# Bile Duct Cancer **Table of Contents** **Table of Contents** [Overview](#section-overview "Overview") [Signs & Symptoms](#section-4471 "Signs & Symptoms") [Causes & Risk Factors](#section-4476 "Causes & Risk Factors") [Diagnosing Bile Duct Cancer](#section-5701 "Diagnosing Bile Duct Cancer") [Staging and Grading Bile Duct Cancer](#section-4481 "Staging and Grading Bile Duct Cancer") [Treatments & Services](#section-5711 "Treatments & Services") [Find Care](#section-5716 "Find Care") [Request an Appointment](#section-7516 "Request an Appointment") ## Overview Bile duct cancer, also called cholangiocarcinoma, is a rare cancer that begins in the thin tubes that carry bile from the liver to the small intestine. Most bile duct cancers are adenocarcinomas, meaning they form in the glandular cells that line the bile ducts. This disease can develop inside the liver (intrahepatic cholangiocarcinoma) or in the ducts outside the liver (extrahepatic cholangiocarcinoma). Because bile duct cancer often develops quietly and may not cause symptoms until it is more advanced, early evaluation and specialized care are especially important. Our team provides comprehensive support from diagnosis through treatment to ensure patients receive timely, individualized care. ## Signs & Symptoms Bile duct cancer can block the normal flow of bile from the liver to the small intestine. When this happens, bile builds up in the bloodstream and tissues, leading to several noticeable symptoms. Common signs may include: - Jaundice (yellowing of the skin and whites of the eyes) - Dark urine - Pale or clay-colored stools - Itchy skin - Abdominal discomfort or pain - Loss of appetite - Unexplained weight loss - Fever These symptoms can be caused by conditions other than bile duct cancer, but it's important to speak with your doctor if you notice any of these changes or if they persist. ## Causes & Risk Factors The exact cause of bile duct cancer is not fully understood. Most cases develop without a clear reason, but certain factors can increase the likelihood of this rare cancer forming. These risk factors include: - **Chronic inflammation of the bile ducts:** Conditions such as primary sclerosing cholangitis (PSC) significantly increase the risk of bile duct cancer. Long-standing inflammation in the digestive tract, such as ulcerative colitis, can also elevate risk. - **Abnormalities in the bile ducts:** People born with structural abnormalities like choledochal cysts have a higher risk of developing bile duct cancer later in life. - **Parasitic infections:** In some parts of Africa and Asia, chronic infection with liver flukes is a known cause of bile duct cancer. - **Age:** Although bile duct cancer can occur at any age, it is most often diagnosed in adults over the age of 65. - **Smoking:** Tobacco use has been linked to an increased risk of bile duct cancer. The harmful chemicals in cigarette smoke can contribute to chronic inflammation and cellular changes in the bile ducts. - **Chronic hepatitis C infection:** Long-term hepatitis C infection can lead to ongoing liver inflammation and scarring, which increases the risk of bile duct cancer over time. Bile duct cancer is *not* contagious and cannot be passed from person to person. ## Diagnosing Bile Duct Cancer Diagnosing bile duct cancer typically involves a combination of imaging, endoscopic procedures, and tissue sampling. Your care team will begin with a physical exam, a review of your health history, and blood tests to assess liver function. From there, several specialized tests may be used to confirm a diagnosis and determine the extent of disease. ##### Ultrasound Frequently the first test performed. Ultrasound uses sound waves to create images of the bile ducts, liver, and surrounding organs. It can identify blockages or abnormal structures. ##### CT Scan A CT scan takes detailed cross-sectional images of the abdomen and can show tumors, blockages, or changes in nearby organs. Sometimes a contrast dye is used to improve visibility. ##### MRI / MRCP MRI provides detailed images without radiation. A specialized version, MRCP (magnetic resonance cholangiopancreatography), offers high-resolution views of the bile ducts and is particularly useful for identifying narrowings or blockages. ##### ERCP (Endoscopic Retrograde Cholangiopancreatography) An endoscope is guided through the mouth into the small intestine to reach the opening of the bile duct. Dye is injected to visualize the ducts on x-ray. ERCP can diagnose blockages and may also be used to place a stent if needed. ##### Endoscopic Ultrasound (EUS) Similar to ERCP, but includes an ultrasound probe at the tip of the endoscope. EUS provides highly detailed images and can help guide biopsies of suspicious areas. ##### PTC (Percutaneous Transhepatic Cholangiography) A thin needle is inserted through the skin and into the liver to inject dye directly into the bile ducts. This test creates detailed x-ray images and can also be used to obtain tissue samples. ##### Biopsy A biopsy is the only way to confirm a diagnosis of bile duct cancer. Tissue samples may be taken during ERCP, EUS, or PTC. The sample is examined under a microscope to determine cancer type and characteristics. ##### Angiogram Used to assess nearby blood vessels and determine whether the cancer is affecting major arteries or veins. ##### Diagnostic Laparoscopy A minimally invasive surgical procedure that uses a small camera to examine the bile ducts, liver, and abdominal cavity. It may help determine whether the cancer can be surgically removed. ## Staging and Grading Bile Duct Cancer Understanding the stage and grade of bile duct cancer helps your care team determine the most appropriate treatment and predict how the cancer may behave. ### Staging Staging describes how far the cancer has grown and whether it has spread beyond the bile ducts. Bile duct cancer can spread through the bloodstream or the lymphatic system, so doctors often examine nearby lymph nodes and surrounding organs to identify the stage. StageDescription of StageStage 1ACancer is contained within the bile ductStage 1BCancer has grown through the bile duct wall but has not reached nearby lymph nodes or structuresStage 2ACancer has spread into nearby organs such as the liver, pancreas, or gallbladder, or into nearby blood vessels, but not the lymph nodesStage 2BCancer has spread to nearby lymph nodesStage 3Cancer involves major blood vessels near the liver or has grown into nearby organs such as the stomach, bowel, or abdominal wall; lymph nodes in the area may also be affectedStage 4Cancer has spread to distant parts of the body, such as the lungs### Grading Grading describes how the cancer cells look under a microscope compared with normal cells. - **Low-grade tumors** look more like normal cells and tend to grow and spread more slowly. - **High-grade tumors** look more abnormal, are typically faster-growing, and are more likely to spread. ## Treatments & Services Treatment Options [Chemotherapy](/all-treatments-services/chemotherapy) [Radiation Therapy](/all-treatments-services/radiation-therapy) [Surgical Oncology](/all-treatments-services/surgical-oncology) ## Find Care If you’re experiencing symptoms or have been diagnosed with bile duct cancer, our specialists are here to support you. We offer timely evaluations, advanced diagnostic tools, and coordinated treatment planning tailored to your needs. Our Locations We offer locations across the DFW metroplex so you can receive leading cancer care and support close to home. [Find a Location](/locations) Our Care Team Get to know the compassionate experts who guide your care with a whole-person approach—spirit, mind, and body. [Meet Our Team](/our-care-team) ## Request an Appointment Contact us to request an appointment or ask a question below. **For emergencies call 911 or visit your nearest hospital.** This form is blocked by your cookie preferences. Accept cookies to load form