Bile Duct Cancer

Bile duct cancer, also known as Cholangiocarcinoma, is a type of cancer that starts in the bile ducts. Bile ducts are small tubes that carry bile (a digestive fluid) from the liver and gallbladder to the intestine. When cancer develops here, it can block bile flow and cause symptoms like jaundice (yellow eyes/skin).

Types of Bile Duct Cancer

Intrahepatic

Starts in small bile ducts inside the liver.

Perihilar

Starts near where the bile ducts leave the liver (most common type).

Distal

Starts in the bile duct closer to the small intestine.

Common Symptoms

Symptoms may start slowly and can look like other liver or stomach problems.

Common symptoms include

• Yellow eyes/skin (jaundice)
• Dark urine and pale stools
• Itching
• Pain in the upper right side of the belly
• Loss of appetite and weight loss
• Fever (sometimes)
• Feeling tired or weak

Risk Factors

Bile duct cancer is uncommon, but the risk can increase with:

Liver and bile duct conditions

• Primary sclerosing cholangitis (PSC)
• Long-term bile duct inflammation or infections
• Bile duct cysts (choledochal cysts)
• Bile duct stones or repeated blockage

Liver health issues

• Chronic liver disease or cirrhosis
• Chronic hepatitis infection (in some cases)

Other factors

• Older age
• Smoking
• Certain parasitic infections (in some regions)

Diagnosis

Doctors usually combine symptoms, blood tests, and scans.

Tests commonly used

• Liver function tests (to check bile blockage)
• Imaging: ultrasound, CT scan, MRI/MRCP
• ERCP or other scope-based tests (to view ducts and sometimes place a stent)
• Biopsy or tissue sampling (to confirm cancer)
• Tumor markers may be checked along with other tests (not used alone)

Treatment

Treatment depends on location, stage, and overall health.

Surgery (when possible)

If the cancer is found early and can be removed, surgery offers the best chance for long-term control.

Liver transplant (selected cases)

In specific situations (mainly certain perihilar cases), transplant may be considered under strict specialist criteria.

Chemotherapy and targeted treatment

Used when surgery is not possible, after surgery, or when cancer has spread. Some patients may also benefit from targeted therapies, depending on tumor testing results.

Radiation therapy

It may be used in selected cases for control of disease or symptoms.

Supportive care (symptom relief)

• Stents or drainage to open blocked bile ducts
• Medicines to reduce itching and manage pain
• Nutritional support and infection prevention

When to Seek Urgent Medical Help

Get medical help quickly if you have:

• Sudden worsening jaundice
• Fever with chills (possible bile duct infection)
• Severe belly pain with vomiting
• Confusion, extreme weakness, or bleeding tendency

Specialists to Consult

• Gastroenterologist
• Hepatologist (liver specialist)
• Surgical oncologist / Hepatobiliary surgeon
• Medical oncologist

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