Appointment sheet
Cystic duct carcinoma
Prepared with OnCo (onco.cc/prep/cystic-duct-carcinoma/). Orientation, not medical advice; your team knows your case.
My details
Name
Date of appointment
Hospital and clinician
Who is coming with me
What I know, what is unclear, changes to discuss
Saved in this browserWhat I know so far
What is unclear to me
Changes since last time
My questions
9 on the sheetNewly diagnosed
- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example Extent: confined to the duct or beyond it, T category by the gallbladder scheme, Bile duct margin status, Bile cytology in remnant duct cancer), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
Resectable disease
- 5.For my situation (resectable disease), which of the standard options do you recommend and why?
Advanced disease
- 6.For my situation (advanced disease), which of the standard options do you recommend and why?
- 7.Am I a candidate for Gemcitabine + cisplatin, Durvalumab, Pembrolizumab, and what side effects should I expect?
Any stage
- 8.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 9.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
The words I may hear
- Intrahepatic, perihilar, distal and gallbladder cancer: Bile duct cancers are named by where they start: inside the liver, at the hilum where the ducts join, in the lower duct near the pancreas, or in the gallbladder.
- Cystic duct margin: The cut end of the short duct that joined the gallbladder to the main bile duct, examined by the pathologist after a gallbladder is removed.
- Radical (extended) cholecystectomy: The cancer operation for gallbladder cancer: the gallbladder (if still present) is removed together with a rim of the liver it sits against and the lymph nodes along the bile duct and liver blood vessels.
- Obstructive jaundice and biliary obstruction: Yellowing of the skin and eyes because a tumour blocks the bile duct, most often pancreatic or bile duct cancer.
- Lymphadenectomy (lymph node dissection): Surgically removing the lymph nodes that drain a tumour, both to stage the cancer and to clear any spread.
Tests and results to bring
Biomarker results to ask for: Extent: confined to the duct or beyond it, T category by the gallbladder scheme, Bile duct margin status, Bile cytology in remnant duct cancer.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Resectable disease: Extrahepatic bile duct resection with regional lymphadenectomy, with cholecystectomy and liver bed resection as for radical cholecystectomy when the gallbladder is still present. (Radical (extended) cholecystectomy, Lymphadenectomy (lymph node dissection), Cystic duct margin, Biliary stenting and drainage)
- Advanced disease: As for biliary tract cancer. (Gemcitabine + cisplatin, Durvalumab, Pembrolizumab)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.
Answers and next steps
Saved in this browserWhat I was told
Agreed next steps, dates and who to call