About bile duct cancer
Bile duct cancer develops after accumulated changes in the DNA of the cells in the bile ducts. (DNA is the genetic material that tells cells what to do.) As these faulty cells divide and multiply, they eventually cause a cancer.
Anyone can get bile duct cancer but you may be more at risk if you:
- Are aged 65 or over
- Have certain medical conditions such as abnormal bile ducts, long-term inflammation in the bowel (ulcerative colitis) or bile ducts (cholangitis), a parasite in the liver (liver flukes), bile duct stones or liver cirrhosis
Symptoms of bile duct cancer may not be obvious or you may have no symptoms at all.
Symptoms can include:
- Whites of your eyes turning yellow or your skin turning yellow (jaundice) – this may be less obvious on brown or black skin
- Itchy skin, darker pee and paler poo than usual
- Loss of appetite or losing weight without trying
- Feeling tired or having no energy
- Having a high temperature or feeling hot or shivery
Sometimes bile duct cancer can affect your digestion and cause symptoms including:
- Feeling or being sick
- Pain in your tummy
It is important to see a health professional if you have symptoms or changes in your body that are unusual for you.
Ask for an urgent GP appointment, call 111 or visit 111.nhs.uk if:
- Your skin or the whites of your eyes turn yellow
- You're being sick for more than 2 days
- You have symptoms that you’re worried about, but are not sure where to get help
See a GP if you have:
- Lost a noticeable amount of weight
- Have symptoms of bile duct cancer that get worse or do not get better
Treatment depends on a range of factors including the type, size, stage and location of your tumour. It may also depend on your age, general health and genetic factors (linked to the DNA changes in your cells) that tell us how your cancer developed.
Treatment options can include one or more of the following:
- Surgery – this may be before, during or after other treatments
- Drug therapies such as chemotherapy and immunotherapy. The general term for these is systemic anti-cancer therapies (SACT)
- Radiotherapy
When you are diagnosed, your care will be discussed at a multidisciplinary team meeting (MDT) where different specialists will consider the best treatment options for you. Your doctor will discuss this with you so you can decide what is right for you.
Sometimes it might be decided that none of the above treatment options are appropriate for you, usually if your disease is very advanced. Your care will be palliative – concentrating on your quality of life and symptom management – and will be led by your community team of your GP, district nurses and palliative care team.
Genomics and cancer
Genomics is the study of a person’s genes (or ‘genome’) – the material in DNA that makes each person unique. Cancer is caused by changes in the DNA of a cell that tell it to multiply out of control.
Understanding where this change has occurred – for example, which gene is faulty – can help us know which treatment will give you the best chance of killing the cancer cells and stopping new ones from growing.
Your clinical team will explain this to you in more detail at your appointment.
Our treatments
At The Clatterbridge Cancer Centre, we provide specialist non-surgical treatment for bile duct cancer. We also work closely with other specialists and surgical teams in other hospitals to plan and coordinate your care every step of the way.
Systemic anti-cancer therapy (SACT)
SACT is a term used to describe the different drug therapies for cancer. These include:
- Chemotherapy – which aims to kill cancer cells
- Immunotherapy – which aims to train your immune system to attack cancer
- Targeted therapies – which aim to target the DNA and cell changes that cause cancer
The treatments we offer for bile duct cancer include:
Chemotherapy
- Treatment for bile duct cancer that can be removed: You might have chemotherapy after your surgery, to reduce the risk of the cancer coming back.
- Treatment for bile duct cancer that cannot be removed or has come back (recurrence): The aim of chemotherapy is to try to control the cancer, slow its growth and to relieve any symptoms you may have.
Because different cancers are sensitive to different chemotherapy drugs, everyone’s treatment plan is designed according to the specific type of cancer. Your general health and fitness is also important when deciding on your treatment plan.
Targeted therapy
This may be used in a small group of patients with specific genetic mutations. These drugs can be used to treat some advanced bile duct cancers that cannot be removed by surgery or have spread to distant areas after at least one previous chemotherapy treatment.
Immunotherapy
Durvalumab is an immunotherapy drug that may be used in combination with first line chemotherapy for bile duct cancer. Your doctor will tell you if you might benefit from this treatment. There is a small subset of patients with a specific genetic profile that might be eligible and benefit from immunotherapy in later lines of treatment as well.
For more information on immunotherapy.
All treatment options will be discussed with you at your outpatient appointment.
Find out more about systemic anti-cancer therapy at The Clatterbridge Cancer Centre.
Radiotherapy
Radiotherapy can be used to treat bile duct cancer. Sometimes radiotherapy is given instead of surgery. Sometimes it is used to shrink the tumour before, during or after other treatment. Sometimes it is used to relieve symptoms such as pain.
We use different types of radiotherapy, depending on the type, size, location and stage of the cancer.
The radiotherapy treatments we offer for bile duct cancer include:
- Traditional external beam radiotherapy – where radiation is delivered from outside the body
- Stereotactic ablative radiotherapy (SABR) – a way of very precisely targeting radiotherapy to certain cancers
Find out more about radiotherapy at The Clatterbridge Cancer Centre.
Clinical trials
Research and trials of new cancer treatments are an important part of our work. Your consultant will tell you about any clinical trials that may be suitable for you.
You are also very welcome to ask us about clinical trials during your appointments. We will be happy to answer any questions you have.
Find out more about clinical trials.
Treatment locations
We have a multi-site model where we visit hospitals across Cheshire and Merseyside to provide treatment and consultations closer to patients’ homes.
We provide systemic anti-cancer therapies (e.g. chemotherapy, targeted therapies and immunotherapy) for breast cancer at the following sites:
- Clatterbridge Cancer Centre – Liverpool
- Clatterbridge Cancer Centre – Wirral
- Marina Dalglish Centre, Aintree University Hospital
- Halton – CanTreat Unit
- Southport and Ormskirk Hospital
- St Helens – Lilac Centre
- Outreach services to the Isle of Man
We provide radiotherapy for bile duct cancer in our three specialist sites:
Clinical trials for bile duct cancer are delivered at Clatterbridge Cancer Centre – Liverpool.
The team consists of medical oncologists, advanced nurse practitioners, clinical nurse specialists, radiographers, pharmacy, research practitioners and administrative support.
Our operational management team makes sure the service runs smoothly.
Consultants
Medical Oncologists
Professor Dan Palmer
Dr Olusola Faluyi
Dr Nils Elander
Nurses
Advanced Nurse Practitioners
Sarah Stevenson
Diane Foster
Clinical Nurse Specialists
Abbey Phudaphatt
Alison Griffin
Cancer Support Worker
Sarah Wallace
Other team members
Dietitian
Lauren Roberts
Virtual tour of Radiotherapy unit (CCC-Liverpool)
Our Cancer Information and Support Centres can provide individualised help and support for patients and families affected by cancer. The team’s main base is in Clatterbridge Cancer Centre – Liverpool but they also work at our Aintree and Wirral hospitals.
There are also local Macmillan services in other hospitals across our region.
External sites that offer extra support and information about liver cancer include: