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You will face many hard decisions if a loved one or you have been diagnosed with liver, biliary (bile duct cancer or cholangiocarcinoma), or pancreatic cancer. Including several questions like where should you go for treatment? What are the available treatment options? How to maintain your quality of life? We have tried to describe these concers, the types, and possible treatment, which will help you decide.

Liver Cancer

What Is Liver Cancer?

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Liver cancer is cancer that develops in the liver, the largest internal organ located below the right lung. Hepatocytes are the cells present in the liver, and these cells are responsible for breaking down and storing nutrients and removing waste from the body. Our liver also produces bile, a digestive fluid or enzyme, and also makes proteins that stop bleeding. Than primary liver cancers (cancer that starts in the liver), liver metastases (liver cancer that has spread from some other body part) are more common. But nowadays, the number of people with primary liver cancer is increasing in the US, as more people are affected by liver diseases that increase the risk of liver cancer, like hepatitis C.

What Are the Types of Liver Cancer?

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  • Hepatocellular Carcinoma - It is the most common primary liver cancer that begins in hepatocytes. Usually, a single tumor forms that spread to other organs eventually. Excessive alcohol consumption, chronic hepatitis B and C infection, nonalcoholic fatty liver disease, and too much iron in the body are some risk factors.
  • Intrahepatic Cholangiocarcinoma - It is the second most common type of primary liver cancer that starts in the bile duct (the tube that delivers bile). People infected with hepatitis B or C virus, those with primary sclerosing cholangitis (a condition resulting in inflammation and scarring of the bile ducts), and nonalcoholic fatty liver disease are at an increased risk of developing this type of liver cancer.
  • Fibrolamellar-Hepatocellular Carcinoma (FLL-HCC) - Otherwise called fibrolamellar carcinoma. It is a rare type of liver cancer that develops in young adults (ages between 20 and 30 years). It is less aggressive than the other forms.
  • Angiosarcomas, Hemangiosarcomas, and Hemangioendotheliomas - Tumors that form in the inner lining of blood vessels. They are curable and almost always seen in infants.
  • Hepatoblastomas - These curable liver tumors consist of tissue that looks like fetal liver, bile duct cells, or mature liver cells when seen under the microscope.
  • Benign Liver Tumors - Non-cancerous tumors in the liver do not cause symptoms and are diagnosed accidentally. Adenomas, hemangiomas, liver cysts, and focal nodular hyperplasias are some of the most common benign liver tumors.

What Are the Treatment Options for Liver Cancer?

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All cancer patients at MSKCC are offered compassionate and personalized care from their experts. Specialists experienced in surgery, chemotherapy, radiation therapy, rehabilitation, and maintaining the quality of life will work closely to develop a customized treatment plan to ensure the best outcome possible. Doctors at MSKCC have treated more than 5,000 liver cancer patients in the last 10 years. Patients also benefit from new chemotherapy drugs and other therapies through thousands of ongoing clinical trials at MSKCC.

Biliary Cancer (Bile Duct Cancer or Cholangiocarcinoma)

What Is Biliary Cancer?

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Biliary cancer or cholangiocarcinoma is cancer that forms in the thin bile ducts that carry the digestive enzyme bile. These ducts serve as the connection between the gallbladder and small intestine. Biliary cancer is common in people older than 50 but can occur at any age. It is a rare and extremely challenging cancer to treat.

What Are the Types of Biliary Cancer?

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  • Intrahepatic Cholangiocarcinoma - This develops in the parts of the bile ducts that are present within the liver, which is why it is also classified under liver cancer.
  • Hilar Cholangiocarcinoma - Also called perihilar cholangiocarcinoma. It is when cancer develops in the bile ducts that exit the liver.
  • Distal Cholangiocarcinoma - This biliary cancer develops in the bile duct closest to the small intestine.

What Are the Treatment Options for Biliary Cancer?

