Topic: H. Pylori as a cause of bile duct cancer....has anyone researched this

I have none of the "usual and known" definite risk factors for CC.  And, being someone who wants to know the hows and whys, I've been looking into what could have caused this other than a purely random event  I don't think any of the CC is purely random.  My surgeon is doing research on the underlying cause of Bile duct cancer ...the basis of which she believes is mostly from inflammation from whatever source.  That said...what is the source?  In some cases, like cirrhosis of the liver or hepatitis B and C...the connection is pretty strong. But what about us for whom there is no strong risk factor.

In my case, I had C-Diff early 2013 that was treated with three separate antibiotic rounds, two of which were vancamiacin, an antibiotic which is a controlled drug, since it's the current super-dug kept in reserve for only the most drug resistant bacterial infections.  But, after the treatments, a diarrhea continued...not as bad as the C-Dff....but none-the-less, it was a cause of concern.  I also had a colonoscopy, (almost due anyway) to look for another cause of the continued diarrhea and to take some colon biopsies of the lining to look for C-Diff.  There was nothing in the colon and biopsies showed the C-Diff was gone.

My little grandson, who I babysat, kept giving me upper resp. infections, and for one on Oct 3 last year, I went to the doctor and she gave me a Z-Pack for bad bronchitis.  On day 5 of the Z-pack, the diarrhea went away and stayed gone for two months, when it returned over 4-6 days in early December.  I was tested again for C-Diff the end of Dec, and it was still negative. 

Then, in late Jan 2014, the grandson again gave me another upper resp. infection that cause me to immediately get pneumonia.  Again my doctor gave me a Z-pack...and again, the diarrhea went away on day 5 of the same antibiotic.    However, at the initial appt, my doctor asked how the diarrhea was...if it was gone....and when I said no, she thought and then said she wanted to get a CT scan of my pelvic organs.  That was done the following day and is when the tumor in my liver was found,.

The diarreha had no returned a month later when I A=had the resection on Feb 28th to renove a good hunk of the left liver node and the diarrhea has not returned since. 

I immediately began questioning whether there was some connection between the diarrhea....the Z-pack making it go away....and the bile duct cancer.  But, all doctors said it didn't seem likely....that it was a fluke.

When I met with my oncologist here locally last week, I presented this to him.  He thought for a minute and mumbled something about H. Pylori, but then discounted it.  It was hard to understand his accent, so I didn't pursue the conversation.

BUT...of course, being someone who is curious and a researching kind of gal, I got on the web...put some search parameters into Google for H. Pylori and Bile Duct Cancer...and darned if it didn't pop up with a number of hits. 

H, Pylori, a bacteria , is normally found in the stomach and is known for causing ulcers and eventually sometimes, stomach cancer.  It is thought not to be able to survive the environment of the bile fluid so it shouldn't be there.  However, studies of bile duct cancer patients have shown that it does indeed manage to move into the bile ducts.  Since it's a bacteria....which can develop into an infection and thus inflammation.....the potential is there for being a cause of bile duct cancer. 

And....a further search for H.Pylori and Z-pack, showed that the active antibiotic in the Z-pack is something used in the treatment of H. Pylori....(which is probably why my oncologist mentioned H. PYlori).  However it usually takes more than one back to back round of the antibiotic to kill it off....and sometimes along with a couple other drugs.  Of course, like a lot of bacteria...it's getting resistant to antibiotics and has become harder to kill, 


So why did the H Pylori cause diarrhea?.....when it isn't one of it's usual symptom.....????....because I'm speculating that once the H. Pylori got into the bile ducts....it then went into the colon where it can cause diarrhea. 

So, my theory is now...that H. Pylori was allowed to proliferate following either the antibiotic that caused the C-Diff...or the antibiotics that were used to treat it.....and that it settled only in the left node of the liver, where my tumors grew...one 5.3 cm and one pea sized small one.  I further speculate that when the surgeon did the resection, she cut away enough of the node with the tumors with an unusually large 2.2 clean margin, that she in effect, cut away the liver/bile duct cells that had been damaged by the H. Pylori that allowed the cancer to start.  And that is why the diarrhea has not returned...because there is no H. Pylori in the bile ducts to feed into the colon. 

