Hepatobiliary Cancer: Causes, Symptoms, and Treatment

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Medically Reviewed by Dr. Aman Priya Khanna
Written by Sparshi Srivastava, last updated on 13 June 2024| min read
Hepatobiliary Cancer: Causes, Symptoms, and Treatment

Quick Summary

Hepatobiliary cancer is a type of cancer that starts in the liver or bile ducts.

The most common cause of hepatobiliary cancer is chronic liver disease, such as cirrhosis.

Symptoms of hepatobiliary cancer can include abdominal pain, jaundice, weight loss, and fatigue.

Did you know that the predominance of liver cancer in India, especially among cirrhotic patients, was found to be 1.6%, as evaluated by Musunuri et al., 2022.  But Dutta et al., 2019 also reported that our country contributes almost 10% to the global mortality burden for bile duct cancer. These values highlight the urgent need to increase awareness regarding hepatobiliary cancer to alleviate the heath.

This blog will explore everything related to hepatic and biliary cancerous conditions. Providing comprehensive discussion of the causes, symptoms, diagnosis and treatments. Continue reading to know it all and make appropriate health choices.

Understanding Hepatobiliary System and its Function

The hepatobiliary system produces, stores, and transports bile. Understanding its natural functioning can shed light on prevalent cancer issues in India.

  1. Liver is the largest gland of the human body. It synthesises bile, which is associated with the digestive action

  2. Gallbladder stores and concentrates the fluid produced through the hepatic system. 

  3. Bile ducts transport bile between liver and gallbladder to the small intestine for fat digestion. 

Issues in these parts of the body can result in various health problems, including jaundice, liver damage, gallstones and cancer.

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What is Hepatobiliary Cancer?

The malignancies developing or progressing in the hepatic and biliary parts of the body are classified under hepatobiliary cancer. Its understanding, and early detection are crucial in facilitating quick treatment to increase the quality of life effectively. 

  1. Liver Cancer: It is also known as Hepatocellular Carcinoma (HCC), significantly impacting the hepatic cells. 
  2. Bile Duct Cancer: Also known as Cholangiocarcinoma. It affects the part responsible for carrying bile juice into the small intestine.
  3. Gallbladder Cancer: It originates in the small pear-shaped organ (gallbladder) that stores bile juice. 
  4. Hepatoblastoma: A rare type of liver cancer that usually affects children under the age of 3. 
  5. Angiosarcoma: An uncommon cancer that arises from the blood vessels within the liver, spleen, skin and breast.

It is important to note that these types of cancer can have different stages and grades, which can affect the treatment options and prognosis for the patient. 

Hepatobiliary Cancer

Consult with a healthcare provider for accurate diagnosis and treatment.

Causes of Hepatobiliary Cancer

While understanding the disease progression, it is also essential to explore the root causes responsible for cancer. It helps in mitigating the risks and reducing complexities associated with hepatobiliary cancer. Some of the recognised reasons for this are: 

Viral Infection:

Long-term Hepatitis B or C infection can cause inflammation, damaging the liver cells. It increases the likelihood of acquiring cancerous diseases. 

Fatty Liver:

A condition that leads to fat accumulation in the liver. It is reversible and is further divided into:  

  1. Non-alcoholic fatty liver disease (NAFLD) 

  2. Non-alcoholic Steatohepatitis (NASH) 

If untreated, it can damage the liver, causing scarring and cirrhosis. 

Alcoholic Liver Disease:

Regular, heavy liquor consumption can damage the liver. Prominently leading to inflammation, scarring and liver failure, ultimately raises the risk of liver cancer. 

Cirrhosis:

The hepatic tissue gradually becomes scarred in cirrhosis, a chronic form of liver disease. This increases the chance of malignant liver cell growth through severe swelling, genetic mutations, etc.

Causes of Hepatobiliary Cancer

Gallstones:

These are hardened deposits that can form in the gallbladder. It blocks a bile duct, causing infection and increasing the risk of developing bile duct cancer

Haemochromatosis:

Some diseases can lead to the accumulation of iron in the liver, which can eventually trigger cancer. Excessive concentration of the mineral can increase toxicity in the organ, leading to significant damage. 

Primary Sclerosing Cholangitis (PSC):

A condition in which bile ducts undergo inflammation and scarring, which can eventually trigger abnormal cancer cell growth. 

