Virgilio Lorenzo Jr

Health workers at the Dr. Jose Fabella Memorial Hospital in Manila work through the long weekend on October 31, 2023. Mark Demayo, ABS-CBN News

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<div><span class="fr-img-caption fr-fic fr-dib" style="width:608px"><span class="fr-img-wrap"><img src="https://od2-image-api.abs-cbn.com/prod/editorImage/17396793925021000020928.webp" class="fr-fic fr-dib" style="width:608px"/><span class="fr-inner">Health workers at the Dr. Jose Fabella Memorial Hospital in Manila work through the long weekend on October 31, 2023. Mark Demayo, ABS-CBN News</span></span></span></div><p>February is National Cancer Awareness Month, a time to amplify discussions on lesser- known but equally devastating malignancies, such as biliary cancers, which include cholangiocarcinoma (bile duct cancer) and gallbladder cancer.</p><p>These cancers remain among the most challenging to diagnose and treat, yet their burden is growing in the Philippines and worldwide.</p><p>February 20 also marks World Cholangiocarcinoma Day, an opportunity to increase awareness of this rare but aggressive cancer.</p><p>Despite advances in medicine, biliary tract cancers often present late, leading to poor prognoses. As super specialists in Hepato- Pancreato-Biliary (HPB) surgery, we must push for better early detection, multidisciplinary management, and improved access to life-saving treatments.</p><div><strong>The Silent Threat: Why Biliary Cancers Are Difficult to Diagnose</strong></div><p>Biliary cancers are often termed &quot;silent killers&quot; because early symptoms are either mild, vague, or nonexistent.</p><p>Jaundice (yellowing of the skin and eyes), unexplained weight loss, abdominal pain, and changes in liver function tests often appear only in advanced stages. By then, the disease has usually spread, making curative treatment difficult.</p><div><a href="https://www.abs-cbn.com/news/health-science/2025/2/4/air-pollution-fuels-lung-cancer-among-non-smokers-study-1710">Air pollution fuels lung cancer among non-smokers: study</a></div><p>Several factors contribute to this late diagnosis:</p><p>1) Lack of early warning signs: Unlike colorectal or breast cancer, biliary cancers lack routine screening methods.</p><p>2) Overlapping symptoms with other diseases: Gallstones, hepatitis, or other liver conditions can mimic early biliary cancer symptoms.</p><p>3) Limited diagnostic tools: Imaging (such as MRI and CT scans) and blood markers (like CA 19-9) help, but no single test definitively confirms the disease.</p><p>A biopsy is often needed for diagnosis, but obtaining tissue from deep-seated bile ducts or the gallbladder is technically difficult and challenging.</p><div><strong>Surgical Challenges in Biliary Cancers</strong></div><p>Surgery for cholangiocarcinoma and gallbladder cancer offers the best chance for cure and long term survival. It is among the most complex in HPB surgery, often requiring:</p><p>1) Major liver resections for intrahepatic or perihilar cholangiocarcinoma.</p><p>2) Radical bile duct resections with lymphadenectomy.</p><p>3) Multivisceral resections when adjacent organs are involved.</p><p>Robotic and minimally invasive techniques, which may help in selected cases require highly specialized expertise. Even with successful surgery, recurrence rates are high, necessitating adjuvant chemotherapy or radiotherapy.</p><div><a href="https://www.abs-cbn.com/lifestyle/health-wellness/2024/6/30/surgical-site-infection-prevention-1649">Surgical Site Infection prevention: Top 5 things to remember before you go under the knife</a></div><div><strong>Complexity in Treatment: The Role of Multidisciplinary Care</strong></div><p>The cornerstone of biliary cancer treatment is surgery, offering the best chance of cure—but only if diagnosed early. Unfortunately, most cases present at unresectable stages, requiring a combination of therapies. This is the reason why a multidisciplinary approach is necessary to increase the chance of survival.</p><p>The Need for Multidisciplinary and Personalized Approaches</p><p>Given the aggressive nature of biliary cancers, treatment requires a multidisciplinary team, including: </p><p>✔ HPB surgeons </p><p>✔ Medical oncologists </p><p>✔ Radiation oncologists </p><p>✔ Gastroenterologists </p><p>✔ Interventional radiologists </p><p>✔ Pathologists</p><p>Emerging treatments such as targeted therapy and immunotherapy are offering new hope, but access to these treatments remains a challenge in many parts of the Philippines. Clinical trials and research collaborations are needed to improve outcomes.</p><div><strong>Raising Awareness, Improving Outcomes</strong></div><p>As we observe National Cancer Awareness Month and World Cholangiocarcinoma Day on February 20, let’s push for:</p><p>1) Increased awareness among physicians and the public to recognize early symptoms.</p><p>2) Better access to diagnostics, including high-resolution imaging and molecular testing. 3) Advocacy for comprehensive cancer care, ensuring that Filipino patients have access to timely, multidisciplinary treatment.</p><p>4) Stronger research efforts to explore genetic and environmental risk factors unique to the Filipino population.</p><p>Biliary cancers may be rare, but their impact on patients and families is devastating. As the Philippine College of Surgeons call for Quality Surgery for All, we, at the Philippine Association of HPB Surgeons stand together with PCS advocating for early detection, exquisite surgical techniques, multidisciplinary approach and better treatment access to give our patients the best possible chance in survival.</p><p>This February, let’s spread the message: Biliary cancer is real, and early detection saves lives. </p><div><em>--</em></div><div><em>Established in September 1936, the Philippine College of Surgeons is the country&#x27;s premier organization of surgical professionals.</em></div>

<p>February is National Cancer Awareness Month, a time to amplify discussions on lesser- known but equally devastating malignancies, such as biliary cancers, which include cholangiocarcinoma (bile duct cancer) and gallbladder cancer.</p>

February is National Cancer Awareness Month, a time to amplify discussions on lesser- known but equally devastating malignancies, such as biliary cancers, which include cholangiocarcinoma (bile duct cancer) and gallbladder cancer.

Shining a Light on Biliary Cancers: The challenge of cholangiocarcinoma and gallbladder cancer

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Shining a Light on Biliary Cancers: The challenge of cholangiocarcinoma and gallbladder cancer

ABS-CBN News,

Catherine SC Teh,

MD,

MSc,

FPCS,

FRCSEd,

(Hon)FACS,

G.CIEHF

Published February 16, 2025 12:19 PM PHT

Read More:

Philippine College of Surgeons

Cancer

Cholangiocarcinoma

Gallbladder cancer

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