Cholangiocarcinoma (Bile Duct Cancer) Diagnosis

In most cases, a cholangiocarcinoma diagnosis is made after a patient consults with a physician about possible signs of bile duct cancer, such as jaundice or abdominal pain. Because early detection can result in a better outcome, and because cholangiocarcinoma does not usually produce symptoms until it reaches an advanced stage, it is vital to see a physician regarding any potential warning signs as soon as possible. If a physician suspects that cholangiocarcinoma is the cause of a patient’s symptoms, the physician will usually perform a physical examination and order a series of tests.

There are several different tests that can be used to confirm or rule out a cholangiocarcinoma diagnosis. Some options include:

• Physical examination – A physician will review the patient’s overall health, examine his or her skin and eyes for signs of jaundice, and check his or her abdominal region for lumps, tenderness and fluid buildup – all of which can be signs of cholangiocarcinoma.
• Blood testing – Lab tests can detect the amounts of bilirubin, albumin and liver enzymes (alkaline phosphatase, AST, ALT and GGT) in the blood; excessive levels can indicate bile duct blockages or other problems. Blood tests can also reveal tumor markers CEA and CA 19-9, both of which are potential signs of cancer.
• Imaging – Imaging tests, such as X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans and abdominal ultrasounds can often show the presence of a bile duct blockage or tumor.
• Cholangiography – A cholangiogram is a specialized imaging test that can reveal a blocked, narrowed or widened bile duct.
• Magnetic resonance cholangiopancreatography (MRCP) – An MRCP is a noninvasive test that produces images of the bile duct.
• Endoscopic retrograde cholangiopancreatography (ERCP) – A physician passes a long, flexible tube (endoscope) down the patient’s throat, through the esophagus and stomach and into the first part of the small intestine (duodenum). A small tube is then passed from the end of the endoscope into the bile duct. Images are taken with the use of contrast dye, which helps outline the bile duct and possible blockages. During an ERCP, a physician can also use a small brush (biliary brushing) to obtain tissue or fluid samples for later evaluation under a microscope.
• Percutaneous transhepatic cholangiography (PTC) – A physician places a thin, hollow needle through the skin of the abdomen and into the bile duct within the liver. After injecting a contrast dye through the needle, the physician will take a series of images. Similar to an ERCP, this test can also be used to obtain tissue or fluid samples.
• Angiography – A physician injects a small amount of contrast dye into an artery to outline blood vessels before taking X-ray images, which can reveal blood flow blockages due to tumors.
• Biopsy – During an ERCP or PTC procedure or a fine needle aspiration or core biopsy, a tissue or fluid sample is obtained from the bile duct and evaluated under a microscope for signs of cancer.

At Moffitt Cancer Center, we assess each patient on a case-by-case basis, paying close attention to the unique dynamics of his or her condition and using the latest advances in diagnostic techniques. Following a cholangiocarcinoma diagnosis, our multispecialty team of experts works together to develop a highly individualized treatment plan designed to ensure the best possible outcome and highest quality of life for the patient. A high-volume cancer center, Moffitt has the extensive experience and advanced tools necessary to diagnose and treat bile duct cancer.

If you’ve recently received a cholangiocarcinoma diagnosis or would like more information about bile duct cancer, you can turn to the experts at Moffitt. Call 1-888-663-3488 or complete a new patient registration form online. We see patients with and without referrals.