Answers
What is bile duct cancer (cholangiocarcinoma)?
Short answer
Cholangiocarcinoma is a cancer of the bile ducts, inside or outside the liver. It often shows up as painless, deepening jaundice with itching, pale stools and weight loss. Tests such as MRCP, CT and EUS find it, and a sample taken during EUS or ERCP confirms it. Surgery can cure early cases; stents relieve jaundice in others.
Symptoms
- Yellow eyes and skin that keep getting deeper, often without pain
- Itching, dark urine and pale stools
- Weight loss, loss of appetite and tiredness
- Sometimes fever if the blocked bile becomes infected
Who is at higher risk
- Long-standing inflammation of the bile ducts, such as primary sclerosing cholangitis
- Choledochal cysts
- Bile duct stones present for many years
- Cirrhosis and chronic hepatitis B or C
Tests
Blood tests including liver tests and the tumour marker CA 19-9, an ultrasound, and then MRCP and CT to see where the duct is blocked and whether the cancer has spread. EUS and ERCP allow brushings or biopsies to confirm the diagnosis.
Treatment
- Surgery offers the best chance of cure when the cancer is found early and has not spread
- Stents placed by ERCP or EUS, or drainage through the skin, relieve jaundice and itching
- Chemotherapy and other medicines help control the disease
- Care is planned by a team, including a gastroenterologist, surgeon and oncologist
Eating well during treatment
Eat more
- Small, frequent meals with protein: dal, curd, paneer, eggs, fish
- Nutrition drinks or shakes if eating is poor
- Lower-fat meals if stools are pale, oily or loose
Cut down
- Alcohol
- Raw or undercooked food during chemotherapy
- Unproven 'cancer cure' diets and supplements that may harm the liver
Good to know
- Keeping weight steady helps people tolerate treatment better.
- A dietitian can plan meals around jaundice, poor appetite or diabetes.
Common questions
Can bile duct cancer be cured?
Yes, when found early and removed completely by surgery. Many are found later, when treatment aims to control the disease and relieve symptoms.
Does a stent treat the cancer?
No. A stent relieves jaundice and itching and lets other treatment go ahead, but it does not remove the cancer.
Does a high CA 19-9 mean cancer?
Not on its own. CA 19-9 can also rise with a blocked bile duct or infection. It is useful together with scans and biopsy.