Bile duct cancer care
Find a GI specialist
Cancer of the bile ducts is aggressive and very rare. You may not have heard of it unless you know someone who’s been diagnosed with it. You can count on us to seek out the most advanced treatments for this disease and provide access to any clinical trials that may help fight it.
About bile duct cancer
Bile duct cancer grows in the bile ducts – a cluster of very small tubes shaped like a tree. The tiniest branches (ductules) start in the liver and feed into progressively larger ducts. This duct system carries bile (a fluid that helps digest fats) down to your gallbladder for storage and releases bile to your small intestine when needed.
Most cancers of the bile ducts grow in gland cells inside the bile ducts and are called cholangiocarcinomas. There are a few other kinds of bile duct cancers that are very rare. The term cholangiocarcinoma is sometimes used to mean bile duct cancer.
Types of bile duct cancers
Bile duct cancers are described based on where they start to grow. The three types are:
- Intrahepatic bile duct cancers: Start in bile ducts within the liver.
- Perihilar bile duct cancers: Start in the area around where the ducts leave the liver. Also called hilar bile duct cancers or Klatskin tumors.
- Distal bile duct cancers: Start toward the bottom of the bile ducts, close to the small intestine.
Perihilar and distal bile duct cancers are sometimes grouped together and called extrahepatic bile duct cancers. Extrahepatic means they exist outside the liver.
Bile duct cancer symptoms
Cancer of the bile ducts doesn’t usually cause symptoms until it’s become advanced. Symptoms of bile duct cancer are often caused by the size of the cancer. The bile duct tumor may put pressure on nerves or other tissues, or it may cause part of the bile duct system to be blocked.
Jaundice (yellowing of the eyes or skin) is the most common symptom of cancer of the bile ducts. It’s caused when the liver can’t get rid of bilirubin – one of the components of bile fluid. Some other bile duct cancer symptoms are:
- Abdominal pain
- Dark urine
- Fever
- Itching
- Light-colored or greasy stools
- Loss of appetite
- Nausea and vomiting
- Weight loss
Bile duct cancer diagnosis
When you see your doctor and report some of the symptoms listed above, they’ll perform a physical that will include probing the upper right side of your abdomen to check for tender spots or unusual lumps. They’ll ask you about your family medical history and ask about any symptoms you’ve noticed.
Any of these symptoms is more likely to be caused by other more common conditions like gallstones, hepatitis or other liver diseases rather than bile duct cancer. But the tests your doctor runs will help them decide what’s going on with you.
Your doctor will start with blood tests for liver function to discover levels of liver enzymes, bilirubin, albumin and other substances common to diseases involving the liver, gallbladder and pancreas. The results will help point to specific diagnosis.
Results from blood tests will also provide a baseline against which your health care team can compare your progress at any point in your treatment.
Common imaging tests
Imaging tests are vital to diagnosis because they paint a picture about your health. Tools such as CT scans, MRIs, ultrasound or X-rays all provide different kinds of images of your bile ducts and surrounding tissues. Endoscopic retrograde cholangiopancreatography (ERCP) is especially helpful for diagnosing cancer of the bile ducts.
All these imaging tests help with:
- Finding suspicious area that might be cancer
- Guiding a biopsy needle into a suspicious area to take a biopsy (tissue sample)
- Making treatment decisions
Like having initial results from blood tests, having initial images will help during your treatment to:
- Learn if treatments are working
- Look for signs of cancer coming back after treatment
- See whether cancer has spread
Treatment options for bile duct tumors
Recommendations for treatment will depend on your health and the size and stage of your cancer. Any of the following treatments may be recommended either alone or in combination with each other.
Radiation therapy & chemotherapy
Radiation therapy may be recommended before surgery to shrink bile duct tumors to make them easier to remove, after surgery to remove any remaining areas of cancer or as palliative therapy to relieve symptoms of bile duct cancer that are causing pain.
Chemotherapy is treatment with chemo medications to stop or slow the growth of cancer cells. It’s often recommended in some of the same situations as radiation therapy.
Precision medicine
At Aurora Health Care, we’re in the lead with precision medicine, which uses the latest breakthroughs in understanding cancer on a molecular and genetic level. A few of our strategies are:
- Testing for genetic mutations: Finds mutations in your cancer cells and searches through databases to find what’s worked best against similar mutations.
- Targeted therapy: Uses advanced medical science to make medications seek and find specific proteins on cancer cells to stop or slow their growth.
- Immunotherapy: Uses elements of your immune system to fight the growth and spread of cancer cells.
Get care
We help you live well. And we’re here for you in person and online.