You can’t sugarcoat a cholangiocarcinoma diagnosis. The rare cancer type, which starts in the bile ducts, spreads fast. It also isn’t usually detected until it’s spread. That makes effective treatment difficult.
So, you may think, if I could just find the cancer early, that would help with faster treatment, right? Unfortunately, it’s not that simple.
Let’s take a look at some of the challenges with cholangiocarcinoma.
What Is Cholangiocarcinoma?
Cholangiocarcinoma is also known as bile duct cancer or biliary cancer. It affects around 8,000 people in the United States each year.
The cancer forms in the bile ducts. These tubes transport bile. Bile is a fluid made in the liver and stored by the gallbladder. The bile ducts move the fluid from the liver and gallbladder to the small intestine. In the small intestine, bile helps digest fat and rid the body of waste.
Although the bile ducts themselves are thin tubes, they’re part of a larger system called the bile duct system. The type of bile duct cancer you have depends on where the cancer starts.
The three main types of cholangiocarcinoma include:
- Intrahepatic cholangiocarcinoma, which starts in the bile ducts within the liver
- Hilar cholangiocarcinoma (or perihilar cholangiocarcinoma), which starts in the bile ducts just outside the liver
- Distal cholangiocarcinoma (or extrahepatic cholangiocarcinoma), which starts in the bile ducts near the small intestine
What Are the Symptoms of Cholangiocarcinoma?
Because the bile ducts are so deep inside the body, small tumors don’t show up on routine physical exams. That means most bile duct cancers aren’t found until they’ve grown large enough to cause signs and symptoms. And that’s why the most common symptom of the cancer is jaundice. (That’s the yellowing of the skin and eyes caused by a blocked bile duct.)
Here are some common bile duct cancer symptoms:
- Jaundice
- Itching
- Light-colored/greasy stools
- Dark urine
The buildup of bile causes each of these symptoms of bile duct cancer. A few other biliary cancer symptoms not directly related to bile include:
- Abdominal pain
- Unexplained weight loss
- Fever
These symptoms are more likely due to the tumor pressing into the abdominal wall or abnormal liver function. Still, keep in mind that bile duct cancer is rare. Many of these symptoms could point to a less serious condition. For example, the blockage could be due to gallstones, not a tumor.
What Causes Cholangiocarcinoma?
In addition to learning the symptoms, you may wonder whether there are any risk factors you can avoid or lifestyle changes you can make to lower your risk. Again, the answer is a bit murky.
Smoking is one risk factor you can change, but there aren’t many others you can do anything about. For example, diseases like primary sclerosing cholangitis (hardening and scarring of the bile ducts) and chronic liver disease (scarring of the liver) cause your risk to increase. So do diabetes and certain inherited conditions, like cystic fibrosis and Lynch syndrome.
Diagnosed with Bile Duct Cancer?
Make sure you're getting the right care.
Treating Cholangiocarcinoma
If you’re diagnosed with cholangiocarcinoma, your treatment will likely depend on a variety of factors. Your type of cancer, its location and spread, your overall health, and your personal preference will all play into the right plan for you.
Your doctor may recommend cancer treatments including:
They also may recommend a combination of treatments and therapies. You should always talk to your doctor about your specific diagnosis and what makes the most sense for you.
