Understanding Bile Duct Cancer
- After a stage 4 bile duct cancer diagnosis and a breakup, Florida nurse Alecia Wendland found unexpected love with Glenn Marsh, married him nine months later, and is choosing to live fully and hopefully despite her ongoing cancer battle.
- Bile duct cancer, also known as cholangiocarcinoma, is a rare disease that’s both incurable and increasingly lethal over time.
- The cancer forms in the bile ducts, which carry the body’s enzymes to break down fat to other organs. Only when a doctor can altogether remove the tumor or tumors from the body is survival a possibility for patients.
- A cancer diagnosis impacts not just the patient but their families, too. In many cases, embarking on a cancer journey can bring families, partners, and spouses closer together. However, we also know that added stress can cause a rift in the relationship if not addressed with care.
- Couples battling a cancer diagnosis should remember to maintain open communication, keep up the intimacy where possible, and find support from loved ones.
Sharing her story exclusively to People, Wendland recounted being diagnosed with a rare and aggressive form of bile duct cancer called cholangiocarcinoma in July 2023, after noticing she had a jaundice appearance.
Read MoreThe date went so well, Wendland recalls everything feeling “right,” prompting Marsh to later ask her to be his Valentine.
Even more admirable is that Wendland was upfront at the very beginning of her date about her cancer diagnosis and about one of her children living with Cushing’s syndrome, a rare disorder that occurs when your body makes too much of the hormone cortisol—yet it didn’t drive Marsh away.
Nine months later they got married.

Marsh, who proposed to Wendland about two months before their Nov. 23 wedding, praised his wife as “one of the strongest women I’ve ever met” during a conversation with People.
“I would do anything for her. She is truly my angel,” he added.
Wendland also feels the same for Marsh, telling People, “He’s so protective, and he’s so caring, and he’s so giving.
“He tells me all the time we’re going to fight this, even though I can’t have surgery and it’s stage 4… If I need to be in the hospital, he takes me in a minute. He doesn’t ever hesitate.”
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Wendland shared that her fight with cancer brought a heightened sense of urgency to their relationship, as they’re determined not to lose or “waste” any time together.
Marsh, who decided to move in with Wendland after four month of dating, added, “We’re doing everything that we can while we can, because we both know that we’re on a timetable.”
As they navigate life together, Wendland—who recently finished radiation therapy—is now receiving chemotherapy treatments every two weeks.
While one of her tumors has shrunk, others in her liver have grown. However, she remains optimistic that her new chemotherapy regimen will reduce the remaining tumors. Wendland told People that surgery isn’t an option due to the cancer having already spread to her lymph nodes.
Since Wendland or Marsh choose not to ask her doctors how much time she has left, they’ve decided instead to focus on embracing each day and living life to the fullest.
Understanding Bile Duct Cancer
Bile duct cancer, or cholangiocarcinoma, is a rare but aggressive form of cancer that quietly develops in the bile ducts, the vital pathways that transport bile (a digestive fluid) from the liver to the small intestine.
This cancer does have some treatment options. And the earlier it’s caught, the more promising the outcomes.
“When we consider bile duct cancer it usually gets kind of swept under the same shingle as liver cancer but it is not the same thing and treatment approaches can be very different,” Dr. Mariam F. Eskander, a surgical oncologist and assistant professor of surgery at the Rutgers Cancer Institute of New Jersey, previously told SurvivorNet.
Bile Duct Cancer: Understanding Your Diagnosis and Treatment Options
Understanding the Biliary System
The biliary system, also known as the bile duct system, includes your liver, gallbladder, and bile ducts working together to make and transport bile, a digestive fluid. It’s purpose is to help your body efficiently use the food you eat and mange the waste products. The liver produces bile, which breaks down fats in your food, making them easier to absorb.
Bile ducts are tubes that carry bile from your liver to your gallbladder and then to your small intestine when needed for digestion. The gallbladder stores bile until your body requires it to digest fats, providing a vital role in your digestive process.
