Bile Duct Cancer

Bile duct cancer, or cholangiocarcinoma, is a rare cancer that affects the tubes that connect the liver to the small intestine.

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Bile duct cancer is rare, but the number of people diagnosed with this cancer has been rising. The reason for the rise may be because testing for bile duct cancer has become more accurate and more common in older adults.

Experts in bile duct cancer care

Bile duct cancer is rare, but at University of Iowa Health Care Holden Comprehensive Cancer Center, we have a team of experts who specialize in treating it. That team includes fellowship-trained medical oncologists, radiation oncologists, surgical oncologists, and transplant specialists.

We customize treatments and therapies just for you, and we offer clinical trials of the latest advanced diagnostic and treatment options. Our dedicated nurses help coordinate all aspects of your care, and we offer counseling services and support groups to extend your care long after your treatment.

Risk factors for bile duct cancer

Bile duct cancer is more common in older adults. The average age of a patient diagnosed with bile duct cancer is around 70.

Certain kinds of bowel disease can increase your risk of getting bile duct cancer. Chronic inflammation and irritation in the bile ducts can also increase your risk of bile duct cancer. These conditions can be caused by:

Narrow bile ducts or cysts: These can lead to blockages or inflammation in the bile ducts.
Ulcerative colitis: This inflammatory bowel disease can cause inflammation and sores anywhere along your digestive tract.
Liver parasites: Small parasites called liver flukes are often found in fresh waters in Southeast Asia. Fish from the region can become infected with the parasite and can be transmitted to people who eat the fish if it’s under-cooked or raw.

Signs and symptoms of bile duct cancer

Bile duct cancer often has no major symptoms in its early stages. Bile ducts are deep inside the abdomen, where early lumps or tumors can’t be felt.

Yellowing of the skin or the whites of the eyes is known as jaundice and can be a sign of bile duct cancer. Other symptoms include:

Excessive skin itching
Abdominal pain or a bloated feeling
Loss of appetite
Weight loss

How bile duct cancer is diagnosed

If your provider suspects that your liver is not working properly, you may have liver function tests. These tests can identify the levels of various enzymes in the liver, or they can show infections or blockages in the bile ducts. These could include:

Abdominal ultrasound. An abdominal ultrasound can help show tumors, enlarged bile ducts, a build-up or fluid, or other abnormalities.
Computed tomography (CT). A CT scan helps your providers see if there is a blockage or infection in the bile duct.
Magnetic resonance imaging (MRI). An MRI scan can help get more detailed images of your liver and bile duct, allowing your provider to locate tumors.

Your provider may also run tumor marker tests, which look for substances released by tumor cells that can sometimes be found in the blood. Increased levels of carcinoembryonic antigen (CEA) and CA 19-9 are often found in patients with bile duct cancer.

Based on your specific needs, your provider may recommend additional tests outside of those listed.

Cancer patient in hallway at Holden Comprehensive Cancer Center

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That’s why getting a second opinion matters. Our cancer experts can confirm your diagnosis and help you understand all your treatment options.

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Treatments for bile duct cancer

If caught early enough, some bile duct cancers can be treated with surgery, before its spread to other areas of the body. The surgeon also may remove other nearby tissue to make sure the cancer cells don’t spread.

If the cancer has spread, the doctor may recommend removing all or part of the liver or pancreas. This could require a liver transplant. Treatments like chemotherapy and radiation therapy may be used to treat bile duct cancer that has spread to other parts of the body.

Bile duct cancer can also be treated with immunotherapy, which is a type of cancer treatment that helps your immune system detect and fight cancer.