Clinical evaluation by the doctor to look for the presence of jaundice (yellowness of skin and eyes) or presence of scar marks (due to itching) and presence of any lumps in the tummy.
Blood tests including LFTs (bilirubin level in your blood high due to the blockage of the bile duct).
Hemoglobin (Hb level) can below
Tumor markers. These are substances normally seen in the blood, however, in people with cancer, they may be high. In bile duct cancer, the tumor marker associated with it is Ca19.9.
MRI (magnetic resonance imaging)
Endoscopic Retrograde Cholangio-Pancreatography (ERCP)
Endoscopic ultrasound (EUS)
You may undergo one or more of the scans in order to help identify the tumor and assess your suitability for the various treatments.
All of the previously mentioned tests may lead the doctor to diagnose bile duct cancer. However, the only definite way to confirm this diagnosis is to examine some of the abnormal tissue (cancer cells) under a microscope. Some cells may be taken during the ERCP procedure (these are called brushings). These cells taken to the laboratory for cytology examination. However, the results of cytology do not always produce a diagnosis and may give a negative result, despite cancer existing. If a larger sample of tissue required we may perform a biopsy. This when a needle passed through your skin, into the affected area. If your doctor planning to treat your cancer with surgery, you may not undergo a biopsy, as tissue confirmation can obtain after the operation, by the laboratory.
Complete surgical removal of the cancer is the mainstay of bile duct cancer treatment. The aim of the treatment to treat cancer and any symptoms it may cause. Treatment of the bile duct cancer depends on the stage of cancer and may differ from person to person because of:
Location of Cancer:
The bile duct cancer can occur anywhere within the bile duct system. There bile ducts throughout the liver – these called intra (within) hepatic (liver) bile ducts. some of which may run alongside major vessels that supply blood to or return blood from the liver.
There are also bile ducts that run from the liver to the gall bladder, and then from the gall bladder to the duodenum – these called extra (outside) hepatic ducts.
Size of Cancer:
The bile duct cancers can grow to a relatively large size causing any symptoms. Some cancers too small to identify scanning tests.
The spread of Cancer:
CT scans can detect whether cancer spread to any other part of the body – including the lymph glands. As the lymph system runs throughout the body, cancer that may have spread to the lymph system can increase the risk of further cancer spread (metastases) or increase the risk of cancer recurrence where main cancer already surgically removed.
Age of the patient:
Age can affect how well your body works, however, when deciding on which treatment the best for each individual. it important to assess each person’s actual health, rather than expected health for someone of that age.
Associated medical problems:
Are you well despite having another illness or does you have other medical problem limiting your lifestyle or life expectancy? Curable or palliative (may alleviate symptoms) therapies may offer to you, depending on the factors mentioned above. The clinical team caring for you will discuss, with you, the different treatments and therapies available. They will assist and support you in making decisions and choices about what is right for you.