Bile duct cancer

surgery (taking out the cancer or taking steps to relieve symptoms caused by the cancer), radiation therapy (using high-dose x-rays to kill the cancer cells); and chemotherapy (using drugs to kill cancer cells).

The chances of recovery and the choice of treatment depend on the location of the cancer in the bile duct, the stage of the cancer and the patient’s general health. Cancer arising in the extrahepatic bile duct is an uncommon disease. It is curable by surgery in fewer than 10% of all cases. The prognosis depends in part on the exact anatomic location of the tumor, which affects its resectability. Total resection is possible in 25% to 30% of cases in which the tumor arises in the distal bile duct, a resectability rate that is clearly better than for tumors that occur in more proximal sites. Bile duct cancer may occur more frequently in patients with a history of primary sclerosing cholangitis, chronic ulcerative colitis, choledochal cysts, or infections with the fluke Clonorchis sinensis. The most common symptoms of bile duct cancer are jaundice, pain, fever, and pruritus. In most patients, the tumor cannot be completely removed by surgery and is incurable. Palliative resections or other palliative measures such as irradiation (e.g., brachytherapy or external-beam radiation therapy) or stenting procedures may maintain adequate biliary drainage and allow for improved survival. Many bile duct cancers are multifocal. Perineural invasion has a negative impact on survival.

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