Primary Biliary Cholangitis (PBC):

It is an autoimmune disease in the immune system. It attacks the bile duct, leading to organ damage and cancer."
Causes of Hepatobiliary Cancer

Common Symptoms Visible in Hepatobiliary Cancer Patients

Patients must note the symptoms carefully because they indicate the occurrence and severity of the disease. Some common signs include:

  1. Extensive discomfort and pain in the abdomen, usually right-sided. 
  2. Unusual weight loss can be indicative of late-stage cancer. 
  3. Loss of appetite can be a metabolic response to malignancy or tumour. 
  4. Jaundice due to blockage of the bile duct by carcinogenic cells. 
    Symptoms of Hepatobiliary Cancer
  5. Nausea is experienced as cancer cells interfere with hepatic structure. It leads to problems with food digestion and absorption. 
  6. Swelling in the abdomen can be a potential indicator. As malignant cells grow in size, organ enlargement occurs.
  7. Itchy skin can happen due to cancer-related bile duct blockage, causing bile salts to accumulate in the skin.
  8. Hepatic confusion/ encephalopathy, characterised by disorientation and other neurological issues that can cause coma. This symptom is associated with liver tumours.

Symptoms of Hepatobiliary Cancer

How to Diagnose Hepatobiliary Cancer?

After identifying the causes and evaluating the symptoms, the next step is to confirm the disease through reliable assessment methodologies. Since hepatobiliary cancer can develop in different parts and impact other organs like the liver. A diverse range of tests are used. Some of the diagnostic approaches include: 

Imaging:

Various visualisation techniques can help in the diagnosis of hepatobiliary cancer, including:  

  1. Ultrasound 
  2. Computed Tomography Scan (CT) 
  3. Magnetic Resonance Imaging (MRI) 
  4. Positron Emission Tomography Scan (PET) 

Biopsy:

It involves extracting a small tissue from the patient's liver to examine cancerous cells.

Serum Biomarkers:  

  1. Alpha-fetoprotein (AFP) is produced by the growing embryo's liver and yolk sac. 
  2. Prothrombin induced by Vitamin K Absence or Antagonist-II (PIVKA-II) is used to assess the protein generated by the liver in the absence of Vit-K. 

High levels of AFP and PIVKA-II indicate cancer. 

Diagnosis of Hepatobiliary Cancer Image

Endoscopic Retrograde Cholangiopancreatography (ERCP):

A flexible tube attached to a camera is passed inside the small intestine through the mouth. It helps to examine the bile duct and extract a tissue sample for testing. 

Percutaneous Transhepatic Cholangiography (PTC):

Utilises X-rays to observe and assess the bile duct thoroughly. 

A cancer diagnosis can be challenging and requires multiple tests to confirm. The expert doctors at HexaHealth will guide you on the best course of action based on your condition and medical history. 

Preoperative Considerations a Patient Should Look into 

Cancer treatments include a holistic approach which ensures the patient’s safety at every step of the healthcare journey. Post-diagnosis of hepatobiliary cancer, the risk of hepatic failure and the need for liver transplant increases significantly.

Thus, doctors integrate some methods to consistently monitor the level of damage acquired by the patient’s liver. It helps prevent complications and prepares on time in case of a liver transplant. The commonly employed techniques include: 

MELD & PELD:

These preoperative scoring systems check the possibility of liver transplant based on the extent of damage. Model for End-stage Liver Disease (MELD) is for adult patients, whereas Paediatric End-stage Liver Disease (PELD) is for children. 

It evaluates the laboratory values, including bilirubin, creatinine, and prothrombin time (PT). The frequency of tests varies based on the patient's condition and previous results. It can be scheduled every three months to 3 weeks or, in complex cases, every seven days.

Child-Turcotte-Pugh (CTP) score:

A system used to assess the severity of liver cirrhosis. It considers several clinical and laboratory parameters, including bilirubin levels, albumin levels, prothrombin time, ascites, and C encephalopathy. 

The test score ranges between A (5-6), B (7-9), and C (10-15). The values indicate that five is the least serious and 15 is the highest severity level. Like MELD/PELD, it is conducted on three-monthly intervals or weekly as per the extent of organ dysfunction.

Let’s Know More about the Treatment Options for Hepatobiliary Cancer

Patients often need clarification regarding the type of treatment modality they would be prescribed. Thus, acquiring appropriate information about the methods employed for addressing the disease is necessary. The list below describes a few approaches used in hepatobiliary cancer:

  1. Tumour Removal

  1. Liver resection/hepatectomy removes the affected or just a part of the liver.
  2. Cholecystectomy is used for extracting the gallbladder to stop cancer cells from spreading. 
  3. Roux-en-Y establishes a new connection between biliary ducts and the small intestine. It bypasses the central bile duct, which is blocked due to the overgrowth of cancer cells. 
  1. Liver Transplant: The patient's diseased liver is replaced with a healthy donor's liver. 
    Treatment for Hepatobiliary Cancer

  2. Radiation Therapy: An X-ray light is focused on the tumour to destroy the cancerous cells. 

  3. Targeted/Ablation Therapy: This treatment focuses on the specific abnormality of the tumour. A combination of medicines is administered to the patient to inhibit the growth of the tumour.

