Recently, in a TV program, a couple who endured a long battle after being diagnosed with stage 4 intrahepatic biliary tract cancer appeared and drew attention. Intrahepatic biliary tract cancer is a cancer that occurs in the bile duct, a passageway that makes bile from liver cells and moves it to the intestine.
When symptoms appear, the disease is already advanced
Hepatocellular carcinoma is the most common primary tumor occurring in the liver (74.5%), followed by intrahepatic biliary tract cancer. Intrahepatic biliary tract cancer develops into cancer cells because the biliary tract epithelium in the liver does not proliferate normally.
Intrahepatic biliary tract cancer occurs most frequently in those in their 60s and 80s by age group, and occurs slightly more in men than in women. The exact cause is still unknown, and it is presumed that environmental and genetic factors are involved in a complex way.
The risk factors known so far include liver flukes (gandystoma), a parasite that can be infected when raw freshwater fish are eaten, intrahepatic gallstones, primary sclerosing cholangitis, an autoimmune inflammatory disease of the biliary tract, and biliary cysts, a congenital biliary anomaly. There are also studies that show a high incidence of hepatitis B and hepatitis C virus carriers.
Most patients with intrahepatic biliary tract cancer do not show any symptoms until advanced stage. When the typical symptoms of intrahepatic biliary tract cancer, such as abdominal pain, weight loss, jaundice, general itching, and fever, appear, it is often difficult to treat.
Hepatectomy should be considered first for treatment
In the case of a diagnosis of intrahepatic single-sided cancer in a hospital, the basic treatment is liver resection. In general, hepatic resection is considered first when it is possible to resection the tumor and there is no cirrhosis or the liver function is not severe enough. When performing liver resection, it is important to completely excise the tumor without leaving any tumors.
However, when tumors are scattered in both left and right lobes, when the underlying liver disease such as peritoneal dissemination, distant metastasis, cirrhosis or primary sclerosing cholangitis is severe, when the remaining normal liver after resection is less than 20-30%, when other systemic diseases are severe, etc. It is known that it is better not to have liver resection.
If liver resection is not possible, chemotherapy or radiation therapy is performed. For chemotherapy, gemcitabine and cisplatin are usually tried first.
Intrahepatic single-sided cancer has a poor prognosis because it has many metastases outside the liver in the early stage of onset. It is confirmed that the 5-year survival rate after surgery is 20-30%.
In some cases, regular check-ups are recommended for early detection
To prevent intrahepatic biliary tract cancer, the first step is to eliminate risk factors. Liver fluke infection, known as a risk factor for intrahepatic biliary tract cancer, can be prevented by not eating freshwater sashimi, and intrahepatic stones can be prevented by removing the stones.
However, experts say that most people do not have any risk factors for intrahepatic biliary tract cancer, and there are many cases without symptoms in the early stages of cancer, so there is no clear recommendation for early screening. It is recommended that people with primary sclerosing cholangitis or congenital biliary anomaly consult a doctor to receive regular check-ups for early detection of intrahepatic biliary tract cancer.