Bile duct cancer is cancer that forms in the slender tubes (bile ducts) that carry the digestive fluid bile through your liver. Bile duct cancer is also called cholangiocarcinoma.
Bile duct cancer is a rare form of cancer that occurs mostly in people older than age 50. Bile duct cancer can cause signs and symptoms such as yellowing of the skin and eyes (jaundice), intense itchiness of the skin, and white-colored stools.
Bile duct cancer is an aggressive form of cancer that progresses quickly and is difficult to treat.
- Teamwork. At Mayo Clinic, specialists in gastroenterology and hepatology work with experts in medical oncology, radiation oncology, surgery and transplant to form a multidisciplinary team to treat bile duct cancer. Other professionals are included as needed.
- Experience. Bile duct cancer is an uncommon type of cancer. Mayo Clinic doctors have experience treating many cases of bile duct cancer.
- A full range of treatment options to consider. Mayo Clinic doctors will work with you to review all of your treatment options and choose the treatment that best suits your needs and goals. The range of treatments offered to people with bile duct cancer includes chemotherapy, radiation therapy, photodynamic therapy and many types of surgical procedures, such as minimally invasive surgery, the Whipple procedure and liver transplant.
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A variety of tests and procedures are used to diagnose bile duct cancer at Mayo Clinic, including:
- Visually inspecting the bile ducts for signs of cancer. Doctors use a long, thin tube with a camera on the end (endoscope) to inspect your bile ducts for signs of cancer. An endoscope is passed down your throat, through your stomach and into the first portion of your small intestine, where your bile duct empties.
Endoscopy can be combined with imaging tests, such as ultrasound and endoscopic retrograde cholangiopancreatography, to create pictures of the bile ducts and with biopsy procedures to collect tissue samples.
- Removing a sample of tissue for testing. Laboratory testing of suspicious tissue helps your doctor make a diagnosis. Information gathered during testing may help shape your treatment plan.
A biopsy sample can be collected with a needle that is inserted through your skin. Or a sample can be removed during endoscopy.
- Imaging tests. Imaging tests give your doctor more clues about your bile duct cancer and can help determine the extent of your cancer. Imaging tests may include CT, MRI, positron emission tomography (PET) and bile duct X-ray (cholangiography).
- Exploratory surgery. Sometimes doctors use exploratory surgery to investigate a suspected cancer. This procedure can involve one large incision or several small incisions (minimally invasive surgery). Minimally invasive surgery involves special tools that are inserted through the incisions, along with a camera that allows your doctor to see inside your body.
Your treatment options for your bile duct cancer will depend on the specifics of your cancer, such as the size, location and extent, as well as your health and personal preferences. Your treatment team will work with you to find a treatment that meets your needs.
Treatments for bile duct cancer may include:
- Surgery. When possible, doctors try to remove as much of the cancer as they can. For very small bile duct cancers, this involves removing part of the bile duct and joining the cut ends. For more-advanced bile duct cancers, nearby liver tissue, pancreas tissue or lymph nodes may be removed as well.
- Liver transplant. Surgery to remove your liver and replace it with one from a donor (liver transplant) may be an option for certain types of bile duct cancers. For many people, a liver transplant is a cure for bile duct cancer, but there is a risk that bile duct cancer will recur after a liver transplant.
- Chemotherapy. Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be an option for people with advanced bile duct cancers to help slow the disease and relieve signs and symptoms.
- Radiation therapy. Radiation therapy uses high-energy sources, such as X-rays, to damage or destroy cancer cells. Radiation therapy can involve a machine that directs radiation beams at your body (external beam radiation) or it can involve placing radioactive material inside your body near the site of your cancer (brachytherapy).
- Photodynamic therapy. In photodynamic therapy, a light-sensitive chemical is injected into a vein and accumulates in the fast-growing cancer cells. Laser light directed at the cancer causes a chemical reaction in the cancer cells, killing them. This treatment can help relieve signs and symptoms, and may also slow cancer growth.
- Biliary drainage. Biliary drainage is a procedure to restore the flow of bile. Biliary drainage can involve bypass surgery to reroute the bile around the cancer or stents to hold open a bile duct being collapsed by cancer. Biliary drainage helps relieve signs and symptoms of bile duct cancer.
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Researchers at Mayo Clinic are studying new ways to diagnose and treat bile duct cancers. Bile duct cancer research is conducted in coordination with the Mayo Clinic Cancer Center.
The Mayo Clinic Cancer Center receives funding from the National Cancer Institute (NCI) and is an NCI-designated comprehensive cancer center — recognition for an institution's scientific excellence and multidisciplinary resources focused on cancer prevention, diagnosis and treatment.
See a list of publications by Mayo Clinic authors on bile duct cancer on PubMed, a service of the National Library of Medicine.
April 03, 2013