Bile duct cancer with lower survival rates than liver and lung cancer, causes and symptoms
Dec 16, 2024
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According to the recently published national cancer registration statistics, cancers occurring in the gallbladder and biliary tract account for 2.7% of all cancers. It was reported as 10th in cancer incidence in men and 9th in women, and special attention is needed as the number of patients is gradually increasing due to aging.
Bile duct cancer is a malignant tumor that occurs in the bile duct. The bile duct is a long, thin tubular organ that extends from the parenchyma of the liver through the hepatic portal to the gallbladder, pancreas, and duodenal papilla. Malignant tumors that occur in this area are collectively called bile duct cancer or biliary cancer.
Among the major cancers, bile duct cancer has a poor prognosis, and it is classified as intractable cancer because it has a lower 5-year survival rate than liver cancer or lung cancer, and the 5-year survival rate is only 29%. There are no obvious symptoms in the early stages, and even if symptoms appear, they are often found in an already advanced state because they are similar to liver disease.
Depending on the site of occurrence, it is divided into intrahepatic bile duct cancer, hepatic bile duct cancer, and extrahepatic bile duct cancer, and in particular, intrahepatic bile duct cancer is difficult to detect early because symptoms appear only after a fairly advanced stage.
The most important factors of bile duct cancer are recurrent bile duct inflammation and smoking. Repeated gallstones in the bile duct, bile duct parasitic infections such as hepatostoma, primary sclerosing cholangitis, viral hepatitis, ulcerative colitis, gallbladder polyps, and smoking are known risk factors. When bile duct cancer occurs, symptoms such as weight loss, fatigue, loss of appetite, nausea, vomiting, epigastric pain, jaundice, and abdominal mass palpation may occur, and liver function may be accompanied by bile duct obstruction.
Serum tumor marker test, ultrasound, abdominal computed tomography (CT), magnetic resonance imaging (MRI), PET-CT, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound are used for the diagnosis of bile duct cancer. After determining the location and degree of invasion of the lesion, the appropriate treatment according to the stage is determined through multidisciplinary cooperation including internal medicine and surgery.
In early cholangiocarcinoma, surgical resection is prioritized in the absence of major vascular involvement and distant metastasis. Depending on the location of occurrence, hepatic resection, biliary resection, pylorus-preserving pancreatic duodenal resection, etc. may be performed. In the case of advanced bile duct cancer, medical treatments such as chemotherapy and radiation therapy are mainly performed, and endoscopic high-frequency cauterization and bile duct stent insertion are also performed in parallel.
The recently introduced endoscopic high-frequency cauterization not only improves malignant bile duct obstruction caused by bile duct cancer and extends the stent retention period, but also has the effect of directly necrosis of the tumor. In addition, in the treatment of bile duct cancer, 'kitruda (component name pembrolizumab)' and 'impinji (component name dervalumab)' are known to be effective in combination therapy with conventional chemotherapy, so they can be considered as optional options for the treatment of refractory bile duct cancer.
"Bile duct cancer is often difficult to detect early because the symptoms are not clear, and it is often diagnosed belatedly due to its fast progression and poor prognosis," said Professor Lee In-soo of gastroenterology at Korea University Anam Hospital. "As prevention and early diagnosis are important, we should actively strive to prevent and detect bile duct cancer through smoking cessation, abstaining from alcohol, maintaining proper weight, regular blood tests, and abdominal ultrasound." In addition, "Bile duct cancer is a malignant tumor with poor prognosis, but it can be treated more through surgical treatment, active chemotherapy, and endoscopic intervention."
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bellho@sportschosun.com
