Bile duct cancer (also known as cholangiocarcinoma) is caused by an abnormal and uncontrolled growth of cells in your bile duct.
Bile is a digestive fluid that helps to break down fats. It's made by your liver and stored in your gallbladder. Bile passes from your gallbladder into your small bowel to help break down fatty food when you eat. Bile ducts are tubes that connect your liver and gallbladder to your small bowel.
Bile duct cancer almost always starts in a type of tissue called glandular tissue and is therefore known as an adenocarcinoma. Bile duct cancer is rare; about 1,000 people are diagnosed with it each year in the UK.
There are different types of bile duct cancer depending on where it originates.
This factsheet is about extrahepatic bile duct cancer. Intrahepatic bile duct cancer is treated the same way as liver cancer.
Symptoms of bile duct cancer include:
These symptoms might be caused by something else other than bile duct cancer. But if you have any of them, contact your GP.
The exact reasons why you may develop bile duct cancer aren't fully understood at present. However, there are certain factors that can increase your chances of getting it, which include the following.
There are other things that may increase your chance of getting bile duct cancer, but doctors are less certain of these. They include having conditions like diabetes, cirrhosis (scarring of the liver), hepatitis B, hepatitis C and fatty liver disease. Smoking tobacco, drinking alcohol, being obese, and being exposed to poisons such as dioxins, nitrosamines and vinyl chloride may also increase your risk.
Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history. Your GP may refer you to an oncologist (a doctor who specialises in cancer care).
You may have the following tests to confirm your diagnosis.
If you're found to have cancer, you may need to have other tests to check if the cancer has spread. The process of finding out the stage of a cancer is called staging. The following tests may be used to diagnose bile duct cancer or to check if the cancer has spread.
The main treatment for bile duct cancer is surgery. It’s the only way bile duct cancer can be potentially cured. Other options include procedures to help your symptoms and chemotherapy and radiotherapy. Your treatment will depend on the position and size of the cancer in your bile duct, how far it has spread, and your general health. Your doctor will discuss your treatment options with you.
Surgery can remove the cancer if it hasn't spread beyond your bile duct. This option isn't always suitable as the bile duct is in an awkward position and it may not be possible to remove all of the cancer.
There are a number of options for surgery.
Some surgical procedures can’t cure you but can help with some of your symptoms.
Non-surgical treatments will aim to improve your symptoms and your quality of life. They may include the following.
A less common treatment is photodynamic therapy. This uses a light-sensitive medicine and a laser to destroy cancer cells. Your doctor will inject the medicine into a vein. This will get absorbed by cells around your body – the medicine will enter more cancer cells than healthy cells. He or she will then pass a laser over the cells to activate the drug, which will then destroy the cells.
However, there’s some uncertainty and conflicting evidence about how safe and effective this treatment is. More research is being done but results have yet to be published. If you’re interested in it, talk to your doctor about what it involves and whether it’s the right option for you.
You can take part in clinical trials as new treatments constantly become available and need to be assessed. Speak to your doctor for more information about them.
After treatment for cancer, you will have regular check-ups with your doctor to see if there is any evidence that the cancer has returned. If the cancer has already spread, you will regularly see doctors or specialist nurses to have treatment for any symptoms you might have.
Being diagnosed with cancer can be distressing for you and your family. An important part of cancer treatment is having support to deal with the emotional aspects as well as the physical symptoms. Specialist cancer doctors and nurses are experts in providing the support you need, and may also visit you at home. If you have more advanced cancer, further support is available to you in hospices or at home, and this is called palliative care.
Reviewed by Natalie Heaton, Bupa Health Information Team, May 2014.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.
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