Yellowing of the skin and eyes is often associated with hepatitis or liver disorders. However, this condition can also be a sign of bile duct cancer (cholangiocarcinoma) . Unfortunately, this cancer is often not diagnosed until it has reached an advanced stage, as its initial symptoms are nonspecific and resemble common digestive tract disorders. Recognizing symptoms early allows patients to receive faster evaluation and treatment.
What is Bile Duct Cancer?
Bile duct cancer is a cancer that develops in the ducts that carry bile from the liver to the small intestine. As the tumor grows, bile flow can be obstructed, leading to a buildup of bilirubin, a yellow substance in the body. This condition causes the skin and whites of the eyes to appear yellow, a characteristic symptom of bile duct cancer.
Symptoms to Watch Out For
In its early stages, bile duct cancer often doesn't cause any obvious symptoms. Some signs to watch out for include:
- Yellowing of the skin and eyes.
- Dark colored urine.
- Pale colored stools.
- Itching all over the body without any clear cause.
- Pain in the upper right abdomen.
- Nausea, decreased appetite, and weight loss for no reason.
- The body gets tired easily or feels weak.
These symptoms don't always indicate bile duct cancer. However, if they persist or worsen, you should see a doctor immediately to determine the cause.
Causes and Why is Diagnosis Often Late?
The exact cause of bile duct cancer is unknown. However, the risk is higher in individuals over 50 years of age, those with chronic inflammation of the bile ducts, chronic liver disease, or bile duct stones (hepatolithiasis). Some studies also suggest that diabetes and obesity may increase the risk.
Bile duct cancer is often diagnosed late because it doesn't show any obvious symptoms in the early stages. Furthermore, the symptoms often resemble other conditions, such as stomach problems, gallstones, or liver disease. To confirm the diagnosis, doctors may perform laboratory tests, ultrasound, CT scan, MRI, or other tests as needed.
Immunotherapy as a Modern Therapy
Treatment for bile duct cancer is tailored to the stage of the disease, the location of the cancer, and each patient's overall health. In addition to surgery, chemotherapy, and targeted therapy, immunotherapy is currently available as a modern treatment option for patients who meet the indications.
Immunotherapy works by helping the immune system recognize and fight cancer cells. Unlike other therapies, immunotherapy harnesses the immune system's natural abilities, enabling a more effective response in some patients.
Research developments in recent years have shown that immunotherapy can be an effective treatment for bile duct cancer in patients who meet medical criteria. Doctors will conduct a thorough evaluation before determining whether this therapy is an appropriate option.
Conclusion
Bile duct cancer is a disease often diagnosed late because its symptoms are nonspecific and easily mistaken for digestive disorders or other liver diseases. Therefore, don't ignore symptoms such as yellowing of the skin or eyes, dark urine, upper right abdominal pain, or unexplained weight loss.
If you or a loved one is undergoing treatment for bile duct cancer or would like to learn about appropriate treatment options for your condition, don't hesitate to consult a hematologist-medical oncologist . Through a thorough evaluation, your doctor can determine the appropriate treatment plan, including considering modern therapies such as immunotherapy if medically indicated.
Article written by Dr. Ryan Ardian Saputra, Sp.PD, Subsp. H.Onk.M (K) (Internal Medicine Specialist - Medical Hemato Oncology Consultant at EMC Alam Sutera & Tangerang Hospital).