About Bile Duct Cancer

About Bile Duct Cancer

At Penn Medicine's Abramson Cancer Center, patients with bile duct cancer receive their care from a multidisciplinary team of nationally recognized experts in the diagnosis, treatment and research of gastrointestinal cancer.

Cholangiocarcinoma is a rare cancer involving the bile ducts. Bile ducts are the structures within the gastrointestinal tract that carry bile. Bile is the digestive fluid excreted by the liver, which flows via the bile ducts into the intestine.

There are two types of cholangiocarcinomas:

  • Intrahepatic: cancer that arises from within the liver
  • Extrahepatic: cancer that arises from outside of the liver and distal bile ducts

Cholangiocarcinomas can be further classified based on the tissue from which they arise. Most cholangiocarcinomas are adenocarcinomas, meaning they arise from glandular tissue.

Bile duct cancer is rare, accounting for about 3 percent of all gastrointestinal cancers.

Penn Medicine's multidisciplinary approach to cancer diagnosis and treatment provides better outcomes and gives patients access to the most advanced treatment, surgical techniques and clinical trials.

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right physician.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Bile Duct Cancer Risk and Prevention

Risk factors can increase the chance of getting cancer. There are different kinds of risk factors. Some risk factors for cancer, like age and family history, cannot be prevented.

Patients who feel they are at risk may benefit from consulting with a risk assessment specialist within one of Penn Medicine’s programs at the Abramson Cancer Center or the Abramson Cancer Center at Pennsylvania Hospital at Pennsylvania Hospital.

Bile Duct Cancer Risk Factors

Risk factors increase the chance of developing bile duct cancer. Having a risk factor, or even several, does not always mean that someone will get cancer.

  • Inflammatory diseases of the bile ducts. Studies show that people with inflammatory diseases of the bile ducts such as ulcerative colitis and primary sclerosing cholangitis (PSC) may be at increased risk for developing cholangiocarcinomas.
  • Chronic liver disease. People with chronic liver disease such as hepatitis B or C, alcoholic liver disease or cirrhosis from other causes may be at an increased risk.
  • Parasitic liver disease. Parasitic liver disease, such as an infection with the Chinese liver fluke, may increase the risk for developing cholangiocarcinomas.
  • Congenital liver abnormalities. Choledochal cysts such as Caroli’s diseases have been associated with an increased risk for cholangiocarcinomas.
  • Chemical exposure. Exposure to the chemical thorotrast, a form of thorium dioxide, has been linked to the development of cholangiocarcinoma. Thorotrast was banned in the United States in the 1950s, but its effects may show up as late as 30 to 40 years after exposure.

Bile Duct Cancer Prevention

Most risk factors for bile duct cancer cannot be prevented, such as pre-existing conditions. However, there are some things people at risk can do to prevent cholangiocarcinomas:

  • Control weight. Maintaining a healthy weight through diet and exercise can help prevent cancer. 

Bile Duct Cancer Risk Assessment

Penn Medicine offers programs for patients who want to determine their risk of developing gastrointestinal cancer through Abramson Cancer Center.

These programs offer knowledge about the presence of genetic risk factors for cancer and provide patients with important, sometimes life-saving options.

Bile Duct Cancer Symptoms

Most symptoms from cholangiocarcinoma arise from an obstruction within the bile ducts. Symptoms of bile duct cancer include:

  • Jaundice, or yellowing of the skin and whites of the eyes
  • Abdominal pain, particularly in the right upper portion of the abdomen
  • Itching skin
  • Weight loss without dieting
  • Fever
  • Gray or clay colored stool
  • Dark urine

Staging Bile Duct Cancer

Staging systems provide doctors with a common language for describing tumors. After cancer is first diagnosed, a series of tests are used to investigate the extent of the cancer and to see whether it has spread to other parts of the body from where it started. Staging is a way of recording the size and growth of a cancer, and determining the plan for treatment. By understanding the stage of their cancer, patients can make informed decisions about their treatment.

Staging bile duct cancer attempts to discover the following:

  • The size of the tumor.
  • Whether the cancer has spread to nearby tissues.
  • Whether the cancer has spread to other parts of the body.

Bile Duct Cancer Treatment at Penn

After being diagnosed with bile duct cancer, patients at the Abramson Cancer Center may be evaluated through the Gastrointestinal Cancer Evaluation Center (GICEC). The center provides patients with expert support and evaluation to discuss treatment options and individualized treatment plans.

Patients with bile duct cancer are treated by a multidisciplinary team of cancer specialists who see more patients with gastrointestinal (GI) cancers in one year than many doctors see in their careers.

