Version July 2025
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What is cholangiocarcinoma? —
This is a type of cancer that affects the bile ducts.
The bile ducts are narrow tubes that carry bile. Bile is a fluid that helps the body break down fat. It is made in the liver and stored in the gallbladder, then carried to the small intestine to help with digestion.
Cholangiocarcinoma can form in any part of the bile ducts (figure 1). This can happen:
●In the liver (called "intrahepatic" cholangiocarcinoma)
●Just outside of the liver (called "perihilar" cholangiocarcinoma)
●Closer to where bile enters the small intestine (called "distal" or "extrahepatic" cholangiocarcinoma)
What are the symptoms of cholangiocarcinoma? —
Symptoms can happen when the cancer causes a blockage in the bile ducts, so bile gets backed up. They can include:
●Yellowing of the skin or whites of the eyes, called jaundice
●Itchy skin
●Pale, clay-colored bowel movements
●Dark-colored urine
People can also have other symptoms, such as:
●Pain in the upper right side of the belly
●Weight loss
●Fever
●Feeling very tired
●Night sweats
Some people do not have any symptoms. They might learn that they have cholangiocarcinoma after getting an imaging test.
Is there a test for cholangiocarcinoma? —
Yes. If your doctor suspects that you have cholangiocarcinoma, they will order 1 or more tests. These can include:
●Blood tests
●Imaging tests – These create pictures of the inside of the body and can show abnormal growths. They might include an ultrasound, a CT scan, or an MRI scan. A special type of MRI called "MRCP" might also be used. Sometimes, doctors will put a thin tube down the throat and through the stomach to look at the bile ducts.
●Biopsy – A doctor takes a small sample of tissue from the bile duct. Then, another doctor looks at the sample under a microscope to check for cancer.
What is cancer staging? —
This is a way in which doctors find out if a cancer has spread past the layer of tissue where it began and, if so, how far.
How is cholangiocarcinoma treated? —
Treatment depends on the stage of your cancer and where it is located. Sometimes, cholangiocarcinoma can be cured with surgery. But often, this is not possible. In these cases, treatment focuses on relieving symptoms.
Treatment options might include:
●Surgery – In some cases, the cancer can be removed with surgery. Depending on where the cancer is, the surgeon might also need to remove part of the liver, gallbladder, pancreas, or nearby lymph nodes. They can also do procedures to help drain bile if a duct is blocked.
●Chemotherapy – These are medicines that kill cancer cells or stop them from growing.
●Radiation therapy – This kills cancer cells.
●Ablation therapy – This is a procedure that can kill cancer cells in the liver. It does not involve surgery. Doctors can do ablation therapy in different ways. They can kill the cancer cells using heat, microwaves, a laser, or radiation therapy.
●Blocking the cancer's blood supply – Doctors can do a procedure called "embolization" to block off the blood vessel that sends blood to the cancer. This keeps the cancer from growing by "starving" it of its blood supply. Sometimes, this procedure is combined with chemotherapy ("chemoembolization") or radiation ("radioembolization").
●Targeted therapy – Some medicines work only for cancers that have certain characteristics. Your doctor might test your cancer to see if it would respond to these medicines.
●Immunotherapy – These are medicines that work with the body's infection-fighting system (the "immune system") to stop cancer growth.
In certain situations, doctors might recommend a liver transplant.
What else should I do? —
Follow all of your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.
Getting treated for cholangiocarcinoma involves making many choices, such as what treatment to have. Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:
●What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
●What are the downsides to this treatment?
●Are there other options besides this treatment?
●What happens if I do not have this treatment?
Patient education: Chemotherapy (The Basics)
Patient education: External beam radiation therapy (The Basics)
Patient education: What are clinical trials? (The Basics)
Patient education: Palliative care (The Basics)
Patient education: CA 19-9 test (The Basics)
