Referral to a bile duct cancer specialist

Seeing your GP

It can be hard for GPs to decide who may have cancer and who might have a more minor condition. For some symptoms, your doctor may ask you to wait to see if the symptoms get better or respond to treatment, such as antibiotics.

UK referral guidelines

There are guidelines for GPs to help them decide who needs a referral. These vary between the different UK nations.

The guidelines below are from Scotland and Northern Ireland. GPs in England and Wales follow the National Institute for Health and Care Excellence (NICE) guidelines. NICE don’t have specific referral guidelines for bile duct cancer.

Your GP will use these guidelines as well as their own experience and judgement. You will see a specialist or have tests as soon as possible. Ask your GP when this is likely to be.

Scotland

In Scotland the guidance groups the symptoms of cancer of the pancreas, liver, bile duct and gallbladder together. You should have an urgent referral if you have a condition called ​obstructive jaundice​ and this is not causing you any pain. 

Your GP should also refer you if you have unexplained weight loss, particularly if you are over 55, and you have one or more of the following: 

• a lump (mass) in the upper area of your tummy

• newly diagnosed diabetes

• new and unexplained back pain

• ongoing symptoms affecting the gastrointestinal tract (such as vomiting or feeling full after eating small amounts) and tests such as ​endoscopy​ have not shown a cause

• an abnormal area found on a scan

Northern Ireland

In Northern Ireland the guidance groups together the symptoms of:

• pancreatic cancer

• cancer of the food pipe (oesophagus)

• stomach cancer

• cancer of the first part of your bowel (duodenum)

• liver cancer

• bile duct cancer

• cancer of the gallbladder

Your GP should refer you urgently for an endoscopy or to see a specialist if you are any age, have indigestion and any of the following:

• symptoms such as blood in your poo, or your poo is black or tar-looking due to bleeding in your ​digestive system​

• difficulty swallowing (dysphagia)

• losing weight without trying to

• being sick and this is not getting better

• lack of ​iron​ in the body (iron deficiency anaemia) – this is picked up with a blood test

• a lump (mass) in the upper part of your tummy (abdomen)

• an abnormal result from a test called a ​barium​ meal

Your GP should refer you urgently for an endoscopy if you are 55 years or older and you have recently developed indigestion that is unexplained.

Your GP should refer you urgently to see a specialist if you have:

• difficulty swallowing 

• unexplained pain in the upper part of your tummy and weight loss. You may or may not have back pain with this

• a lump in the upper part of your tummy and you do not have indigestion

• ​obstructive jaundice​

Some people with obstructive jaundice will have an urgent ultrasound. Your GP will tell you if this is necessary for you.

Your GP might refer you urgently to see a specialist if you have no sign of indigestion and you:

• are being sick, this is not getting better and you are losing weight

• have unexplained weight loss or have a lack of iron in your body

Your GP might refer you urgently to see a specialist if you have unexplained indigestion that is getting worse and you are known to have:

• ​Barrett’s oesophagus​ 

• abnormal cells (dysplasia)

• inflammation and thinning of the stomach lining (atrophic gastritis)

• changes to the lining of the food pipe and stomach that looks like the lining of the bowel (intestinal metaplasia)

• had peptic ulcer surgery over 20 years ago

Other symptoms

Your GP will consider any other symptoms you have, so do mention these.

Read more about the symptoms of bile duct cancer

Risk factors

Your GP might also take into account whether you have any risk factors that affect your chances of developing bile duct cancer.

Read about the risk and causes of bile duct cancer

If you're still worried

Sometimes you might feel that your GP is not concerned enough about your symptoms. If you think they should be more concerned, print this page and the symptoms page. Ask your GP to explain why they don’t think you need a referral.

Contact your GP again if your symptoms don't get better or you notice any new or unusual symptoms.

What should you do if you don’t get an appointment?

If your GP has referred you to a specialist, ask them when you should get your appointment. Contact them again if you don’t get one. Or some hospitals have a referral service you could try contacting if you know which hospital you are going to. Explain that you are waiting for an urgent suspected cancer referral.

Go to more information about an urgent referral, what to expect and questions to ask

Waiting times

Your hospital is working towards waiting time targets. For example, a target to find out whether you have cancer or not. And there are targets to start treatment if you are diagnosed with cancer. These are slightly different depending on where you live in the UK.

Find out about cancer waiting times