicines: Oral antihistamines, cholestyramine (Questran).
  • Topical Treatments: Corticosteroid cream, calamine lotion, or antihistamine cream.
  • Skin Care: Use mild soap, moisturizing lotions, and oil or oatmeal bath mixtures.
• Clothing Tips: Wear loose-fitting clothes, avoid wool and synthetic fabrics.
• Environment: Keep surroundings humid and cool.

Despite treatment options, it is completely normal to feel curious about more questions related to the experience of people suffering from end-stage bile duct cancer. Getting in touch with a supportive community before, during, and after the treatment can help reduce the stress of the entire process.

Here are some resources for end-stage bile duct cancer care:

1. Patient Access Network (PAN) Foundation for financial support
2. For any more information related to cancers: 1-800-227-2345 
3. Online Bookstore from the American Cancer Society: for more questions on diet, people’s experience and more.

Feel free to ask any more associated questions about supportive care and current medical research related to bile cancers at [email protected]

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