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About advanced bile duct cancer

Find out about advanced bile duct cancer (cholangiocarcinoma) and how it might affect you. 

What is advanced cancer?

Advanced bile duct cancer means that the cancer has spread beyond the bile ducts or has come back some time after you were first treated. Unfortunately, most people with bile duct cancer already have advanced cancer when they are diagnosed. This is because it usually doesn’t cause symptoms at an early stage. The symptoms can also be vague and difficult to spot.

Advanced cancer can be divided into either:

  • locally advanced bile duct cancer
  • bile duct cancer that has spread elsewhere in the body

Locally advanced cancer

Locally advanced cancer means that the cancer has spread into lymph nodes or organs near the bile duct. Bile duct cancers tend to spread locally along the bile duct.

Depending on where it started, the cancer may have grown into the liver, small bowel, pancreas or major blood vessels. This can mean that surgery is not possible. The tests you have to diagnose your cancer will help your specialist surgeon decide whether surgery is possible.

Bile duct cancer that has spread elsewhere

Doctors call cancer that has spread to another part of the body secondary cancer or metastatic cancer. It means that the cancer has spread through the bloodstream or lymphatic system to other organs further away.

The most common places for bile duct cancer to spread are the lungs, bones and the lining of the abdomen (called the peritoneum). But it can spread to other areas.

Types of treatment

Even if you can’t have surgery to cure your cancer, treatment is still available to control symptoms. The treatment may shrink your cancer or slow its growth even if it can’t get rid of it completely.

Your doctor may suggest chemotherapy, radiotherapy, more rarely surgery or a combination of treatments. You will also have medicines to control symptoms.

The best treatment for you depends on a number of factors including:

  • where the cancer has spread to
  • the size and number of any secondary cancers
  • your general health
  • any treatment you have already had
  • if you have jaundice your doctor can treat it by putting a small tube called a stent into the bile duct or you may have bypass surgery

Treatment decisions

When you have advanced cancer it can be difficult to decide which treatment to try or whether to have treatment at all. You will need to think about the quality of your life when you are having treatment. This includes thinking about the possible side effects.

You also need to consider other factors such as travelling to and from hospital. And you need to understand what each treatment can achieve.

Your doctor will be able to talk this through with you and answer any questions you have. You may also find it helpful to talk things over with a close relative or friend. Or there may be a specialist nurse or counsellor at the hospital you can talk to.

Last reviewed: 
22 Jan 2015
  • Diagnosis and management of cholangiocarcinoma

    S Sandhu and others

    Current Gastroenterology Reports. 2008 February; 10(1):43-52.

  • Cancer: Principles and Practice of Oncology (10th edition)
    VT De Vita, TS Lawrence and SA Rosenberg
    Lippincott, Williams and Wilkins, 2015

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