Bile duct cancer (cholangiocarcinoma) is categorized as “distal” when it develops near the small intestine. The first step toward treating distal bile duct cancer is to accurately determine the stage, or progression, of the disease.
Like many other cancers, bile duct malignancies are often evaluated with the help of the TNM system from the American Joint Committee on Cancer (AJCC). This widely used system measures three key factors:
- The tumor (T) – The size of the original tumor
- Lymph node involvement (N) – If and how many lymph nodes contain cancer cells
- Metastasis (M) – How far cancer has spread beyond the original tumor site
A number between zero and four is then assigned to each letter to indicate severity. For example, a T4 score specifies a larger tumor than a T1 score, and an M0 score means that the cancer has not spread to nearby structures.
How is distal bile duct cancer staged?
Based on the findings of the TNM system, distal bile duct cancer is staged using numbers. In general, here is what each stage may describe:
- Stage 0 – The cancer is in its earliest stages, has not affected deeper tissues and has not spread to nearby lymph nodes or structures.
- Stage 1 – The cancer has grown less than one fifth of an inch into the bile duct wall.
- Stage 2A – The cancer has grown more into the bile duct wall (up to one half of an inch) or has spread to a few nearby lymph nodes.
- Stage 2B – The cancer has grown more than one half of an inch into the bile duct wall or has spread to a few nearby lymph nodes.
- Stage 3A – The cancer has spread to at least four lymph nodes.
- Stage 3B – The cancer has traveled to nearby blood vessels.
- Stage 4 – The cancer has spread to distant organs, such as the lungs or liver.
Moffitt Cancer Center’s Gastrointestinal Oncology Program offers a full spectrum of diagnostics, treatment and supportive care to patients with distal bile duct cancer. To speak with a Moffitt oncologist specializing in this type of cancer, call 1-888-663-3488 or complete a new patient registration form online. A referral is not required to visit Moffitt.