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Bile duct cancer (cholangiocarcinoma)

Cancer of the bile duct (cholangiocarcinoma) is a rare type of cancer that mainly affects adults aged over 65.

Bile ducts are small tubes that connect the liver and small intestine. They allow fluid called bile to flow from the liver, through the pancreas, to the gut, where it helps with digestion. Cancer can affect any part of these ducts.

Bile duct cancer can sometimes be cured if it is found very early, but it's not usually found until a late stage, when a cure is not possible.

Symptoms of bile duct cancer

There are not usually any symptoms of bile duct cancer until it grows large enough to block the bile ducts.

This can cause:

  • yellowing of the skin and whites of the eyes (jaundice)
  • itchy skin
  • your poo to turn pale
  • darkening of your pee
  • loss of appetite and weight loss
  • persistent tiredness and feeling unwell
  • tummy (abdominal) pain and swelling – some people feel a dull ache in the upper right side of their abdomen
  • high temperature
  • chills and shivering

See your GP if you have persistent symptoms that you're worried about – particularly if you have jaundice. These symptoms can have several causes, so it's important to get a proper diagnosis.

Causes of bile duct cancer

The cause of bile duct cancer is unknown. Most happen without a known cause, although some things can increase your risk of getting it.

These include:

  • primary sclerosing cholangitis – a rare type of liver disease that causes long-term inflammation of the liver
  • bile duct abnormalities – such as cysts (fluid-filled sacs) in the bile ducts that are present from birth
  • biliary stones in the liver – hard stones, similar to gallstones, that form in the bile ducts
  • infection from a liver fluke parasite (a parasitic worm; usually only a problem in Asian countries)
  • exposure to certain chemicals and toxins, including thorotrast (a type of dye that used to be used in medical scans)

There may also be a link with long-term hepatitis B and hepatitis C infections, liver scarring (cirrhosis), diabetes, obesity, smoking and excessive alcohol consumption.

Tests for bile duct cancer

Several tests may be needed to help diagnose bile duct cancer. These will usually be done in hospital.

Tests you may have include: 

  • blood tests to check for signs of cancer or a problem with your liver
  • scans, such as an ultrasound scanCT scan or MRI scan
  • An X-ray where a special dye is injected into your bile ducts to make them easier to see
  • biopsy where a small sample of tissue is removed so it can be examined for signs of cancer

Find out more about how bile duct cancer is diagnosed.

Treatments for bile duct cancer

It's not usually possible to cure bile duct cancer because it's often diagnosed after it has already grown and spread.

But even if bile duct cancer is found at a late stage, treatment can help control the symptoms for months or possibly years.

The main treatments for bile duct cancer are:

  • surgery to remove the affected area – this is only suitable for a small number of people, but could get rid of the cancer completely
  • inserting a hollow tube (stent) into the bile duct to stop it becoming blocked – this can help relieve symptoms such as jaundice
  • chemotherapy – a medicine that stops cancer cells from growing and may relieve your symptoms
  • radiotherapy – where a beam of radiation is aimed at cancer cells to stop them from growing and to relieve your symptoms

Find out more about how bile duct cancer is treated.

Outlook for bile duct cancer

The outlook for bile duct cancer depends on which part of the bile duct is affected and how far the cancer has spread.

Even if it's possible to remove the cancer, there's a chance it could come back later. 

There are no UK-wide statistics for bile duct cancer, but it's estimated that:

  • around 30 out of 100 men will survive for 1 year or more after being diagnosed
  • 25 out of 100 women will survive for 1 year or more after being diagnosed
  • around 5 out of 100 men and women will survive for 5 years or more after being diagnosed

Cancer Research UK has more information about survival statistics for bile duct cancer.

Bile duct cancer support group

The AMMF (The Alan Morement Memorial Fund) is the main UK charity that provides support for people affected by bile duct cancer.