Cholangiocarcinoma: The facts

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What is cholangiocarcinoma?

Cholangiocarcinoma, or bile duct cancer, is a liver cancer that arises within the biliary system, and is the second most common primary liver cancer in the world.  It can occur in the small bile ducts within the liver, the big branches in the centre of the liver (hilum) or in the main or common bile duct draining out of the liver and which carries the bile from the liver to the gall bladder and down to the small intestine.

How is cholangiocarcinoma diagnosed?

Although early diagnosis is key to survival, unfortunately, currently there is no early detection method for cholangiocarcinoma.  Patients who are diagnosed in time for surgery have a far higher likelihood of surviving five years.  Without surgery, cholangiocarcinoma has one of the lowest survival rates of all cancers. As well as general health tests including checking liver function, biopsy and a combination of methods of scanning may be used to diagnose cholangiocarcinoma.

 What causes cholangiocarcinoma?

In the west, the exact cause of cholangiocarcinoma is unclear. It is likely that this cancer arises due to a combination of factors, including other illnesses that cause chronic damage to the liver and/or bile ducts, certain toxins and possibly a small genetic predisposition, although it is not believed to be a directly inherited disease.  Although most cases of cholangiocarcinoma are in people over 60 years of age, it appears to be increasing across all age groups including younger people. The cause of this ongoing rise is currently unknown.

In Southeast Asia, especially Thailand, which has the world’s highest incidence of cholangiocarcinoma, associated risk factors include eating raw fish infected with liver fluke and chronic typhoid, neither of which occurs in the western world.

What are the symptoms of cholangiocarcinoma?

Cholangiocarcinoma causes few symptoms in its early stages. Any symptoms that there are tend to be quite vague, such as abdominal discomfort, loss of appetite, tiredness, general malaise, weight loss, which are often initially attributed to other less serious and more common conditions.

When the disease is more advanced, symptoms may then include jaundice (yellowing of the skin and eyes), changes in stool and urine, itchy skin.

For further information on cholangiocarcinoma, see the websites of the World Cholangiocarcinoma Day partners on the Home page.