Bile duct cancer, a condition predominantly seen in individuals over the age of 40, arises from the cells lining the bile duct, both inside and outside the liver. Notably, men are at higher risk compared to women. It's crucial to be aware that in certain regions, consumption of raw freshwater fish can increase the likelihood of liver fluke infections, contributing significantly to the incidence of this cancer.

Types of Bile Duct Cancer

  1. Intrahepatic Bile Duct Cancer:
    • Originates in the cells lining the bile duct within the liver.
    • The cancer spreads, growing along the bile duct similarly to liver cancer, often leading to confusion between the two.
  2. Extrahepatic Bile Duct Cancer:
    • Begins in the bile duct outside the liver.
    • This form results in a blockage in the bile duct, leading to yellowing of the skin and eyes.

Risk Factors

The predominant risk factor in specific regions is the ingestion of raw freshwater fish, increasing the chance of liver fluke infections. Other factors include:

  • Chronic bile duct inflammation.
  • Bile duct disorders and stones.
  • Sclerosing Cholangitis.
  • Congenital genetic anomalies, such as choledochal cysts.

Symptoms of Bile Duct Cancer

While the early stages often go unnoticed, advanced bile duct cancer presents signs such as:

  • Yellowing of skin and eyes (jaundice).
  • Discomfort in the abdomen, swelling, and a sensation of fullness.
  • Pain, especially in the upper right abdomen, back, and shoulders.
  • Fever, itchiness, light-coloured stool, and dark urine.
  • Fatigue, appetite loss, weight loss, nausea, vomiting, and an enlarged liver.


A comprehensive approach to diagnosing bile duct cancer includes:

  • Reviewing the patient’s history.
  • Physical examination.
  • Blood tests assessing liver function and potential tumour markers.
  • Ultrasound of the liver and upper abdomen.
  • Computerised tomography (CT scan) and Magnetic Resonance Imaging (MRI).

Treatment Options

Tailoring the treatment based on the severity, cancer stage, and the patient's general health:

  1. Surgery: A standard and primary approach, targeting the tumour directly.
  2. Palliative Therapy: Used if, during surgery, the spread is too extensive to entirely remove the cancer. It alleviates symptoms like itchiness and jaundice.
  3. ERCP: A non-invasive diagnostic and treatment technique, especially if surgery isn't feasible.
  4. Chemotherapy/Radiotherapy: Employed when the cancer isn't fully removable, or post-surgery to enhance the likelihood of a complete cure.

Follow-Up Care

Post-treatment, it’s paramount to schedule regular follow-ups. Doctors typically perform an ultrasound or x-ray every 3-6 months for a minimum of 2 years, monitoring potential cancer recurrence.