Cancers can develop in any part of the bile duct and, based on their location, are divided into 3 groups. About half of the cancers develop in the smaller bile duct branches inside the liver and are called intrahepatic (inside the liver) bile duct cancers. These can be confused with cancers that start in the liver cells and are called hepatic carcinomas. It is possible to tell these 2 types of tumors apart by looking at them under a microscope.

Bile and bilirubin also cause itching. Jaundice is almost always due to hepatitis or to blockage of the bile duct. It is important to realize that most causes of bile duct blockage are not caused by cancer. Most often a stone in the bile duct that escaped from the gallbladder (gallstone) causes the jaundice. Whenever jaundice occurs, a doctor should be seen immediately

Causes

The cause is unknown although people with chronic inflammatory processes such as ulcerative colitis or parasitic infections of the bile ducts, or with congenital abnormalities of the bile ducts are at higher risk for developing this cancer. No one cause has been clearly demonstrated.

Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. Its main function is to store bile, a bitter, yellow-green fluid that's produced in the liver cells. Bile is essential for the proper digestion of fats and is one of the main ways your body eliminates drugs, cholesterol and waste products of metabolism.

Symptoms

If cancer develops in the bile ducts it may block the flow of bile from the liver to the intestine. This causes the bile to flow back into the blood and body tissues, and leads to the skin and whites of the eyes becoming yellow (known as jaundice).

As the cancer grows and spreads, pain often develops in the upper abdomen and sometimes spreads to the back. The pain may become worse after the person eats or lies down. Cancer of the pancreas can also cause nausea, loss of appetite, weight loss, and weakness.

Tumors can prevent the normal passage of food or interfere with its absorption by blocking the flow of pancreatic enzymes.

Bloating, weight loss, decreased appetite, fever, nausea or an enlarging abdominal mass are all signs that may be attributable to bile duct cancer. Pain usually signifies advanced disease.

Signs and symptoms of bile duct cancer include weight loss, loss of appetite, and fever. Early bile duct cancers usually do not cause pain. Usually the main symptoms from intrahepatic bile duct cancer are weight loss and fatigue. Jaundice occurs later. As the cancer spreads, pain may develop in the stomach area.

Treatment

Treatments for bile duct cancer vary with the size of the tumor and how far it has advanced. Among treatments are surgery, liver transplantation, chemotherap, radiation therapy, photodynamic therapy and biliary drainage. Where the cancer cannot be completely removed but has not spread outside the liver, liver transplantation may be an option. Mayo Clinic is one of the few institutions in the world offering transplantation for bile duct cancer. Read more about treatment for bile duct cancer.

Complete removal of the tumor is the only effective and potentially curative treatment for cancers of the lower bile duct. The treatment usually requires a Whipple operation. Distal bile duct cancer is more amenable to complete removal compared to pancreatic cancer. Five-year survival rates of up to 40% are found after complete removal of distal bile duct cancer.