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About advanced bile duct cancer

Find out about advanced bile duct cancer (cholangiocarcinoma) and the treatment you might have. 

What is advanced cancer?

Advanced bile duct cancer is cancer that has spread outside the bile ducts. It can also mean cancer that has come back some time after you were first treated (recurrent cancer).

Unfortunately, most people with bile duct cancer already have advanced cancer when they are diagnosed. This is because it usually doesn’t cause symptoms early on, and when it does cause symptoms they can 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, such as the lungs

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.

A locally advanced cancer might have grown into the liver, small bowel, pancreas or major blood vessels. This can mean that surgery is not an option (it is unresectable).

The tests you had to stage your cancer shows whether surgery might be possible. Surgery for bile duct cancer is a major operation, and your surgeon has to consider if you are fit enough to have the surgery.

Bile duct cancer that has spread elsewhere

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

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

If you can’t have surgery to try to cure your cancer, you can have other treatment to shrink or slow down its growth. This helps to control any symptoms you might have.

Your doctor might suggest chemotherapy, radiotherapy, more rarely surgery or a combination of treatments. You also have medicines such as painkillers, to control symptoms.

The best treatment for you depends on:

  • where the cancer has spread to
  • the size and number of any secondary cancers
  • your general health
  • any treatment you have already had
  • your wishes

Bile duct cancer can block the bile ducts which causes jaundice (yellowing of the skin and white of the eyes). Your doctor usually puts in a small tube called a stent to relieve the blockage.

Clinical trials

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.

Treatment decisions

It can be difficult to decide which treatment to try or whether to have treatment at all when you have an advanced cancer.

Having treatment can affect your quality of life. It’s important to understand what the aim of treatment is, what the side effects are and to think about other factors such as the time that you’ll spend in hospital.

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

Last reviewed: 
26 Feb 2018
  • Guidelines for the diagnosis and treatment of cholangiocarcinoma: an update
    SA Khan and others 
    Gut, 2012. Volume 61, Pages 1657-1669

  • Biliary cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow up
    JW Valle and others
    Annals of Oncology, 2016. Volume 27, Pages 28-37

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

Information and help