Bile duct cancer (cholangiocarcinoma) is a rare but aggressive type of cancer.

The bile duct system, or "biliary" system, is made up of a series of tubes that begin in the liver and end in the small intestine. Bile is a fluid the digestive system uses to help break down fats and digest foods.


Symptoms of bile duct cancer

In most cases, there are no signs of bile duct cancer until it reaches the later stages, when symptoms can include:

jaundice – yellowing of the skin and the whites of the eyes

unintentional weight loss

abdominal pain

See your GP if you have signs of jaundice or are worried about other symptoms. While it is unlikely you have bile duct cancer, it is best to get it checked.


Why does bile duct cancer happen?

The exact cause of bile duct cancer is unknown. However, some things may increase your chances of developing the condition. The most common include being over 65 years old or having a rare chronic liver disease called primary sclerosing cholangitis (PSC).


Types of bile duct cancer

There are two main types of bile duct cancer, depending on where the cancer begins:

cancer that starts in a part of the bile duct inside the liver is known as intrahepatic bile duct cancer

cancer that starts in part of the bile duct outside the liver is known as extrahepatic bile duct cancer



Cancer of the bile duct can be difficult to diagnose, so you may need several tests, including: 

blood tests

ultrasound scans

computerised tomography (CT) scans

magnetic resonance imaging (MRI) scans

For some of these tests, you may need to be injected with a special dye that highlights your bile ducts.

You may also need a biopsy. This involves removing a small sample of tissue so it can be studied under a microscope. However, in some cases, your surgeon may prefer to remove the suspected tumour based on the results of your scans alone.


How is bile duct cancer treated?

Cancer of the bile duct can usually only be cured if cancerous cells haven't spread. If this is the case, some or all of the bile duct may be removed.

Only a small proportion of bile duct cancer cases are diagnosed early enough to be suitable for surgery. This is because symptoms usually develop at a late stage.

Despite this, treatment such as chemotherapy can relieve the symptoms of bile duct cancer and improve the quality of life of people in the advanced stages of the condition.


Who is affected?

Less than 2,000 people are diagnosed with bile duct cancer each year in Great Britain.

However, studies suggest that cases of bile duct cancer are increasing in most countries. The reasons for this are unknown.

Most cases of bile duct cancer occur in people over the age of 65. The condition affects men and women almost equally.


Can bile duct cancer be prevented?

There are no guaranteed ways to avoid getting bile duct cancer, but you can reduce your chances of developing it.

The most effective ways of achieving this are reducing your alcohol intake, as cirrhosis is a risk factor, and trying to ensure that you don't become infected with hepatitis B or hepatitis C.



Symptoms of bile duct cancer 

Bile duct cancer doesn't usually cause any symptoms until the flow of bile from the liver is blocked.

In most cases, the condition is at an advanced stage by this time.

The blockage will cause bile to move back into the blood and body tissue, resulting in symptoms such as:

jaundice – yellowing of the skin and whites of the eyes, itchy skin, pale stools (faeces) and dark-coloured urine

unintentional weight loss

abdominal pain – most people feel a dull ache in the upper right hand side of their abdomen (stomach)

high temperature (fever) of 38C (100.4F) or above and shivering

loss of appetite


When to seek medical advice

Always visit your GP if you have jaundice. While jaundice is unlikely to be caused by bile duct cancer, it could indicate an underlying problem with the liver, such as hepatitis.