Bile duct cancer

Bile duct cancer, also known as cholangiocarcinoma is a type of cancer that develops in the bile ducts (tubes that transport bile from the liver).^1,2 It is regarded as being a rare type of cancer.^1,2  Bile ducts connect your liver to your gall bladder and to your small intestine. The main job of the bile ducts is to transport bile from the liver and gallbladder to the small intestine, helping to digest the fats in food.¹

Bile duct cancer (cholangiocarcinoma) usually starts in any part of the bile duct system.³  There are three types of bile duct cancer, and each type is based on where the cancers first develop:¹

• Intrahepatic bile duct cancers
• Perihilar (or hilar) bile duct cancers
• Distal bile duct cancers

A range of tests may be performed to analyse symptoms, to diagnose bile duct cancer (cholangiocarcinoma), the type, and disease stage. Following a physical examination, further tests may include:^1,3

• Biopsy – where a tiny sample of tissue is taken for analysis
• Blood tests - with the aim to test gallbladder and liver function, plus check for tumour markers
• Imaging scans - may include X-ray, ultrasound,
  magnetic resonance imaging (MRI) scan, computed tomography (CT) scan, and magnetic resonance cholangiopancreatography (MRCP)
• Endoscopic retrograde cholangiopancreatography (ERCP) - this test is a type of X-ray, that is used to create an image of the bile duct, which can help show if there are any blockages or abnormalities caused by a tumour and if necessary, take a sample of bile duct tissue or insert a small tube (called a stent) to open up the ducts.
• Percutaneous transhepatic cholangiography (PTC) - this is a type of X-ray, and like an ERCP the test is used to help create an image of the bile duct to test for abnormalities or blockages. A stent can be inserted to open up the bile ducts which allows bile to drain into the small intestine or an external bag. This may be used when surgery is not an option.

The treatment options recommended for bile duct cancer will usually depend upon a few different factors including general health, age, type, location of the tumour, the disease stage and your personal preferences.⁴ Treatment options may include: 

• Surgery – Surgery may be combined with other treatments. It may involve complete or partial removal of the cancer ⁴
• Radiation therapy - Radiation therapy uses high energy X-rays or other particles to treat cancer and can be used at all stages ⁴
• Chemotherapy  - Chemotherapy is an approach to cancer therapy which involves the administration of medicine, usually orally or by injection, which is intended to kill cancer cells or minimise their growth and spread. Chemotherapy can be used in conjunction with other cancer treatments. ^4,5
• Immunotherapy – Immunotherapy is a type of treatment that is intended to help your own immune system fight cancer. There are different types of immunotherapy for cancer that work in different ways.¹
• Targeted therapy – This type of treatment is designed and aims to attack specific cancer cells. Targeted therapy medicines mimic antibodies that our bodies naturally produce that target and attach to proteins on cancer cells, making it easier for our immune system to find and destroy the cancer.¹
   

All cancer treatments may have side effects. The type and severity of side effects will vary between individuals. ^4,6,7 You can ask your doctor for detailed information about the side effects which you may experience with any treatment recommended for you.

Recommendations to help you stay well during treatment

• Rest when needed – it is important to acknowledge when you are fatigued and rest when you need to ^6,7
• Aim to maintain a healthy diet,⁶ and we also encourage you to think about eating foods that interest you rather than what you think you should eat
• Appetite changes are common, and you may experience taste changes or nausea. Help manage this by eating small, frequent snacks and avoiding smells that make you nauseous ⁶
• Drink adequate water ⁶
• Reach out to support groups and others who have had cancer treatment ⁷
• Record your side effects in a diary or journal ⁸
• Speak to your doctor about incorporating some gentle exercise into your weekly routine ^6,7
• Ask for and accept help from family, friends and neighbours ⁷
• Be open with employers about your treatment and discuss flexible working options if you need them

We understand that a cancer diagnosis may be emotional and life-changing. Even before your initial meeting with the GenesisCare team, you may experience a wave of emotions. It’s natural to feel disbelief, anxiety, sadness, anger and loneliness.⁹

The GenesisCare team will aim to know your name and to get to know who you are as a person. Your nursing team and oncology team are here to support you before, during and after your cancer treatment. We are here to help guide you to access the support you need which may include a psychologist, exercise physiologist, physiotherapist, and dietitian.

Please contact your local GenesisCare centre for more details on the services available. View a list of our centres here.

Other bile duct cancer information, resources and support services are available to assist you during your cancer journey.

These include: