Cholangiocarcinoma: The Basics

Cholangiocarcinoma is cancer of the bile duct. The bile duct carries bile from the liver to the small intestine. Cholangiocarcinoma happens when bile duct cells grow out of control. As the number of cells grows, they form a tumor.

Cholangiocarcinoma that has spread from the bile duct to another part of the body is called metastatic cancer.

Risks

Risks may be:

• Older age.
• Weighing more than is healthy.
• Having a family member with cholangiocarcinoma.
• Issues such as hepatitis, cirrhosis, primary sclerosing cholangitis, inflammatory bowel disease (ulcerative colitis and Crohn’s disease), choledochal cysts, and biliary stones or infections.

Signs of Cholangiocarcinoma

Signs:

• Painless yellowing of the skin and whites of the eyes (jaundice).
• Itchy skin.
• Weight loss and not wanting to eat.
• Fever.
• Gray-colored  and/or greasy stool.
• Dark-colored pee.

Diagnosis of Cholangiocarcinoma

Your healthcare team will do a full exam of your body and ask you questions about your health. Tests can be:

• Endoscopic or laparoscopic ultrasound.
• Endoscopic retrograde cholangiopancreatography (ERCP).
• Cholangiography.
• CT, MRI, PET.
• Blood tests.

These tests are important but a biopsy is the only way to know for sure if you have cancer. A biopsy:

• Looks at a piece of the bile duct using a microscope.
• Is used to find out the cancer type, how normal it is [grade], and if it has spread.

A pathology report details these results and is sent to your healthcare provider, about 5-10 days after the biopsy. This report is an important part of planning your treatment. You can ask for a copy of your report for your records.

Staging Cholangiocarcinoma

To guide treatment, cholangiocarcinoma is "staged." This stage is based on:

• Where and how big the tumor is.
• If there are cancer cells in the lymph nodes.
• If there are cancer cells in other parts of the body.

Stages range from stage I (smallest tumors) to stage IV (tumors that have spread to other parts of the body, also called metastatic cancer). The stage and type of cholangiocarcinoma will guide your treatment plan.

Treatment

Often, these treatments are used:

• Surgery that removes the whole tumor is the only way to cure this cancer. The type of surgery depends on how big and where the tumor is. Surgery may also be done to remove only part of the tumor. Surgery can also be done with other treatments. 
• Radiation, the use of high energy x-rays to kill cancer cells, can sometimes be used. Brachytherapy may also be used in some cases. 
• Chemotherapy, the use of medication to treat cancer, can be used alone or with surgery and radiation. Sometimes chemotherapy is given only in the area where the tumor is. 
• Immunotherapy and targeted therapy may also be used, depending on the type of cholangiocarcinoma you have.
• Palliative therapy is the use of treatments to help manage the side effects of your cancer.

This article is a basic guide to cholangiocarcinoma. You can learn more about your type of cholangiocarcinoma and treatment by using the links below.

Cholangiocarcinoma (Bile Duct Cancer): Staging and Treatment

Surgical Procedures: Surgery and Staging for Bile Duct Cancer (Cholangiocarcinoma)