Bile Duct Cancer: Explained
When the bile duct system works smoothly, you absorb all of the nutrients from your food properly. However, when any part of the biliary system is diseased,problems can arise. Bile duct cancer can occur in any part of the bile duct system. It is classified into two main types:
- Intrahepatic (within the liver)
- Extrahepatic (outside the liver)
“Bile duct cancers can also affect the bile duct system that runs from within the liver to outside the liver. So we have what are called intrahepatic cholangiocarcinomas, that’s bile duct cancer within the liver. And extrahepatic bile duct cancers which are cholangiocarcinomas that are outside of the liver,” Dr. Elliot Newman, the chief of surgical oncology at the Northwell Health Cancer Institute at Lenox Hill Hospital in Manhattan, tells SurvivorNet.
Bile duct cancer often first shows up in the later stages with subtle symptoms that can be mistaken for less serious conditions.
“Unfortunately bile duct cancers often don’t have symptoms. Patients usually seek medical assistance once symptoms appears. That usually means that the cancer has grown bigger and more advanced,” Dr. Eskander notes.
Common symptoms include:
- Jaundice (yellowing of the skin and eyes due to a build up of bile in the system)
- Itching
- White or clay-like stool (acholia)
- Dark urine (choluria)
- Abdominal pain
- Unexplained weight loss
- Fever
- Fatigue
- Night sweats
Eskander explains that bile duct cancer accounts for about 3% of digestive system cancers. Each year in the US, this translates to roughly 12,000 new cases outside the liver and an increasing number of cases diagnosed inside the liver.
The rising number of cases may be due to improved diagnosis, changing disease classifications, and higher rates of conditions like cirrhosis (liver scarring) and hepatitis C, which elevate the risk of developing this cancer.
Watch: Liver & Bile Duct Cancer: Treatment Progress
Breakups & Divorces Can Happen Amid Cancer: How To Cope
Sometimes people assume that if you’re married and you’re going through cancer, you at least have someone there to get through the tough times with. That’s not always the case, ovarian cancer survivor Amanda Crowell Itliong previously told SurvivorNet. Unfortunately, divorces during cancer do happen — but it’s not always a bad thing, the Detroit native said.
“Women do sometimes get divorces during this time,” she said. “It happened to me and I thought it was the worst thing that could ever happen — and it wasn’t. It wasn’t even a little bit the worst thing that could ever happen. It turned out pretty great in the end. Sometimes, things like cancer can show you that a relationship isn’t the right relationship.”
During the time of her interview, Amanda had been facing ovarian cancer for five years. Like many women who have the disease, she’s had to deal with several recurrences. She explained that after her first diagnosis, her husband at the time wasn’t really there for her — and could not really handle the stress in a helpful way. She wants other women to know that even if you experience relationship issues, or even the end of a relationship, because of cancer — it’s possible to move on.
Navigating relationships during cancer — A survivor’s guide
“I was able to find happiness and good sex, passion and everything, with somebody else after all of that was over,” Amanda said. “Sometimes I think it has to do with believing it’s going to be OK, and figuring out how to work something out. If we get used to what works and what doesn’t with our bodies, we can get creative and come up with a lot of good solutions that mean you can still have a really positive sex life. It might just not look like it did before.”
Remember, when going through a challenging chapter with your significant other, it’s necessary to truly understand the diagnosis so that you can help navigate the physical and emotional symptoms that come along with it, and there are a lot.
Dr. Jayanthi Lea, a gynecologic oncologist at UT Southwestern Medical Center, previously told SurvivorNet, “I encourage caregivers to come into visits with my patients because, in that way, the caregiver is also listening to the recommendations what should be done in between these visits, any changes in treatment plans, any toxicities [side effects] that we need to look out for, changes in dietary habits, exercise, etc.”
Mental Health: The Importance of Support for Cancer Survivor
It is important for cancer survivors to have a strong support system during and after cancer. Sometimes especially after cancer, when even more intense emotions can set in unexpectedly after the physical and emotional journey a patient has gone through.
Dr. Shelley Tworoger, a researcher at Moffitt Cancer Center told SurvivorNet that “there’s a number of common things cancer patients can experience, such as anxiety, depression, financial toxicity, social isolation and sometimes even PTSD.”
Helping to ease some of those feelings is a great way to support your loved one.
The importance of self-care and the things that bring you joy
Licensed clinical psychologist Dr. Marianna Strongin says having people by your side during this “arduous chapter” in your life can be very beneficial.
“Studies have found consistently that loneliness is a significant risk factor for physical and mental illnesses and the trajectory of recovery,” Strongin said.
“Therefore, it will be important that you surround yourself with individuals who care and support you throughout.”
Contributing: SurvivorNet Staff
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