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Surgery to remove the bile duct and surrounding lymph nodes is the treatment of choice for bile duct cancer that is localized and has not metastasized. In some cases, more extensive surgery is necessary with other treatments, such as radiation or chemotherapy, or if the tumor is inoperable or surgery is contraindicated due to the patient's general health. All cancer patients at MSKCC are offered compassionate and personalized care from their experts. Specialists who are experienced in surgery, chemotherapy, radiation therapy, rehabilitation, and maintaining the quality of life will work closely to come up with a customized treatment plan to ensure the best outcome possible. Patients can also benefit from new chemotherapy drugs and other therapies through thousands of ongoing clinical trials at MSKCC.

Pancreatic Cancer

What Is Pancreatic Cancer?

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Pancreatic cancer originates in the cells of the pancreas, the small gland located in the abdomen behind the stomach. Our pancreas releases digestive enzymes and produces hormones that regulate blood sugar levels. Both cancerous and noncancerous tumors can occur in the pancreas. As pancreatic cancer does not cause symptoms unless it spreads to other organs, it is rarely detected at the early stages when it is most curable.

What Are the Types of Pancreatic Cancer?

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  • Exocrine Pancreatic Cancer - The glands that produce enzymes that aid in digestion are called exocrine glands, and the tumors that develop from these glands are called exocrine pancreatic cancer. The common subtypes include:
    • Adenocarcinomas.
    • Adenosquamous carcinomas.
    • Acinar cell carcinoma.
    • Ampullary cancer.
    • Giant cell carcinomas.
  • Endocrine Pancreatic Cancer - The islets of Langerhans (glands formed by clusters of cells) release the insulin and glucagon hormones and are called endocrine glands. Endocrine pancreatic cancer develops from these endocrine glands. The common subtypes include:
    • Insulinomas.
    • Glucagonomas.
    • VIPomas.
    • Gastrinomas.
    • Somatostatinomas.

What Are the Treatment Options for Pancreatic Cancer?

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If you have been diagnosed with pancreatic cancer, the doctor will then perform various tests to identify if cancer has spread through a PET scan. Depending on the results, cancer will be staged, and the treatment plan will be formed. All cancer patients at MSKCC are offered compassionate and personalized care from their experts. MSKCC's pancreatic cancer team is one of the US's largest and busiest clinical and research practices. Specialists experienced in surgery, chemotherapy, radiation therapy, rehabilitation, and maintaining the quality of life will work closely to develop a customized treatment plan to ensure the best outcome possible. MSKCC surgeons perform almost 300 pancreatic cancer surgeries (traditional as well as minimally invasive) every year. Patients also benefit from new chemotherapy drugs and other therapies through thousands of ongoing clinical trials at MSKCC.

MSKCC’s Surgeons and Experts

  • Eileen M. O'Reilly, MD
    Eileen M. O'Reilly, MD Clinical Expertise: Pancreatic Cancer; Gallbladder Cancer; Bile Duct Cancer; Primary Liver Cancer; Gastrointestinal Neuroendocrine Cancers
  • Wungki Park, MD
    Wungki Park, MD Clinical Expertise: Pancreatic Cancer; Bile Duct Cancers/Cholangiocarcinoma; Gall Bladder Cancers; Developmental Therapeutics; Immunotherapy; Early-Phase Clinical Trials
  • Ghassan K. Abou-Alfa, MD
    Ghassan K. Abou-Alfa, MD Clinical Expertise: Gastrointestinal Oncology; Pancreas, Gallbladder, and Bile Duct Tumors; Primary Liver Cancer
  • James J. Harding, MD
    James J. Harding, MD Clinical Expertise: Gastrointestinal Cancers; Liver Cancer (Hepatocellular Carcinoma); Bile Duct Cancers (Cholangiocarcinoma); Gallbladder Cancers; Fibrolamellar Carcinoma; Early Drug Development; Immunotherapy
  • William R. Jarnagin, MD, FACS
    William R. Jarnagin, MD, FACS Clinical Expertise: General Surgical Oncology; Benign and Malignant Disease of the Liver, Bile Ducts and Gallbladder; Pancreatic Cancer