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Wednesday, October 03, 2012

Cancer of the liver bile ducts in Japan

 肝内胆管がん

"Bile" is more than a fierce emotion or a staple of demon possession horror movies. It is a substance, produced by the liver and further concentrated by the gallbladder, that is secreted into the intestine to digest what we've eaten, especially the fat.

Bile duct


Bile ducts are tubes that branch tree-like through the liver and the gallbladder. The branches of the ducts in both organs lead to their own "trunk." Both trunks then join in what is called the common bile duct, joined a little further on in the ampulla (or papilla) of Vater by a third duct, the main pancreatic duct, to feed their much maligned fluid to the duodenum, i.e. the first section of the small intestine into which the stomach directly feeds its masticated contents.

Cancer of the intrahepatic bile ducts, i.e. the bile ducts in the liver, also known by its scientific name of cholangiocarcinoma, is a rare cancer in most countries, except in Japan, Chile and Northern India where it occurs more frequently. Liver bile duct cancer is more common in people aged 65 or over. It is a cancer that develops inside the bile ducts, thus blocking them.

Liver bile duct cancer is slow-growing, but is usually advanced by the time it's discovered. Its blocking of bile ducts gives rise to a number of different symptoms, including jaundice, fever, loss of appetite, loss of weight, abdominal pain, chills, fever, and very light colored stool.

Because discovery is difficult and usually delayed, treatment often results in removal of the whole liver and a liver transplant.

There has been the story in the Japanese news for the past year or so, that has been getting increased coverage over the past month, of workers at printing factories in Japan dying from liver bile duct cancer. It first came to light at an Osaka printing factory, but over 60 other cases have been discovered since then throughout Japan. In fact, printing workers in Japan have been found to be 2,900 times more likely to die from bile duct cancer than the average Japanese.

Bile duct cancer is therefore a focus of research in Japan, and scientists at Kyushu University just announced a breakthough in their understanding of it. Their research found that liver bile duct cancer starts not with bile duct cells, as was first thought, but with liver cells, which somehow trigger cancer in the bile ducts.

Hopefully this discovery will help further improve the health of aging Japan, and lead to treatments that patients throughout the world can benefit from.

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