Advancing Care for Hepato-pancreato-biliary (HPB) Cancers

Liver Cancer

Liver cancer can originate from the liver (primary cancer) or start in another organ, commonly the colon, rectum, pancreas, or breast, and spread to the liver (secondary cancers or liver metastases).

Liver cancer can affect people of any age. In the early stages, it often has no symptoms. Only when the cancer has advanced, the following symptoms may be noticed:

• Jaundice (yellowing of the skin and eyes)
• Itching (anywhere)
• Dark-colored urine
• A lump below the rib cage
• Bloating
• Nausea
• Pain in the abdomen (right side) and/or near the right shoulder
• Tiredness
• Unexplained weight loss or loss of appetite

Usually, the cause of liver cancer is not known, but diseases such as hepatitis and cirrhosis of the liver can cause liver cancer.

Learn more about our Liver Cancer Program here.

Pancreatic Cancer

Our pancreas is a small gland that helps us to digest food and regulates our blood sugar levels by producing insulin and glucagon. Most pancreatic cancers are caused by tumors which begin in the ducts of the pancreas (called adenocarcinoma).

Unfortunately, pancreatic cancer often has no symptoms until it has advanced. As it progresses, symptoms of pancreas cancer may include:

• Jaundice (yellowing of the skin)
• Itchy skin
• Dark urine
• Weight loss
• Lighter feces
• Loss of appetite
• Nausea/vomiting
• New or worsening diabetes
• Pale colored or light-colored feces
• Tiredness
• Blood clots in the body Certain risk factors may increase the risk of developing pancreatic cancer:
• Being male
• Being over 45
• Chronic pancreatitis and hereditary chronic pancreatitis
• Exposure to certain chemicals
• Having diabetes, especially type 2 diabetes
• Obesity
• Smoking

Learn more about our Pancreatic and Biliary Cancer Program here.

Biliary Cancers

Biliary cancers are rare diseases, with different types being named after where the cancer has formed. Bile duct cancer (also call cholangiocarcinoma) begins in either the bile ducts inside the liver (called intrahepatic) or in the bile ducts outside the liver (called extrahepatic). Gall bladder cancer begins in the walls of the gallbladder.

Risk factors for bile duct and gallbladder cancer include:

• Being between the ages of 50 and 70
• Family history of certain genetic disorders, including Lynch syndrome
• Living with any of the following conditions:
• Primary sclerosing cholangitis
• Chronic liver diseases (including cirrhosis, bile duct stones, cholangitis)
• Hepatitis B or C
• Inflammatory bowel diseases (IBD) such as Crohn’s disease and ulcerative colitis
• Smoking

Learn more about our Pancreatic and Biliary Cancer Program here.

Advanced diagnostics and treatment

Important technological advancements in the diagnosis of HPB cancer mean that these complex diseases are being diagnosed earlier. Advanced diagnostic tools include:

• Advanced imaging techniques: MRI with MRCP (magnetic resonance cholangiopancreatography) offers detailed images of even the smallest tumors, whilst sophisticated software also provides important information about organ function and allows for surgical simulation.
• Combined PET-CT scans: Provide precise localization of cancerous lesions, crucial for staging and treatment planning and avoiding unnecessary surgical intervention.
• Liquid biopsy techniques: Can identify cancer signatures without the need for tissue biopsies.
• Endoscopic techniques: Combined with imaging modalities, can guide biopsy accurately and provide high quality images.
• Molecular and genomic testing: Enabling more personalized treatment approaches by identifying specific genetic mutations associated with HPB cancers.

Learn more about innovation in the diagnosis and treatment of HPB cancers here.

Advanced treatment options are supporting better outcomes for patients with HPB cancers. Being treated at a center that provides a comprehensive range of treatment options is key to successfully treating the disease. These include complex surgery options, which can be curative in early-stage cancers.

Surgery may be combined with targeted chemotherapy, advanced radiotherapy techniques and innovative immunotherapy options, depending on the cancer stage and type.

Read more about surgical treatment options for HPB cancers here.

Expert Team

Our Gastrointestinal Cancer team offers a comprehensive and holistic approach to HPB cancer care. The multidisciplinary team creates tailored, patient-centered treatment plans for every patient, to ensure the best possible outcomes.

Led by an expert team of HPB surgeons, the diverse team includes biliary and pancreatic, colorectal surgeons, hepatologists, gastroenterologists, medical and radiation oncologists, intensivists, specialized pathologists and radiologists, genetic counselor and dedicated nursing and support staff.

Learn more