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It can be difficult to diagnose bile duct cancer. You may need to have several different tests.

Some of these tests are described below.

Blood tests

In bile duct cancer, the cancerous cells may release certain chemicals that can be detected using blood tests. These are known as tumour markers.

But tumour markers can also be caused by other conditions, so this test cannot be used to tell for certain whether or not you have bile duct cancer.


Several types of scan can be used to examine your bile ducts in detail and check for lumps or other abnormalities that could be the result of cancer.

These include:

ERCP test

Endoscopic retrograde cholangiopancreatography (ERCP) allows your bile ducts to be seen clearly on an X-ray.  

During the test:

You'll be awake while the test is done. However, you'll usually be given an injection of a sedative medicine to make you very sleepy, and your throat will be numbed with local anaesthetic spray.

PTC test

Percutaneous transhepatic cholangiography (PTC) may also be used to get a detailed image of your bile ducts.

During the test:

You'll be awake while this is done. However, you'll usually be given a sedative medicine to make you sleepy, and local anaesthetic to numb the area where the needle is inserted.

Stages of bile duct cancer

If you're diagnosed with bile duct cancer, it will be possible to give your cancer a "stage". This is a number that indicates how far the cancer has spread.

Doctors use the TNM system to stage bile duct cancer, which consists of 3 factors:

The doctor will give each factor a number based on how much the cancer has grown or spread. For example, "T3 N1 M1" would describe a large cancer that has spread into lymph nodes and into another part of the body.

Knowing the stage of your cancer will help your doctors decide on the best treatment for you.

Cancer Research UK has more detailed information about the stages of bile duct cancer.