A woman holding her stomach.
Some common symptoms of bile duct cancer are abdominal pain and nausea.

Understanding Bile Duct Cancer Symptoms

We’ve heard of the major types of cancer: lung, prostate, breast, the list goes on. Cancer can be found in any part of the body, including the tiny bile duct tubes in your digestive tract. In this article, we take a look at bile duct cancer symptoms, the risk factors and treatment options.

What Is Bile Duct Cancer?

Cancer cells can form in bile ducts to form this particular type of cancer. The body’s cells in the ducts start to multiply rapidly or grow out of control, becoming bile duct cancer. This rare disease affects the network of tubes that connect your liver, gallbladder and small intestine.

Where Does Bile Duct Cancer Develop?

The tube networks start in the liver. The liver is where many small ducts collect bile—a fluid made in the liver and stored in the gallbladder. The bile’s primary job is breaking down fats during digestion. Bile passes through the hepatic ducts (the common hepatic duct and cystic duct). There are many types of tubes that can be affected by cancer, primarily:

  • The right and left hepatic ducts, which lead out of the liver and form the common hepatic duct.
  • The cystic duct, which connects the gallbladder to the common hepatic duct.

Bile Duct Cancer Has Two Types

Intrahepatic bile duct cancer forms in the ducts inside the liver. Very few of these cancers are intrahepatic.

Extrahepatic bile duct cancer forms in the ducts outside the liver, usually in one of two places. Perihilar cancer is found where the right and left hepatic ducts form the common hepatic duct. Distal extrahepatic cancer is found in the area of the common duct, which passes through the pancreas and ends in the small intestine.

Bile Duct Cancer Symptoms

Many of these symptoms are warning signals from your body letting you know that there is something wrong with your liver (and the bile ducts by association):

  • Jaundice (when there is yellowing of the skin and the whites of the eyes)
  • Abdominal pain
  • Dark colored urine
  • Clay colored stool
  • Fever
  • Itchy skin
  • Nausea and vomiting
  • Weight loss for unknown reasons

What Are the Causes?

The DNA mutations that cause cancer can either turn on oncogenes or turn off tumor suppressor genes. Oncogenes are the ones that control when cells grow, divide and die. Tumor suppressor genes slow down cell division so they can control the timing of cell death.

There is not an exact cause of bile duct cancer, but there are some risk factors that may make a person more prone to getting it. Research shows that there are some possible causes:

  • Bile duct irritants. Studies have found a link between irritating and inflammatory bile duct conditions, like bile duct stones, a parasite, or something else. Inflammation may encourage mutations in cells to make them grow out of control.
  • Gene mutations. Inherited conditions are not thought to cause many bile duct cancers. Research indicates that gene mutations are actually picked up through life instead of inherited through DNA—possibly due to random events that sometimes occur inside a cell. There is one mutated gene in particular, TP53 (a tumor suppressor gene), that is found in most bile duct cancers. Other genes that may contribute to bile duct cancers are KRAS, HER2 and ALK.

Common Risk Factors

There are some pre-existing conditions that may make this cancer more likely:

  • Chronic ulcerative colitis
  • Certain liver disease
  • Cysts in the bile ducts
  • Primary sclerosing cholangitis (a disease where bile ducts become blocked by inflammation and scarring)
  • Infection with a Chinese liver fluke parasite

Treatment for Bile Duct Cancer

Your doctor will usually diagnose bile duct cancer by a biopsy of tissue samples. A medical professional can not come up with a treatment plan until they see where the cancer is in the bile duct system, the stage of the cancer, if it has metastasized and health conditions of the patient. Bile duct cancer is usually found after it has spread, making it more difficult to treat with surgery. Once the oncologist has assessed the cancer and the patient, they may recommend one or more treatment options.


There are a few surgical options including partial removal of the bile duct, removal of part of the liver, whipple procedure (removes the head of the pancreas, gallbladder, part of the stomach, part of the small intestine and the bile duct), and palliative surgeries to ease symptoms.

Radiation Therapy

Using high-energy x-rays or other types of radiation, a specialist targets cancer cells or prevents them from growing. This type of therapy can either be done with a machine outside of the body (external radiation), or radioactive substances placed inside the body (internal radiation).


Chemotherapy drugs stop cancer from growing in one of two ways: it can kill the cells completely or stop them from multiplying.

Clinical Trials

You can sign up for clinical trials to test new treatments (or alterations to existing methods) to treat cancer. For example, currently a new bile duct cancer clinical trial being tested is a liver transplant.

Prevention Measures

You cannot prevent cancer, but you can make some lifestyle changes to lower your risk of getting cancer. These types of changes include maintaining a healthy weight through diet and exercise, cutting out or cutting down on alcohol, stopping smoking, protecting yourself from blood-borne or sexually transmitted infections, treating hepatitis infections to prevent cirrhosis, and avoiding exposure to radioactive chemicals and asbestos.

Bile duct cancer is less common than other types, but any cancer has the ability to spread. If your body sends you clues that something is not right, do not ignore them. Make an appointment with your doctor to keep yourself as healthy as possible.