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Understanding Intrahepatic Cholangiocarcinoma (Bile Duct Cancer)

Learn about a diagnosis of intrahepatic cholangiocarcinoma, and potential treatment options.

Where does intrahepatic cholangiocarcinoma form?

Intrahepatic cholangiocarcinoma forms in the bile ducts within the liver. This contrasts with other types of cholangiocarcinoma, which may form in bile ducts outside of the liver. Bile ducts are the tubes that go from the liver and gallbladder to the small intestine.

Focusing treatment on the liver can help when bile duct cancer is contained within the liver

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Common symptoms of intrahepatic cholangiocarcinoma

Symptoms may not appear until the tumor blocks a bile duct. These symptoms include:

Jaundice (yellowing of the skin or eyes)
Abdominal pain or discomfort
Dark urine and pale stools
Itchy skin
Unexplained weight loss
Fever or fatigue
Night sweats
Nausea and vomiting

How intrahepatic cholangiocarcinoma is diagnosed

Intrahepatic cholangiocarcinoma may be hard to diagnose since symptoms may not appear until the disease is advanced. The following tests and procedures may be used to diagnose intrahepatic cholangiocarcinoma:

Imaging tests such as ultrasound, CT scans, or MRI
Liver function blood tests: high liver enzyme levels may reflect liver or bile duct damage
Biopsy to see whether cells are cancerous

Treatment options for intrahepatic cholangiocarcinoma

There are several treatment options for intrahepatic cholangiocarcinoma, depending on the nature of the tumors, and where it has spread. A Patient Educator can talk with you about the specialists who are available to discuss your options with you. These options may include liver-directed therapies, surgery, or systemic therapies.

Liver-directed therapies

HAI therapy, which delivers medicine continuously and directly to the liver, using an implantable pump.
Ablation therapies that use heat or other methods to treat tumors.
In some cases, liver-directed therapy may be used to shrink the tumors to a point where they can be resected (removed by surgery) at a later time.

Surgery

Surgery to remove tumors in the liver, known as resection, may be possible depending on the size and location of the tumors.
Seeing a surgeon early in your treatment journey can help you evaluate your full set of treatment options. The surgeon can help you understand if you may be a candidate for surgery now or in the future.
Some patients may become candidates for liver transplant, which replaces a diseased liver with a healthy donor liver.

Systemic therapies

Systemic chemotherapy is often considered as a first-line treatment following diagnosis. Your doctor can describe the systemic chemotherapies that may be available to you.
Targeted therapies focus on specific pathways that cause cancer to grow. Molecular targets that may be evaluated for intrahepatic cholangiocarcinoma include FGFR2, IDH1/2, BRAF, and HER2.
Immunotherapies harness the body’s own immune system to go after cancer cells. Biomarkers that may be evaluated to determine candidacy for immunotherapy include MSI and TMB.
Combination therapy, combining more than one of the systemic therapies described above, may be considered for some patients.

Important facts about intrahepatic cholangiocarcinoma

Control of disease in the liver is an important factor in survival for patients with intrahepatic cholangiocarcinoma.¹
Care for intrahepatic cholangiocarcinoma involves a multidisciplinary team, including surgical oncologists, medical oncologists, infusion nurses, and interventional radiologists.

Take the next step

A brief quiz can help you understand if liver-directed therapy may be an option.

Take the quiz

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References:

1. Yamashita S, et al. Cancer. 2017;123(8):1354-1362.

Important Safety Information for HAI

The Intera 3000 Hepatic Artery Infusion Pump is used to deliver medications such as chemotherapy to the blood vessels in the liver. With all medical procedures, there are risks associated with the procedure to place the pump in your abdomen and with the use of the pump to deliver medications. The risks associated with placement and use of the pump include but are not limited to bleeding, blood clots, blockage within the device, damage to the blood vessels, fluid or blood build-up around the device under the skin, infection, movement or displacement of the pump or catheter, pump damage, and leakage or incorrect delivery of the medications. Special care may be required after placement of the Intera 3000 Pump and includes but is not limited to avoiding rough physical activity, avoiding deep sea or scuba diving, avoiding saunas, avoiding long periods in hot tubs and avoiding direct sun exposure, heating pads or hot water bottles over the area of your abdomen where the pump is placed. Additional care may be needed for air travel, moving to or visiting a high-altitude place, or if you have a fever. The Intera 3000 Pump is MRI Conditional, which means that certain conditions must be met to safely have an MRI after placement of the pump. Be sure to talk with your doctor so that you thoroughly understand all of the risks and benefits associated with the use of the device. PI-2257307-AA