Pancreatic cancer and bile duct cancer are difficult to diagnose and often fatal because they are discovered in the advanced stages of the disease. Researchers have developed new tests that double the ability to detect bile duct and pancreatic cancers according to a Mayo Clinic study published in the June issue of Gastroenterology.
Pancreatobiliary tumors such as bile duct cancer (cholangiocarcinoma) and pancreatic cancer often present as strictures, or a narrowing of the duct that can either be caused by benign inflammation or cancer. Physicians insert an endoscope down the throat and into the bile duct and pancreas region to examine possible tumors; however, the narrowness of the bile duct makes it difficult to distinguish benign and malignant strictures.
In this study, 498 patients with pancreatobiliary duct narrowing underwent an endoscopic procedure, and cell brushings were taken. Brushings were then analyzed by routine cytology, digital image analysis and fluorescence in situ hybridization (FISH) to determine the various tests’ effectiveness and sensitivity in detecting and diagnosing cancer. While traditional cytology analysis relies on identifying abnormally shaped cells, the FISH test detects malignant cells using colored probes visible with a fluorescence microscope. Since cancer cells have an abnormal amount of DNA, by FISH these cells show extra copies of the probes compared to normal cells. The Mayo research team found that the combination of cytology and FISH raised the detection rate of bile duct and pancreas cancer from 20 percent to 43 percent.
Below is a link to an edited youtube video with Dr. Roberts.
my sister having bilobar cancer of liver poorly diff cholangio carcinoma(inrahepatic).is there any surgical/medical treatment to give her 5-6years life.
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I am 59 year old female. In 2008 I was diagnosed with cholangiocarcinoma. Large mass in left lobe of liver. The left liver lobe and gallbladder resected. Adjuvant chemo therapy followed for 6 months. Cancer free until recent CT Scan shows 4 lesions. My question is with this history could I be a candidate for liver transplant? What type of treatment would you suggest? How many years of life could be added?
Helen, the link below will provide you with information about Mayo Clinic’s transplant center.
http://www.mayoclinic.org/transplant/
Call this number for more specific questions: 1-866-227-7501
Thank you so much for the response. I will call the telephone number tomorrow. I did not mention in my earlier info that my cholangio is intrahepatic. I don’t have any jaundice or weight loss. I have a full feeling and gain weight and feel a pull around the right lower rib cage. My prayers go out to all those dealing with this disease.
My husband was just diagnosed with bile duct cancer. It has spread to the liver and some small place in the lungs. Would he be a candidate for the liver transplant?
We are sorry to hear the news about your husband. Unfortunately, we cannot diagnose conditions, provide second opinions or make specific condition treatment recommendations through this correspondence. If you would like to seek help from Mayo Clinic, please call our appointment offices which are open Monday-Friday.
507 284 4988.
We have received your question and should have a reply soon.
My father died at 57 of pancreatic cancer, and my mom at 77 was just diagnosed with billiary and/or pancreatic cancer(the cause not establsished fully yet). With this kind of genetic material, since I am a mother of six children who are fairly young I would like to know is there anything that can be done to diagnose this terrible disease before it’s too late for any hope?
Thank you for your message.
Unfortunately, we cannot diagnose conditions, provide second opinions or make specific treatment recommendations through this correspondence. However, I have attached a couple of links to pages on our website that you may find helpful: (insert links) If you would like to seek help from Mayo Clinic, please call one of our appointment offices in Arizona at 480-301-1735; Florida, 904-953-0323; or Minnesota, 507-284-2511.
My mother was diagnosed with a Klatskin tumor in Feb 2003 and died in Oct 2003. I was wanting to know if this cancer is hereditary and if so, can you provide me with info on the best preventive measures and best diagnostic tools to use to catch this horrible disease in its earliest stages
Please refer to the following link which will provide more information regarding diagnosis and treatment for Klatskin’s tumors http://www.mayoclinic.org/bile-duct-cancer/types.html.
My mother at age 65 just got diagnosed for bile duct cancer. Mayo clinic for their subspecialty expertise in this cancer is what prompted to contact you, however we live in Los Angeles. We understand the time sensitivity of this rare disease and want to proceed with consultations and staging of it to begin treatments. Do you know of any physician or hospital institution of this expertise in Los Angeles or in California? Please help!
We have received your question and are checking into an answer.
My mother (75 yrs old) has just found out she has a mass of some sort in the bile duct of her liver. Is it possible it could be something other than cancer? She has had exhaustion and dark urine. No where I have read on has ever mentioned exhaustion as a sympton of this type of cancer. Is it possible to have a mass that is not malignent?