Thus, I believe that unless the bigger tumor seeded, I will not see a return of the CC.  I had a huge clean margin, no lymph node mets or mets anywhere, no neural or vascular invasion identified.  I'm starting chemo next week, just in case the big tumor had seeded and there are microscopic cells lurking and the chemo can hopefully kill them off.   

So, the bigger question, past my own case.....is if this is the underlying cause of a lot of CC without obvious risk factors?  I read another article that talked about a counter in Honduras, where a region had 35% of the population with gastric cancer of some sort...and most all were under the age of 50.  From what I could gather, the only common denominator that could be found was that there was an extremely high incidence of H. PYlori in the group.

I ran this by my GP.....and amazingly enough, she didn't discount the idea and when I asked if we could do an H. Pylori test, she agreed to have one run today.  It may show up positive even if the infection is no longer there.....or it may show up negative even though there IS still an infection.  The blood test isn't very accurate, but the breath and poo tests available, aren't available here locally. 
But, nonetheless, if it comes back positive, I am going to ask to be treated as long as it doesn't interfere with the chemo.  If my hunch is right about an infection settling in just the left liver node, I don't want to risk it doing it again in the right node and going through this all over again.

I was going to present this to my Mayo doctor at my next visit...but that could be 3 months from now.  Instead, I am considering writing a letter to both him and the surgeon doing the research on CC and inflammation, so that it can cut down on the clinic time during my next visit. 

Any thoughts anybody? 

Wish I was a lotto winner to fund some research on this.  It wouldn't probably be a factor to cure anybody,  but it certainly might be a factor in stepping up screening for H. PYlori to treat that problem and possibly prevent some cases. 

Anyway, it's speculation and theory, but in my case, it seems to make sense to explain the unexplained diarrhea most of last year which went away twice with the same antibiotic on the same day of treatment.   Even if my H. Pylori test comes back negative, it may just mean that the last antibiotic actually did kill it off finally. 

If anyone else has heard of this possibility, let me know.

Julie T.

"Just for today, I can get through anything."  Hey....I'm a cancer survivor, not a doctor.  The opinions I state are my own, based on my personal experiences or knowledge.  As always, talk to your doctor about your concerns and treatment.

Re: H. Pylori as a cause of bile duct cancer....has anyone researched this

Julie, did you use our Search engine at the top as I believe there are a few posts on H. Pylori. I had my own rare stomach Cancer called a GIST tumor and had surgery in Teddy's last year. They did an H. Pylori test and a C-Diff and I had neither. To the best of my memory only one thing has been close to being proven where CC is concerned and that is a Parasite called Liver Flukes most common in Asia and found in fish. I am sure that is what caused Teddy's CC as he served in Korea and being Sicilian he would eat any fish. You can Google it....extremely interesting.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: H. Pylori as a cause of bile duct cancer....has anyone researched this

Lainy,  Thanks for reminding me about the search function on here.  I didn't think of looking in any of the posts.  The deal with H. Pylori, is that it does sometimes lodge in the liver and there, as an infection, it would cause inflammation and inflammation eventually causes cellular damage to the lining of the bile ducts.  My GP told me that while the blood test can show positive even after H. Pylori is killed off....the blood test also has false negatives...a pretty good percentage.  There is a breath test and poo test which are more accurate...but not available here and she thinks maybe only in a "study" situation.  I haven't looked further into that do to all the other stuff going on. 
I'll check out what the search function pops up.  Thanks again......

Julie T.

"Just for today, I can get through anything."  Hey....I'm a cancer survivor, not a doctor.  The opinions I state are my own, based on my personal experiences or knowledge.  As always, talk to your doctor about your concerns and treatment.

Re: H. Pylori as a cause of bile duct cancer....has anyone researched this

To anyone interested.....I presented my theory concerning H. Pylori causing bile duct cancer (specifically my cancer which was intrahepatic) to my GP when I went to see her last Thursday for an incision check (they aren't healed yet, but greatly improved and closing slowly (at least slowly to me).  She said she really didn't have the expertise to hazard a guess even, but she could offer an H. Pylori blood test if I wanted to do one.  I DID!!! ...of course.  We did it the next day while I was in the hospital having the chemo port installed.

