Understanding Bile Duct Cancer
- Christopher Ingraham, a former Washington Post reporter, announced he’s been diagnosed with bile duct cancer and is getting treatment at the Mayo Clinic in Minnesota.
- Ingraham is best known for insulting Red Lake County in Minnesota and then, after an apology visit there went very well, relocating to the county with his family.
- Bile duct cancer forms in the bile ducts, which carry the body's enzymes to break down fat to other organs.
- Unfortunately, most bile duct cancers are unresectable (can’t be removed by surgery) by the time they’re found.
“Hey everyone. I’ve got kind of a crappy health update to share,” said Ingraham in a series of tweets. “I’m being treated for bile duct cancer at the Mayo Clinic here in MN. As far as cancers go it’s a bad one, right up there with pancreatic cancer in terms of grim overall prognosis.”
Read More“Doctors initially thought it was due to a gallstone, but subsequent imaging showed a large mass in the liver squeezing my bile ducts shut,” said Ingraham.
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Bile Duct Cancer
The bile ducts are a series of thin tubes that go from the liver to the small intestine. Their main job is to allow a fluid called bile to go from the liver and gallbladder into the small intestine, where it helps digest the fats in food, according to the American Cancer Society (ACS).
The type of bile duct cancer, also called cholangiocarcinoma, you may have depends on where the cancer starts. They are grouped into three types:
- Intrahepatic bile duct cancers
- Perihilar (also called hilar) bile duct cancers
- Distal bile duct cancers
The American Cancer Society defines them as such:
Intrahepatic bile duct cancers starts in the smaller bile duct branches inside the liver. Sometimes they’re confused with cancers that start in the liver cells (hepatocellular carcinomas), and they are often treated the same way. Perihilar (also called hilar) bile duct cancers start at the hilum, where the left and right hepatic ducts have joined and are just leaving the liver. These are also called Klatskin tumors. These cancers are grouped with distal bile duct cancers as extrahepatic bile duct cancers.
And the final type is distal bile duct cancers, which are found farther down the bile duct, closer to the small intestine. Like perihilar cancers, these are extrahepatic bile duct cancers because they start outside of the liver.
Ingraham didn’t share which type of bile duct cancer he has, but said his mass was found in his liver and was told by doctors “the tumor unfortunately can’t be removed — it’s too big, and it’s too close to some critical veins and arteries. The only real curative option at this point is a liver transplant.”
He adds, he’s recently made several trips to the Mayo Clinic in Minnesota for various tests and imaging to see if he is a candidate for a liver transplant.
Treating Bile Duct Cancer
The extent of your bile duct cancer plays an important role when deciding treatment options. The main treatment is surgery, according to the ACS. It is the only realistic option for a cure and for this reason the cancer is typically divided between resectable and unresectable.
Most stage 0, I, and II cancers and possibly some stage III cancers are potentially resectable — it might be possible to completely take out the cancer with surgery, said the ACS. But other factors must be considered such as where the cancer is and the health of the patient. Surgery to remove the cancer completely is the preferred treatment if it’s possible
Unfortunately, most bile duct cancers are unresectable by the time they’re found.
Ingraham said his liver is functioning well for the time being and there doesn’t appear to be any metastatic spread beyond the bile ducts at this time.
In an effort to stay positive, he adds “It’s definitely a bad situation but I do have a number of things going for me. I’m relatively young and healthy. At the moment I feel 100% fine and have no symptoms, as doctors successfully placed some stents in my biliary tract to open things up and get the bile flowing again.”
What To Do After A Cancer Diagnosis
A wave of emotions after a cancer diagnosis is normal. You may feel angry at times and sad and uncertain.
“In addition to making a treatment plan with your doctors, it's also important to make sure you have the mental health support you need as well. This is a challenging time, and many people find they need a little extra support to get through it,” says Dr. Lori Plutchik, a New York-based board certified psychiatrist.
Seeking Support: The First 3 Things to Do After a Cancer Diagnosis
Dr. Plutchik suggests trying to find a mental health professional who has experience helping people as they navigate cancer treatment and keeping your care team connected, so they can stay focused on a common goal.
"Make sure that the mental health professional that you work it is reaching out with your consent to the rest of your team, to the oncologist, to the surgeon … it can also be helpful to reach out to family, friends, and any other caretakers that may be involved in the person's treatment,” she adds.
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