Nona, we cannot diagnose conditions, provide second opinions or make specific treatment recommendations through this correspondence. If you would like to seek help for your mother from Mayo Clinic, please call one of our appointment offices
Arizona: 800-446-2279 (toll-free)
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Hello, My mom had a stone in her bile duct and NOT a mass. Just inflamtion caused by the blockage. I would have liked to hear that could happen. It was a nightmare thinking my mom had cancer for three days! I am so sad that they would tell us all that she had cancer when she didn’t! We were told about the the whipple procedure and that she would be in the hospital for two weeks and have radiation and chemo afterwards! They said the biobsy was to determine What Kind of cancer she had NOT IF she had cancer! I am still reeling from all this and needed to vent! this seemed like a safe place to do it. Also maybe this info will help someone else! : (
My unkle was just diagnosed with bile duct cancer(involved the RT and left hepatic duct)in the advance stage and not spreading to the adjacent organs.one week ago he get juondice and tube was applied to open the duct and they were able to open only 3mm and the color is better now. I Would like to know the treatment options for her condition in details for cases similar to her.
Thanks
Thank you for your message.
Unfortunately, we cannot diagnose conditions, provide second opinions or make specific treatment recommendations through this correspondence. If your uncle would like to seek help from Mayo Clinic, please call one of our appointment offices. The numbers can be found here: http://www.mayoclinic.org/patientinfo/appointments.html
After CT scan, surgeon stated he was over 90 percent sure it is cholangiocarcinoma. We are scheduled for PET scan, biopsy of one of the areas, (they state they cannot reach the other). Also colonoscopy.
I was reading about your liver transplant program and would like more information about how patients qualify. We live in Cleveland Ohio, and I’m wondering is there a way I can send records to your dept prior to making an appointment.
I found your information about the FISH test quite interesting. I was diagnosed with cholangio carcinoma at Mayo’s Rochester in October 2007 – subsequent successful modified Whipple Surgery there followed by chemo and radiation in Rockford, Illinois., Dr. Richard Nora, OSF Saint Anthony Medical Center. At 4.5 years have stable CA19-9 in range of 11-12. Regards to Drs. Clain, Silveira, Farnell and Clare Bender.
My husband who is a 43 YO caucasian who was diagnosed with cholangiocarcinoma 18-Apr-2011 at a small local hospital. At which point we were told the only option was palliative care/pain killers until the end. Since it took them approx. 1 wk to review the biopsy and determine what they were looking at I requested a referral to a larger institution. We went to Duke and UVA, both of which said chances of survival were slim but that he was a “poster child for chemo”. To this point all chemistry values are WNL. We re fighting with hematologic toxicity with the most dramatic effect being thrombocytopenia. Our first chemo regimen was GEM/CIS. He demonstrated either tumor bloom or disease progression with CA 19-9 tripling in 2 months. We have switched to FLUFOX and have stable disease for 4 months now. Our next scan is tomorrow. I know you can not diagnose or prognose via this page. Can you tell me if Mayo in Rochester offers other treatment regimens or if they will consult with our oncologist at UVA?
We have referred your question for a reply.
My mother has been ill for over a month with liver symptoms. Her bilirubin was at 15 when admitted to hospital. The stent procedure failed because her ducts were too constricted. Tubes were placed to drain the bilirubin. Her levels flexuate and have gone as high as 23 but not below 18. This has gone on for over 2 weeks now. Although the suspusion is bile duct cancer, no biopsy has been obtained. What other options do we have to reduce the bilirubin and get her to a stabile point where further testings can be done. Is there a physician or faciltiy that you would refer in Pittsburgh, PA to seek treatment from?
Denice, It is difficult to give more definitive advice without the benefit of an evaluation. I would recommend the Center for Liver Diseases at the University of Pittsburgh. Dr. Lewis
I was diagnosed with intrehepatic cholangiocarcinoma in Dec 2010 and went to Mayo Arizona for evaluation in that month. The tumors are all in my liver (still); the primary one was 11 cm in 2010 and my CA 19-9 was 2700. I have undergone lots of chemo (Oxaliplatin), several radioembolizations, one ablation and one chemo-embolization.
I need to start chemo again and am interested in personalized cancer care with treatment based on genomic sequencing. I am now 65, primary Medicare, secondary Anthem Blue Cross PPO. Can I come to Mayo for testing and have a personalized therapy recommended? I live in Sacramento, CA (I did relocate to LA for 11 months for a drug trial and subsequent traditional treatment). I tried sorafanib and had huge side effects. My CA 19-9 is around 110 and am perfectly healthy otherwise.
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IS THE BLOOD TEST ‘CA-19-9″ READING 4 THEN SAID REFERENCE RANGE :0 TO 35 CAN BE POSIBLE MALINGNACY DISEASE ?
We cannot diagnose conditions, provide second opinions or make specific treatment recommendations through this correspondence. If you would like to seek help from Mayo Clinic, please call one of our appointment offices. The numbers can be found at http://www.mayoclinic.org/ under “request an appointment.”
CAN YOU TELL ME THE NORMAL LEVEL OF THE BLOOD TEST ‘CA-19-9″
We’ll check.
The normal value from our laboratory is less than 55 units per ml (U/mL). Values greater than 129 U/mL are more likely to be associated with bile duct or pancreas cancer, but the test can also be increased in non-cancerous conditions such as bile duct inflammation or infection. Different laboratories may have different normal value ranges.