The physicians of Penn Medicine’s GI cancer program are nationally recognized for their expertise in the diagnosis and treatment of cancer.

Penn’s GI cancer treatment team includes:

  • Nationally recognized medical experts with years of experience in diagnosing and treating GI cancer.
  • Nurses with advanced training and experience in caring for patients with GI cancer.
  • Oncology Navigation Specialists to help patients navigate the health system.
  • Registered dietitians to provide nutrition counseling.
  • Cancer counselors to provide individual or family counseling for issues many cancer patients face.
  • Rehabilitation therapists who specialize in the diagnosis and treatment of physical effects from cancer and its treatment.

Patients at Penn Medicine can benefit from participating in clinical trials that take place at Penn. Patients interested in learning more about clinical trials should speak with someone on their treatment team.

Oncology Navigation Specialists

Every step of cancer treatment – from cancer diagnosis, to surgery and treatment to forming a survivorship plan – comes with different needs and issues that should be addressed.

Oncology Navigation Specialists at the Abramson Cancer Center are available to make a patient’s experience as seamless as possible. As experts in navigating complex health care situations, Patient Navigation specialists serve as a consistent point of contact and a reliable source for advice, support and direction for patients and families. They can help in a variety of ways including; providing emotional support, identifying resources, and ensuring access to information, support services, educational programs and community resources.

Learn more about Patient Navigation specialists at the Abramson Cancer Center.

Penn Pancreatic and Biliary Center

Patients at Penn Medicine with bile duct cancer also benefit from the Penn Pancreatic and Biliary Center, one of the busiest pancreatic surgery programs in the United States.

Studies have shown successful treatment of pancreatic cancer requires accurate diagnosis and cancer surgeons who are experienced in complex pancreatic surgeries. The center combines that expertise with leading-edge research and technology, giving patients at Penn Medicine a better chance for positive outcomes.

Learn more about the Penn Pancreatic and Biliary Center.

Diagnosing Bile Duct Cancer

An accurate cancer diagnosis from trusted cancer specialists is the first step in getting personalized treatment options for treating bile duct cancer.

Patients who choose Penn’s Abramson Cancer Center benefit from a multidisciplinary team of cancer specialists including gastroenterologists, radiologists, pathologists and surgeons who work together to provide a diagnosis and treatment plan custom designed for every patient with bile duct cancer.

Cancer specialists at Penn Medicine are highly experienced in using the most advanced techniques for diagnosing cancer and are actively researching better and more precise ways to detect bile duct cancer.

An accurate diagnosis is an important step in planning cancer treatment, so it’s important patients know that when they come to the Abramson Cancer Center, they are taking an important step in getting the best cancer treatment available.

Navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse to help them make an appointment with the right physician. Penn Medicine’s contact center has experienced cancer nurses available and ready to guide patients in finding the cancer specialist right for them.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Read more Diagnosing Bile Duct Cancer

Bile Duct Cancer Treatment

Following the diagnosis and staging of bile duct cancer, cancer specialists at Penn Medicine’s Abramson Cancer Center develop a personalized treatment plan. Penn’s treatment options for bile duct cancer include:

  • Surgery
    • Bile duct resection
    • Partial hepatectomy
    • Whipple procedure
    • Surgical biliary bypass
    • Endoscopic stent placement
  • Radiation therapy
    • 3-D conformal radiation
    • Intensity-modulated radiation therapy (IMRT)
    • Volumetric-modulated arc therapy (VMAT)
    • Proton therapy
    • Brachytherapy
  • Chemotherapy and biologic therapies
  • Clinical trials
  • Other treatments
    • Integrative medicine and wellness
    • Palliative care
    • Penn Home Care and Hospice

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right physician.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN.

Read more Bile Duct Cancer Treatment

Bile Duct Cancer Survivorship

Survivorship programs at Penn Medicine are a distinct phase of bile duct cancer care and are designed to help patients' transition from their cancer treatment routine to a post-cancer care lifestyle.

Cancer treatments can result in physical, emotional and financial complications long after the therapy is complete.

Read more Bile Duct Cancer Survivorship

Stand Up to Cancer

Peter O'Dwyer, MD, professor of Hematology-Oncology and program director of Development Therapeutics in the Abramson Cancer Center, was interviewed on NBC10's 10! Show about Penn's work as part of the Stand Up to Cancer Dream Team... Read more

Clinical Trials

Clinical Trials

Clinical trials are studies to find new ways to prevent, detect and treat cancer. The purpose of each clinical trial is to answer a specific question. Our physicians carefully design these studies to find new ways to improve care and quality of life ... more about clinical trials