  4. Immunotherapy: This treatment aims to boost. Patients' immune systems use various medicines. 

  5. Chemotherapy: Single or a combination of the medication is given to the patient to curb the growth of tumour cells in the liver.
    Treatment for Hepatobiliary Cancer Images

  6. Biliary Stenting: The surgeon places a stent in the bile duct to remove the blockage. 

  7. Transcutaneous Electrical Nerve Stimulation (TENS) is a process to cope with cancer pain through nerve stimulation. 

  8. Transjugular Intrahepatic Portosystemic Shunt (TIPS): The process includes creating a shunt mechanism between the veins carrying blood to the heart. It helps in reducing pressure and preventing bleeding. 

  9. Percutaneous Transhepatic Biliary Drainage (PTBD): PTBD is performed to relieve obstructive jaundice by inserting a catheter into the biliary system through the liver under image guidance. 
    Treatment for Hepatobiliary Cancer

Consult our top experts from the National Liver Board to learn more about the best hepatobiliary cancer treatment choices.

Post-Operative Considerations for a Patient

While considering hepatobiliary cancer, it becomes significant to think that the progress needs to be evaluated at definitive intervals. This helps understand the extent of hepatic damage, prevent post-treatment complexities, and detect cancer recurrence.  

A patient might have to visit the doctor for follow-up on a specific schedule. Generally, these appointments are scheduled every three months for the first two years after surgery and at a six-month gap after that. It can differ based on the disease severity treated or if abnormalities are observed after the procedure.

Some of the prominent methods prescribed after surgery are:

Enzyme Calibration 

 To track the process and look for improvement in patients, the  physician will check the levels of the following:  

  1. Liver Enzyme Tests (LFT): They can help assess liver damage or dysfunction.  

  2. Adenosine Triphosphate (ATP): ATP levels are measured to evaluate how well the liver produces energy. 

Imaging Tests 

The doctor advises for CT scans, MRI, and ultrasounds to detect any potential surgical complications. It also contributes in the 

Resumption of Organ Function 

Another significant factor to consider during the recovery period is organ activities. The functionality of the treated organs is regained gradually. The overall functioning after the medical treatment can differ from patient to patient. 

However, after the treatment, the body generally returns to normal functioning after appropriate aftercare and adhering to the precautionary guidelines provided by the doctor.

Post-procedure Side-effects 

Every treatment method has a certain level of complexity associated with it. These are commonly observed and easily manageable symptoms. Some of these include:

Treatment Modality

Common Side Effects

Radiation and Chemotherapy

Nausea, vomiting, fatigue, hair loss, increased risk of infections etc.

Surgery

Pain and discomfort at the surgical wound for 1-2 weeks or less. Comparatively, less side effects, but needs follow-up

Targeted Therapy

Fatigue, nausea, diarrhoea, skin rash or dryness, high blood pressure

Recurrence/Relapse of Disease

Cancer cells are quite unpredictable; therefore, there is a high chance they may occur again after some time, even after complete removal. It’s essential to keep track of your hepatobiliary system and check yourself regularly.  

Hepatobiliary Cancer Treatment Cost

The expenditure associated with any medical treatment must be considered while making healthcare decisions. 

Cost of Hepatobiliary Cancer Image

Note: These figures are just estimations. It significantly varies due to variables like- 
  1. Patient’s medical condition, including the stage and severity, type of cancer and its recurrence.

  2. Procedure treatment approaches like resection, transplant, hospital, and doctor chosen.

  3. Financing options include cashless, EMI or credit cards, medical loans, and more.  

The majority of health insurance plans cover the cost of hepatobiliary cancer treatment. Our team facilitates paperwork on your behalf, ensuring smooth approval and a cashless facility. Contact HexaHealth at 6366529758 for a simple and hassle-free experience throughout your surgical experience. 

