Your doctor can diagnose bile duct cancer by looking at how your liver and bile ducts work. Your doctor may also order blood tests to check for substances that indicate your liver isn't working properly or there is a blockage in your bile ducts. You can also use Fildena 150 if your doctor prescribes it for you.
Blood Tests
Diagnosing bile duct cancer usually starts with your doctor's physical exam and blood tests. Imaging tests may follow this to see how well your liver and bile ducts work.
Your care team might also look for chemicals in your blood that show how well your bile ducts are working and any buildup of bilirubin, a chemical in bile. A high bilirubin level in your blood can indicate that a tumor is blocking a duct.
Other tests help to find out how far cancer has spread. This is called staging, and it can help the team plan treatment.
Magnetic resonance cholangiopancreatography (MRCP): This test uses a special machine that lets your healthcare provider take pictures of your bile ducts. It doesn't need a contrast agent, and it's not invasive like other types of cholangiograms.
Endoscopic retrograde cholangiopancreatography (ERCP): In this procedure, your doctor passes an endoscope down the throat and into your small intestine to look at your bile ducts. Dye is injected into the vents, and X-rays are taken to see them better. Samples of your ducts can be removed, and stents can be put in them to keep them open.
Some people don't have any symptoms of bile duct cancer until it grows large enough to block the ducts. They might not have jaundice but other signs of cancer, such as muscle aches, fever or tiredness. They might also have tummy pain that goes to the back or is accompanied by flu-like symptoms.
Abdominal Ultrasound
An abdominal ultrasound uses high-frequency sound waves to make images of organs and other structures inside the body. This type of test is usually the first imaging test done when a person has symptoms like jaundice or pain in the right upper abdomen (belly).
During the exam, you lie on a table while a technician moves a small transducer instrument over your abdominal area. The transducer sends high-frequency sound waves that bounce off tissues and create echoes. The echoes are then sent to a computer to produce a picture on a monitor.
The transducer can be used to look at the liver, gallbladder, spleen, pancreas, and other organs in the belly. The blood vessels that connect these organs can also be examined with ultrasound.
Ultrasound is a safe and painless procedure that doesn't use ionizing radiation. However, when the wand touches a tender area, you may feel pressure or discomfort.
You should drink 32 ounces of water one hour before the ultrasound. It would help to drink fluids or eat a light meal while waiting.
The doctor may also perform an endoscopy with an ultrasound probe built into the tube to examine the bile duct. This is a more detailed view and may be helpful when checking for cancer.
CT Scan
Your doctor will probably order a CT scan (or another imaging test) to diagnose bile duct cancer. It can help show if the tumor is growing in your bile ducts and gallbladder. It can also tell your doctor how big the tumor is and whether it has spread to other body parts.
The test is usually done while you're under sedation. A small tube is inserted down your throat and into the bile duct, which lets the doctor see inside it. This helps guide the doctor's needle to the tumor or other areas of concern so that a biopsy can be taken and tested.
During the scan, your doctor will use a special machine to take pictures of your body. This can include your lungs, liver, spleen, blood vessels, kidneys, and other organs.
When the images are ready, your doctor will use a computer to assemble them into a detailed picture of your body. It can show if cancer blocks blood flow to or from your bile ducts. It can also show if there's any abnormal tissue in your bile ducts or gallbladder.
Before the scan, you may be given a special fluid called contrast. This fluid helps outline your intestine and other structures so the doctor can see them in the pictures. You may feel heat or itching at the injection site or a metallic taste in your mouth, but both should disappear after a few minutes.
MRI Scan
Other tests can't see some bile duct tumors and need a special type of scan called an MRI. This safe, non-invasive test uses radio waves and strong magnets to make detailed pictures of soft tissues in the body. A contrast material, usually gadolinium, may be injected into a vein before the scan to show details better.
An MRI scan can be done at a hospital or a clinic. The scanner is controlled by a radiographer trained to carry out imaging investigations. This person will also show you how to lie still during the scan, explain what will happen, and help you stay comfortable.
You will be asked to change into a gown or hospital scrubs before the exam, and you will need to drink plenty of water to stay hydrated—guidelines about eating and drinking before the exam varies between specific exams and facilities. Tell the staff if you have any food allergies or medical conditions that can affect your results.
During your MRI, the radiographer will use a computer to control the scanner. It will produce a loud clanging sound to keep you still, and you will wear headphones to protect your hearing. The radiographer will talk to you through an intercom during the scan and view the images on a screen. They will send the scan to a radiologist, a doctor who supervises and interprets radiology exams.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
ERCP is an endoscopy (an examination of the digestive tract) that uses a thin, flexible tube to examine your bile ducts. It also lets your doctor inject dye into them to help them show up on X-rays.
During an ERCP, your doctor will insert the endoscope into your mouth and your esophagus (the tube connecting the throat to the stomach). They will then pass it down your bile duct into the first part of the small intestine (duodenum).
You will be given a sedative medicine through a vein in your arm. A painkiller medicine for your throat is also given to help you feel relaxed and sleepy.
Your doctor will then use the endoscope to look inside your bile and pancreatic ducts. They will then inject a dye into each vent and take an x-ray of the tubes.
The X-ray shows the size and shape of your bile ducts and can show if there are blockages or narrowings. It may also show if there are cancers or tumors.
If your doctor thinks you have a tumor in the bile duct, they can take a tissue sample (biopsy) for testing. They can do this using a needle biopsy or brush cytology technique.
Other tests that can help doctors diagnose bile duct cancer include cholangiogram and ultrasonography. These tests may not be as accurate as a biopsy. They can also cause discomfort or other side effects.
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Biopsy
When a doctor suspects something is wrong with your bile ducts, they may want to take a tissue sample for testing in a laboratory. These tests can help your doctor learn if the area is cancerous and its type.
For most types of cancer, the only way to make a diagnosis is through a biopsy. In a biopsy, your doctor removes a small tissue sample from an abnormal body area.
There are different kinds of biopsies, and your doctor will determine which one is best for you. They can be done under local anesthetic or with sedation or general anesthesia.
A radiologist inserts a special needle into the skin at the site of the suspected area of cancer. The radiologist then uses imaging guidance to advance the hand to the suspected tumor's location and remove tissue samples for analysis.
If the biopsy is successful, your doctor will send the sample to a laboratory. The lab will use the model to test for signs of cancer and other conditions.
Other tests your doctor might do to help diagnose bile duct cancer include blood chemistry tests and cholangioscopy. These procedures use an endoscope (a thin, lighted tube) to examine your abdomen's bile ducts and other organs.
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