Symptoms and diagnosis of liver cancer

Cholangiocarcinoma is often diagnosed at an advanced stage, since the symptoms are not specific. This affects the prognosis since the cancer is discovered too late and is then non-operable. 

Symptoms appear when the tumor compresses the bile ducts, and the patient experiences jaundice due to the fact that the bile cannot drain properly. 

Institut Curie closely collaborates with the Ambroise Pare Hospital in Boulogne-Billancourt. Together, the two organizations have set up a day unit called OnCare, which specializes in the diagnosis and the start of comprehensive care for patients suspected of having liver cancer or another digestive cancer. OnCare makes it possible for patients to see all the necessary practitioners on the same day in order to streamline the routine tests and consultations that must be carried out. On that day, patients receive an initial assessment, which aims to confirm the presence of cancer and its location, and an extension assessment, which determines how far the cancer has spread. 

The standard test for suspected cholangiocarcinoma is a CT scan. If the disease is intrahepatic, a liver biopsy is also performed. If it is extrahepatic, an echo-endoscopy (endoscopic ultrasound), capable of detecting hepatobiliary abnormalities, is preferred. Patients with metastatic cancer will undergo an additional liver biopsy, as well as an MRI of the liver or a CT scan if it has not yet been performed. Older people can take advantage of an oncogeriatrics consultation. A meeting with a nutritionist doctor is also included. Thus, at the end of the day, the patients leave the unit with a detailed report and a personalized care plan.