These malignant tumors, originating in the biliary tract system, are relatively rare in Europe and the USA. Patients are most commonly affected in their 6 th decade, and the disease is more common in males than in females.
Reasons and risk factors for biliary tract cancers
The exact reason for occurrence of these tumors remain uncertain, however, there exist a number of apparently predisposing other disorders: primary sclerosing cholangitis (a chronic inflammation of the biliary tract system), liver cirrhosis, hepatitis C, gall stones, diabetes mellitus, smoking, and parasite disorders of the biliary tract.
Depending on the anatomic location of the tumour, one distinquishes between intrahepatic (cholangiocellular carcinoma within the liver), hilar (so called Klatskin tumor) and distal biliary tract carcinomas.
What are the symptoms of biliary tract cancer ?
Biliary tract cancers are usually asymptomatic in early stages, the diagnosis is usually done in patients with more advanced tumors. Possible symptoms include jaundice, decolouration of the stool, dark
urin, itching, weight loss, upper abdominal pain, nausea and vomiting.
How can I help ?
Contact me via my mobile phone 0664 206 74 80 and fix an appointment in my private praxis. During our first meeting we will talk about your symptoms and what diagnostic steps will be required. I will examine you physically. In case of existent complaints I will prescribe you effective symptomatic medications. As it concerns further diagnostic steps, I will refer you to a number of examinations in order to verify the diagnosis and to assess the stage of the disease: (1) Laboratory examination (pathological liver function values, elevated tumor markers like CEA and CA-19/9), (3) abdominal CT scan, and (40) endosonography (= endoscopy with an ultrasonic sensor). Sometimes additional examinations such as an MRI scan or an endoscopic retrograde cholangiopancreaticography (ERCP) in case of an obstruction of the biliary tract system will be required.
Depending on the results of these examinations, the best treatment strategy for you will be defined.
The next steps after diagnosis of small bowel cancer
The treatment strategy is dependent on the location and stage of the tumor at the time of initial diagnosis.
If the tumor is localised, it should be operated radically first. Sometimes it is necessary not only to remove the affected biliary tract segment, but also the gall bladder and parts of the liver. I will refer you to an experienced surgeon.
Usually postoperative adjuvant chemotherapy is being recommended with a fairly good tolerated oral medication (Capecitabine), which I will coordinate for you.
If a radical surgical resection is not feasible, there are a number of individual palliative treatment options: (1) Implantation of a stent in the biliary ducts to re-enable outflow of the bile, (2) Radiofrequency- or Laser
therapy, and (3) Chemotherapy with gemcitabine and cisplatin. Alternative promising chemotherapy regimens are presently being investigated in clinical studies. Also in this situation I promise that I will try to find and organise the best treatment strategy for you.
What are the costs ?
The costs for diagnosis and treatment at the Medical University in the AKH, in another public hospital or in a private clinic will be payed by your public or a private health insurance. My honorarium will be agreed upon individually, for a first consultation I will charge an amount of 180 Euro. The public health insurance usually refunds up to 80% of the honorarium a physician with a health insurance contract would request for the same treatment. Private insurances usually refund the entire honorarium of the doctor of your choice.