Best and Affordable Hospitals for Hepatobiliary Cancer Treatment

A network as extensive as 150+ medical centres spread across the country makes HexaHealth stand out in seeking efficient treatment. Our top-rated healthcare brands include:  

A network as extensive as 150+ medical centres spread across the country makes HexaHealth stand out in seeking efficient treatment. Our top-rated healthcare brands include:  

  1. Jaypee Hospital: A tertiary multi-specialty healthcare centre with a capacity of 1200 beds. It has an extensive team of 252 highly trained doctors and is equipped with advanced healthcare facilities. The hospital is renowned for patient-centric treatment and excellence in practice.

  2. Max Group of Healthcare: Amongst the largest chain of healthcare providers operating as a for-profit organisation. It offers a diverse network of 17 hospitals across the country and has more that 4800 doctors affiliated with them. 5

  3. Apollo Group of Hospitals: Founded in 1983, this healthcare organisation has emerged as Asia’s largest integrated medical provider. It offers excellent health facilities and advanced treatment options at its 73 hospitals in India. Apart from that it also has a network of pharmacies, diagnostic centres, research institutions and so much more. 6

  4. Narayana Group of Hospitals: The NABH-accredited healthcare facilities have gained popularity in terms of offering diversified and comprehensive care to patients. With a vast network of 19 advanced hospitals and 3 dedicated cardiac centres it has almost 18,800 medical associates. 7

  5. Action Cancer Hospital: A 130 beds capacity healthcare centre affiliated with NABH offers specialised treatment to a varied range of medical departments. The primary aim of the hospital is to offer affordable and effective care to all. 

  6. Artemis Hospital: Accredited with JCI and NABH, the healthcare facility has the capacity of 550+ beds. It has all the advanced and innovative medical equipment and offers comprehensive care to patients. With a top-notch medical infrastructure and highly recommended doctors, it's the ideal choice for everyone.

Top Hospitals for Hepatobiliary Cancer Treatment ImageTop Surgeons for Hepatobiliary Cancer Treatment

Numerous gastrointestinal surgeons provide top-notch care and are skilled in advanced treatment techniques. Some of the best surgeons you can consider for treating your hepatobiliary cancer are:

  1. Dr Sanjay Goja is an established gastrointestinal (GI) and hepato-pancreato-biliary surgeon. He has an extensive practising experience of 28 years in GI procedures and 15 years of expertise in Liver Transplant Procedure (LTP). Dr Goja is recognised for his contribution in saving lives through 2500 efficient LTPs.

  2. Dr KR Vasudevan is renowned for his skills in gastroenterological and liver transplantation techniques. With over 25 years of practice he is able to deliver patient centric treatments in his field of expertise.

  3. Dr Neeraj Goel is skilled in innovative techniques like minimally invasive and robotic approaches. Along with his 22 years of experience, Dr Goel promises exemplary health outcomes in hepato-pancreato-biliary surgeries.

  4. Dr Subhash Gupta has the practice expertise of over 37 years. His excellence in biliary procedures, liver transplant and gastroenterology are highly recognised and recommended. 

  5. Dr Naimish N Mehta, an esteemed liver transplant and general surgeon is a suitable choice for hepatic treatments. Dr Mehta has a comprehensive experience of 27 years.

  6. Dr Giriraj Bora possesses the practising expertise of 23 years. He is gaining recognition for his contribution in liver and kidney transplant along with other surgical techniques for hepatic cancer.

  7. Dr Neerav Goyal has over 26 years of experience in the field of liver transplant and surgical gastroenterology. His diverse practice in not just treating hepato-pancreato-biliary issues but also addresses cancerous conditions.

  8. Dr Nikhil Gupta is a GI surgeon who shows commendable skills and accuracy in LTPs as well. He has an experience of almost two decades.

Want to know about other surgeons and book appointments? Then, contact HexaHealth at 6366529758 to learn about the top cancer-specialised doctors and hospitals in your city. Our experienced agents can help you acquire easy and convenient consultations with them.

Top Doctors for Hepatobiliary Cancer TreatmentWant to Want to know about other surgeons and book appointments? Then, contact HexaHealth at 6366529758 to learn about the top cancer-specialised doctors and hospitals in your city. Our experienced agents can help you acquire easy and convenient consultations with them.

Why Choose HexaHealth?

HexaHealth is the leading healthcare provider in India. Our AI-powered platforms and focus on positive patient experience are just some benefits. Are you curious why we are the best choice for your hepatobiliary cancer treatment? Here are some of the facilities you can avail yourself of:

  1. Helping you choose the best hospital per location and finances 

  2. Easy consultation booking with the best doctor at ease 

  3. Second opinion from multiple specialist surgeons (National Liver Board) 

  4. Hassle-free treatment cost estimates (look at the services and  modify accordingly) 

  5. Assistance with finances and treatment budget 

  6. Prioritisation of quality over everything else 

  7. 24/7 Personalised care support 

  8. Post-operative care (home care, hospital transfers, etc.)  

Why Choose HexaHealth?

