Cholangiocarcinoma (Bile Duct Cancer) | Loyola Medicine

Cholangiocarcinoma (Bile Duct Cancer)

Overview and Facts about Cholangiocarcinoma

Cholangiocarcinoma, or bile duct cancer, is a rare form of cancer that affects the bile ducts located either inside or outside the liver. Bile duct cancer outside of the liver is more common.

Your bile duct plays a major role in your digestive health as it is responsible for transporting bile, a digestive fluid, from your liver and gallbladder to your small intestine, helping you digest the food you eat. Specifically, bile helps you break down fat and remove toxins and waste from your body. Bile is stored in your gallbladder in between your meals and released while you are eating. Bile duct cancer often blocks or obstructs the flow of bile through the bile ducts.

Symptoms and Signs of Cholangiocarcinoma

A common symptom of bile duct cancer is an obstructed or blocked flow of bile to the small intestine, which often causes additional symptoms of jaundice. Jaundice is the yellowing of skin and the whites of the eyes caused by high levels of a substance called bilirubin in the bloodstream. Jaundice symptoms are also seen in the urine and stool; jaundiced individuals often release very dark urine and pale-colored stool.

Other signs and symptoms of bile duct cancer include:

  • Abdominal pain, particularly if the cancer has grown/enlarged or spread
  • Itching
  • Fever
  • Weight loss
  • Loss of appetite

Causes and Risk Factors of Cholangiocarcinoma

Individuals with bile duct inflammation, bile duct disease or irritation, inflammation and ulcers in their colons (ulcerative colitis), and certain liver diseases like liver cirrhosis (scarring of the liver) are at risk of developing bile duct cancer.

Older adults are more likely to develop bile duct cancer than younger adults and children.

Lifestyle features, such as heavy alcohol drinking and travel to places where liver flukes (liver parasites) are common, can also increase your risk of bile duct cancer.

Exposure to certain chemicals, such as thorium dioxide, dioxins, nitrosamines, and polychlorinated biphenyls (PCBs), also place individuals at risk of developing bile duct cancer.

Tests and Diagnosis of Cholangiocarcinoma

Bile duct cancer can be diagnosed using many different tests, such as blood chemistry tests and biomarker tests. Bile duct tissue may also be identified and sampled using different visual tools including endoscopy and/or laparoscopy, and examined under a microscope (biopsy) to confirm the presence or absence of cancer cells.

Imaging technology, such as ultrasounds, magnetic resonance imaging (MRI), and computed tomography (CT or CAT) scans may also be used to visually identify or confirm the presence of tumors on or within the bile duct.

Treatment and Care for Cholangiocarcinoma

Surgery is often used to remove the cancerous tissue or tumor from the bile duct. During this process, some of the healthy tissue around the tumor is also removed as a precaution to ensure that most of the cancer tissue is removed. Depending on the location and severity of the bile duct cancer, an affected patient may undergo different surgical procedures, such as partial liver removal (partial hepatectomy), a Whipple procedure if the cancer is located near the pancreas, or a liver transplant.

Patients may also be treated with radiation therapy or chemotherapy, especially in cases where surgery does not remove the entire tumor. It is especially important to note that bile duct cancer treatment and the prevention of bile duct cancer recurrence is more likely to occur if treatment is initiated and completed at early stages versus late stages of the disease.