Bile duct cancer: symptoms, diagnosis, and treatment

Here, we explain what bile duct cancer is exactly, whilst also outlining the main associated symptoms and causes.

What is bile duct cancer?

Bile duct cancer is a rare but aggressive form of cancer that originates in the bile ducts, which are the thin tubes that carry bile from the liver to the small intestine. Bile duct cancer can occur anywhere along the bile ducts, from the liver (intrahepatic) to the small intestine (extrahepatic), and can disrupt the flow of bile, leading to jaundice, abdominal pain, and other symptoms.

What causes bile duct cancer?

The exact cause of bile duct cancer is not well understood, but several factors may increase the risk of developing this disease. These risk factors include chronic inflammation of the bile ducts (such as primary sclerosing cholangitis), infection with certain parasites (such as liver flukes), exposure to toxins or environmental pollutants, smoking, obesity, and a family history of bile duct cancer or other liver diseases.

What are the main associated symptoms?

Bile duct cancer often presents with non-specific symptoms in the early stages, making it challenging to diagnose. Common symptoms may include jaundice (yellowing of the skin and eyes), dark urine, pale stools, abdominal pain or discomfort, unexplained weight loss, fever, nausea, and vomiting. As the cancer progresses, it can cause obstruction of the bile ducts, leading to complications such as infection, liver failure, and portal hypertension.

How is bile duct cancer diagnosed?

Diagnosing bile duct cancer typically involves a combination of imaging studies, such as ultrasound, computed tomography (CT) scans, magnetic resonance imaging (MRI), and endoscopic retrograde cholangiopancreatography (ERCP), as well as laboratory tests to assess liver function and tumour markers. A definitive diagnosis is usually made by obtaining a tissue sample (biopsy) from the bile ducts and examining it under a microscope for signs of cancer.

What are the treatment options for patients with bile duct cancer?

Treatment options for bile duct cancer depend on various factors, including the location and stage of the cancer, the patient's overall health, and personal preferences. Surgical resection (removal) of the tumour is often considered the primary treatment for early-stage bile duct cancer, but many patients are not candidates for surgery due to advanced disease or poor overall health. Other treatment options may include chemotherapy, radiation therapy, targeted therapy, immunotherapy, and palliative care to manage symptoms and improve quality of life.