India’s 1st National Liver Board 

HexaHealth has a panel of 5 top expert hepatobiliary specialists who will discuss and share end-to-end guidance and treatment plans based on your medical condition. The NLB panel in India consists of the following experts. Highlights of National Liver Board: 

1. Combined opinions from 5 highly experienced experts 

2. To make sure your diagnosis is correct 

3. Quick response to patient queries with suitable recommendations 

4. Single window for all liver care opinions 

5. Avoid unnecessary cost burden 

We are "Educating, Advocating, and Saving Lives: National Liver Board"
India’s 1st National Liver Board


Takeaway

Hepatobiliary cancer can pose a significant threat to the overall well-being and quality of life for the individuals. Timely diagnosis with effective treatment can alleviate the complications and increase the life expectancy for the patients. 

If you or your loved ones are suspecting hepatobiliary cancer symptoms and require more information. Then HexaHealth is your go to solution. Our consultants along with highly skilled and experienced healthcare professionals ensure your safety at all points of the medical journey.

How to Contact Us?

HexaHealth is your trusted partner for all your healthcare needs. We provide a one-stop solution that covers doctor appointments, diagnostic tests, admissions planning, out-of-hospital assistance, counselling, and disease education. Our vast network includes top hospitals with leading doctors specialising in hepatobiliary cancer treatment in India.

HexaHealth helps in financing your treatment through the best available zero-cost EMI options for up to 4 lakhs with a repayment period of 12 months. We have the best facility for lower-than-market interest rates for high tenures and amounts. We manage all your mental/emotional strain so that you can solely focus on the post-recovery. 

To know more, call us right away at 6366529758 and book your first appointment with the best doctor!

Frequently Asked Questions

Hepatobiliary malignancies are caused by several of factors, including: 

  1. Cirrhosis

  2. Hereditary or genetic disorders, 

  3. Obesity

  4. Diabetes

  5. Chronic viral hepatitis (B and C).

It is essential to know the risks to facilitate diagnosis and avoid complications effectively.

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Depending upon the severity and the stage of cancer, a patient  can choose to undergo:

  1. Surgery 

  2. Chemotherapy 

  3. Radiotherapy 

In order to deeply understand the complexity and make the right decision, one can seek an opinion from the HexaHealth Multi-Disciplinary Board (NLB), where a patient can get a complete  profile on severity and choice of treatment from a board of professional doctors. 

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The chances of survival can be approximately 50% but it depends  on the patient's medical condition. Generally, earlier stages  have higher survival rates, while advanced stages have lower rates. Survival rate after cancer treatment also depends upon your  lifestyle, follow up and medical care.

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Lifestyle changes such as maintaining healthy weight, abstaining from excessive alcohol, and receiving the hepatitis B vaccination can help lower your chance of having hepatobiliary cancer, even though certain variables are involuntary.

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References

All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.


  1. Musunuri B, Shetty S, Bhat G, Udupa K, Pai A. Profile of patients with hepatocellular carcinoma: An experience from a tertiary care center in India. Indian Journal of Gastroenterology. 2022 Feb 28;41(2):127–34.link
  2. Dutta U, Bush N, Kalsi D, Popli P, Kapoor VK. Epidemiology of gallbladder cancer in India. Chinese Clinical Oncology. 2019 Aug;8(4):33–3.link
  3. Hereditary Hemochromatosis | CDC [Internet]. www.cdc.gov. 2022. link
  4. Living as a Liver Cancer Survivor [Internet]. www.cancer.org. link

Updated on : 13 June 2024

Disclaimer: The information provided here is for educational and learning purposes only. It doesn't cover every medical condition and might not be relevant to your personal situation. This information isn't medical advice, isn't meant for diagnosing any condition, and shouldn't replace talking to a certified medical or healthcare professional.

Reviewer

Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES

12 Years Experience

Dr Aman Priya Khanna is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic, Health First Multispecialty Clinic in Delhi. He has 12 years of experience in General Surgery and worke...View More

Author

Sparshi Srivastava

Sparshi Srivastava

B.Tech Biotechnology (Bansal Institute of Engineering and Technology, Lucknow)

2 Years Experience

An ardent reader, graduated in B.Tech Biotechnology. She was previously associated with medical sciences secondary research and writing. With a keen interest and curiosity-driven approach, she has been able to cont...View More

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