Tonight, my GP called me about 7 p.m. .....and.....the test for H. Pylori was positive!!!  The missing link of my theory was found in my opinion.  I realize my speculations aren't exactly scientific method, and may not apply to many of the cases.  However, for those of us for whom who have no known risk factors for ICC, it seems reasonable enough to suspect H. Pylori may be the cause, esp since H. Pylori infection is so prevalent.

As soon as I am through with the antibiotic that the oncologist prescribed yesterday for whatever my infection is (probably under the skin in my shin) is done (7 days), then my GP wants me to start on a drug therapy of three antibiotics at the same time, which is necessary to knock out the H. Pylori.  I asked my GP if this gave any credence to my theory, and all she could say was that she couldn't comment to that....which is doctor speak for, "I have no way to prove that."  But either she was really humoring me big time by doing the H. Pylori test with no current symptoms, or she did think it made some sense.  Maybe it was a bit of both, concerning the ICC diagnosis and all I've gone through the past 3 months. 

Anyway, I'm taking this as positive .....though I"m not quite sure when having a diagnosed with a bacterial infection that is known to cause ulcer and stomach cancer is a good thing, but the good news is that it can be erradicated with antibiotics and if my theory is right, no more liver cells will be damaged by the H. Pylori infection and I won't see this grow again.    Oh....yeah....but I'm still doing the follow up chemo to kill off any possible stray CC cells that may be lurking in my system.  I'm delayed again with the chemo, but that's another story for another post.  For now, I have renewed faith that everything IS going to be okay.  I just must get through what I have to get through and hope that bigger tumor didn't already seed and if it did, that this chemo may knock them into the next solar system.

Julie T.

"Just for today, I can get through anything."  Hey....I'm a cancer survivor, not a doctor.  The opinions I state are my own, based on my personal experiences or knowledge.  As always, talk to your doctor about your concerns and treatment.

5 (edited by marions Tue, 29 Apr 2014 18:10:54)

Re: H. Pylori as a cause of bile duct cancer....has anyone researched this

Julie....interesting.  I have been told that about 50% of the population has this bacteria which can reach the epithelial cells via the mucus lining of the stomach.   We also know that Cholangiocarcinoma cells have the characteristics of epithelial differentiation.  Oh, and I wanted to add this link:
http://www.ncbi.nlm.nih.gov/pubmed/22321036
Hugs,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: H. Pylori as a cause of bile duct cancer....has anyone researched this

Marian....the oncologist did consent to ordering a "poo" test for H. Pylori for me.....so now we will find out (hopefully) if the infection is active.  If it is....then I'll be treated....and if not....then nothing.  Since I had antibodies in the blood test though....it is a certainty that I at least HAD H. Pylori sometime...and other than the Vancomyacin I was given for the C-diff...or it possibly being cut out by surgery.(at least in the liver)..nothing else I've taken for antibiotics could have gotten rid of it.  It's possible that the Vancamyacin killed off the H Pylori...but the damage was already done in the liver/bile ducts....but that doesn't explain the diarrhea that continued for 5 months until I took a Z-pack antibitoic that made it go away...if only for 2 months.  There are too many unanswered questions with this....and I just need to get someone...doctor type....to take it further.  I'm just hoping that the poo test will actually show if the H Pylori is still in my body....and that it isn't lurking in my gall bladder or somewhere that the test won't detect.  Sigh.

Julie T.

"Just for today, I can get through anything."  Hey....I'm a cancer survivor, not a doctor.  The opinions I state are my own, based on my personal experiences or knowledge.  As always, talk to your doctor about your concerns and treatment.

Re: H. Pylori as a cause of bile duct cancer....has anyone researched this

Hi Julie,
I also had H. Pylori several years before my diagnosis. I had the exact same pain, and thought it was my gall bladder. After many tests they finally said no, it wasn't my gall bladder but said I had an ulcer and treated me for H. Pylori. I thought I had another ulcer when the pain came back 5 years later. They were sure it was my gall bladder Again. I wonder if they were wrong the whole time....