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  • Bile duct cancer

Introduction

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Bile duct cancer

Learn more about Bile duct cancer (cholangiocarcinoma); symptoms, causes, steps to diagnosis, and treatment options.

What is bile duct cancer?

What is bile duct cancer?

Bile duct cancer, also known as cholangiocarcinoma, is a type of cancer that develops in the bile ducts (tubes that transport bile from the liver).1,2

It is regarded as being a rare type of cancer.1,2  Bile ducts connect your liver to your gall bladder and your small intestine.

The primary function of the bile ducts is to transport bile from the liver and gallbladder to the small intestine, aiding in the digestion of fats in food.1

Bile duct cancer (cholangiocarcinoma) usually starts in any part of the bile duct system.3  There are three types of bile duct cancer, and each type is based on where the cancers first develop:1

  • Intrahepatic bile duct cancers
  • Perihilar (or hilar) bile duct cancers
  • Distal bile duct cancers

During the early stages of bile duct cancer there may not be any symptoms. Diagnosis usually occurs in the advanced stage of the cancer.4  Symptoms of bile duct cancer may include:1,4

  • Jaundice
  • General weakness
  • Nausea and vomiting
  • Unexplained weight loss and loss of appetite
  • Fever
  • Itchy skin
  • Pain in the abdomen
  • Darkened urine
  • Pale bowel movements

Having one of more of these symptoms does not mean you have bile duct cancer. It is a good idea to speak with your GP or specialist about any questions or concerns that you may have.

Factors that may increase your risk of developing bile duct cancer (cholangiocarcinoma) can include:1,3,4

  • Bile duct stones
  • Infection with the Hepatitis B or Hepatitis C virus
  • Infection with a liver fluke parasite
  • Pre-existing medical conditions, such as bowel disease, including for example, chronic ulcerative colitis or also liver disease, that may include primary sclerosing cholangitis
  • Biliary cysts
  • Exposure to certain chemicals

If you have one or more of these risk factors it doesn't mean that you have bile duct cancer. It is recommended to make an appointment with your GP or specialist to chat through any questions or concerns that you may have.

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Diagnosis

Diagnosing bile duct cancer

A range of tests may be performed to analyse symptoms, to diagnose bile duct cancer (cholangiocarcinoma), the type, and disease stage. Following a physical examination, further tests may include:1,3

  • Biopsy – where a tiny sample of tissue is taken for analysis
  • Blood tests - to test gallbladder and liver function, plus check for tumour markers
  • Imaging scans - may include X-ray, ultrasound,
    magnetic resonance imaging (MRI) scan, computed tomography (CT) scan, and magnetic resonance cholangiopancreatography (MRCP)
  • Endoscopic retrograde cholangiopancreatography (ERCP) - this test is a type of X-ray, that is used to create an image of the bile duct, which can help show if a tumour causes any blockages or abnormalities and if necessary, take a sample of bile duct tissue or insert a small tube (called a stent) to open up the ducts.
  • Percutaneous transhepatic cholangiography (PTC) - this is a type of X-ray, and like an ERCP the test is used to help create an image of the bile duct to test for abnormalities or blockages. A stent can be inserted to open up the bile ducts which allows bile to drain into the small intestine or an external bag. This may be used when surgery is not an option.
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Treatment options

Treatment options

The treatment options recommended for bile duct cancer will usually depend upon a few different factors, including general health, age, type, location of the tumour, the disease stage and your personal preferences.4 Treatment options may include: 

Surgery may be combined with other treatments. It may involve complete or partial removal of the cancer.4

 

Radiation therapy uses high-energy X-rays or other particles to treat cancer and can be used at all stages4

Radiation Therapy

Chemotherapy is an approach to cancer therapy which involves the administration of medicine, usually orally or by injection, which is intended to kill cancer cells or minimise their growth and spread. Chemotherapy can be used in conjunction with other cancer treatments.4,5

Chemotherapy

Immunotherapy is a type of treatment that is intended to help your immune system fight cancer. There are different types of immunotherapy for cancer that work in different ways.1

Immunotherapy

This type of treatment is designed and aims to attack specific cancer cells. Targeted therapy medicines mimic antibodies that our bodies naturally produce that target and attach to proteins on cancer cells, making it easier for our immune system to find and destroy the cancer.1

Targeted Therapy
Senior married couple in cozy winters clothes relaxing and enjoying reading a book together.

