How do I get treatment?
For further information and appointments please see the below contact numbers:
For Mr Rob Hutchins:
020 7234 2940
For the following Consultants:
020 7234 2730
Professor Nigel Heaton
Professor Mohamed Rela
Mr Parthi Srinivasan
Mr Andreas A. Prachalias
Dr Phil M. Harrison
Dr Kosh Agarwal and
Dr Michael Heneghan
Billiary Cancer Diagnosis London
The Diagnostic options for Billiary Cancer, London
Below are the different diagnostic options for Biliary Cancer that the patient may undergo:
Blood test: your doctor may order tests to check for elevated levels of bilirubin or the enzyme alkaline phosphatase, which is released by damaged bile duct cells. Two tumour markers called CA 19-9 (Carbohydrate antigen 19-9) and CEA (Carcino embryonic antigen) may be elevated in cholangiocarcinoma, but they are also raised in other cancers including pancreas, colon, stomach and gynaecological cancers and obstructive jaundice from other causes.
Computerized tomography (CT) scan: this is essentially a highly detailed X-ray that allows your doctor to see your gallbladder in two-dimensional slices. Split-second computer processing creates these images while a series of thin X-ray beams passes through your body. In most cases, you'll have a dye (contrast medium) injected into a vein before the test. By producing clearer images, the dye makes it easier to distinguish a biliary tumor from normal tissue. A CT scan can also help determine if cancerous cells have spread to the common bile duct, lymph nodes or liver.
Endoscopic retrograde cholangiopancreatography (ERCP) in this procedure, an endoscope is passed down your throat, through your stomach and into the upper part of your small intestine. The tests looks at the inside of the pancreas and bile duct with X-ray and can be used to stent your bile tube to relieve jaundice at the same time.
Endoscopic ultrasound (EUS) is a technique that can sometimes provide even better images. In this test, an ultrasound transducer is attached to the end of a flexible, lighted viewing tube (endoscope). The endoscope is passed down your throat into your stomach and duodenum, and from there into the common bile duct.
Laparoscopy (inspection of the abdominal cavity with a camera inserted through a keyhole incision) can sometimes detect small cancerous tumours and liver secondaries missed on other scans, though it is less accurate for blood vessel or lymph node involvement. The combination of laparoscopy with laparoscopic ultrasound may prevent an unnecessary attempt at surgery in some patients
Magnetic resonance imaging (MRI) instead of X-rays, this test uses a powerful magnetic field and radio waves to create images.
PET (Positron emission tomography) scanning can detect cholangiocarcinoma as well as the presence of distant spread, but its use is not routine.
PTC (percutaneous transhepatic cholangiography) is a different procedure but with a similar intent. It involves needle puncture of the skin over the liver, and then of the liver substance. A fine tube is passed into the bile duct, and a stent can then be pushed across the blockage (but from above, in this instance). Again, bile samples, biopsies and brushings can be taken.
The choice between PTC or ERCP is usually determined by local expertise, availability, and failure of one or the other technique, usually ERCP. PTC is preferable for higher strictures and often a combination of both procedures is required. These invasive techniques carry the risk of procedural complications including bleeding, biliary leakage, pancreatitis, cholangitis and duodenal perforation.
Ultrasound: this test uses high-energy sound waves to produce images of your internal organs, including your gallbladder. It has no side effects, it is not invasive and generally takes less than 30 minutes to perform.
Ultrasound is usually one of the first tests done in cases of jaundice and is especially good at providing information about the shape and texture of tumors as well as diagnosing the presence of gallstones and obstructed bile ducts.