What is Cancer
Cancer Type

Bile Duct Cancer (Cholangiocarcinoma)

The bile ducts are the tubes that take bile from the liver and pass it to the small bowel. Two bile ducts come from the liver and one comes from the gallbladder. These join to form the common bile duct. This connects to the small bowel, where it meets the pancreatic duct.
Bile is needed for digesting food. Its main role is to break down fats in food.

 
What is bile duct cancer?
This is cancer that starts in the bile duct. Bile duct cancer can start anywhere along the bile ducts. It has different names depending on where it starts, and symptoms depend on where it grows in the bile duct.
Types of cancer
There are different types of bile duct cancer. Some cancers start in the bile ducts inside the liver and are known as intrahepatic cancers. Others begin outside the liver and are known as extrahepatic bile duct cancers.
  • Klatskin tumours (also called perihilar cancers) start where the right hepatic duct joins the left hepatic duct. About half of all bile duct cancers are Klatskin tumours. 
  • Intrahepatic bile duct cancers begin in the bile ducts in the liver. Treatment for these tumours is the same as treatment for primary liver cancer.
  • Common bile duct cancers begin in the common bile duct.
  • Multifocal bile duct cancer means that there's more than one tumour and they're in different sections of the bile ducts.
How common is it ?
The National Cancer Registry disclosed a total of 8 Klatskin tumour cases registered in Malaysia in their 2007 report. They also reported a total of 39 registered cases of intrahepatic cholangiocarcinoma and 18 cases of gall bladder cholangiocarcinoma in the same year.
 
Cholangiocarcinoma is a rare malignant cancer of the bile duct with poor prognosis. This cancer is difficult to diagnose and often presented at advanced stages, when curative surgical resection that can provide the chance for cure, is not feasible. Bile duct cancer is much more common in Asia and the Middle East, mostly because of a common parasitic infection of the bile duct.
Risks and causes
It's not known what causes most bile duct cancers but there are some factors that increase the risk. People with long-term swelling or irritation in the bile ducts are more likely to get this cancer. People with a bowel disease called ulcerative colitis are also at higher risk. Infection with the liver fluke parasite is thought to cause a large number of bile duct cancers in Africa and Asia.
 
You can't 'catch' bile duct cancer: it's not infectious and can't be passed on to others.
Symptoms
Often the first sign is jaundice. This is when the skin and whites of the eyes become yellow. The urine may also become dark yellow and the bowel motions become light coloured. These symptoms happen because the tumour blocks the bile duct. Bile then builds up in the blood and body tissues.
 
People with bile duct cancer can feel extremely itchy. Stomach upsets, loss of appetite and high temperatures and weight loss are also symptoms.
 
If you have one of these symptoms, but haven't been diagnosed with this cancer, remember that it's rare, and your symptom is likely to be caused by something else. But see your doctor if any symptom persists for more than 2 weeks.
Reviewed By:
Annie Angle cancer nurse, Diploma Oncology Nursing, Royal Marsden, London