All cancer treatments may have side effects. The type and severity of side effects will vary between individuals.4,6,7 You can ask your doctor for detailed information about the side effects which you may experience with any treatment recommended for you.

  • Rest when needed – it is important to acknowledge when you are fatigued and rest when you need to6,7
  • Aim to maintain a healthy diet,6 and we also encourage you to think about eating foods that interest you rather than what you think you should eat
  • Appetite changes are common, and you may experience taste changes or nausea. Help manage this by eating small, frequent snacks and avoiding smells that make you nauseous6
  • Drink adequate water6
  • Reach out to support groups and others who have had cancer treatment7
  • Record your side effects in a diary or journal8
  • Speak to your doctor about incorporating some gentle exercise into your weekly routine6,7
  • Ask for and accept help from family, friends and neighbours7
  • Be open with employers about your treatment and discuss flexible working options if you need them

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Support services

Support services

Cancer Council Australia

Australia's leading cancer charity, Cancer Council aims to lead a cohesive approach to reduce the impact of cancer.

Visit website

GI Cancer Institute

GI Cancer Institute is the community-facing brand of the Australasian Gastro-Intestinal Trials Group, raising awareness and providing patient resources.

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Pancare Foundation

The leading charity committed to inspiring hope, raising awareness, supporting families and funding research for upper gastrointestinal (GI) cancers.

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  1. National Cancer Institute. Bile Duct Cancer. Available from: https://www.cancer.gov/types/liver/bile-duct-cancer/treatment (accessed Feb 2024).
  2. Cancer Council. Understanding liver cancer. Available at: https://www.cancer.org.au/assets/pdf/understanding-liver-cancer-booklet (accessed Feb 2024).
  3. Cancer Council. Bile Duct Cancer (cholangiocarcinoma). Available from: https://www.cancercouncil.com.au/bile-duct-cancer/ (accessed Feb 2024).
  4. Cancer Council. Understanding Gallbladder Cancer. Available from: https://www.cancercouncil.com.au/wp-content/uploads/2021/03/Understanding-Gall-Bladder-Cancer-2021.pdf (accessed Feb 2024).
  5. National Cancer Institute, ‘Chemotherapy to treat cancer’. Access from: https://www.cancer.gov/about-cancer/treatment/types/chemotherapy (accessed Feb 2024).
  6. Cancer Council Australia [website]. Nutrition for People Living with Cancer. Last updated July 2022 [Cited Feb 2024]. Access from: https://www.cancer.org.au/assets/pdf/nutrition-and-cancer-booklet
  7. Cancer Council Australia [website]. Exercise for people living with cancer. Last updated March 2019 [Cited Feb 2024]. Access: https://www.cancer.org.au
  8. Cancer Council Australia [website]. Understanding Chemotherapy. Last updated August 2022 [Cited Feb 2024]. Access: https://www.cancer.org.au
  9. Cancer Council Australia [website]. Emotions and cancer. Updated Nov 2022 [Cited Feb 2024]. Access: https://www.cancer.org.au/assets/pdf/emotions-and-cancer-booklet

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Disclaimer:

This website is provided for information purposes only. Nothing on this website is intended to be used as medical advice, or to diagnose, treat, cure or prevent any disease. It should not be used as a substitute for your own health professional's advice. Any medical procedure or treatment carries risks. Before proceeding with treatment, you should discuss the risks and benefits of the treatment with an appropriately qualified health practitioner. Individual treatment outcomes and experiences will vary.

This website is provided for information purposes only. Nothing on this website is intended to be used as medical advice, or to diagnose, treat, cure or prevent any disease. It should not be used as a substitute for your own health professional's advice. Any medical procedure or treatment carries risks. Before proceeding with treatment, you should discuss the risks and benefits of the treatment with an appropriately qualified health practitioner. Individual treatment outcomes and experiences will vary.
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