Bile duct cancer
Diagnosis and tests
Diagnosing bile duct cancer
Your family doctor (GP) will talk to you about your symptoms and may do blood tests such as:
- A full blood count
- Kidney and liver function tests
- Tumour marker tests. Tumour markers are substances that might be found in your blood, which can show you have cancer
Your GP will refer you to a specialist if they are concerned about your symptoms and think you need more tests.
If you are diagnosed with bile duct cancer we're here for you.
Our cancer nurses are here if you need information or just want to talk. They can help you to understand your diagnosis, what to expect, send you information and tell you about our services.
Further tests for bile duct cancer
You may need further tests to give your doctors more information about your general health and about the cancer. For example:
A special type of X-ray to give a picture of the tissues inside your body.
Read more about CT scans.
A scan that uses magnetic energy to build up a picture of the tissues inside your body. During the scan you will lie inside a tunnel-like machine.
Read more about MRI scans.
A device like a microphone passed over your tummy to give a picture of your kidney, bladder and nearby organs. It can show any abnormal changes.
Read more about ultrasound scans.
This is a special type of X-ray that looks at your bile ducts. Your doctor will pass a thin, flexible tube through your mouth and into your stomach and bowel. The doctor can look at your bile duct and check for any abnormal changes. They can also inject dye into the duct and check for blockages on the X-ray. The doctor may take a sample of tissue (biopsy) of any abnormal looking areas. The sample will be examined under a microscope by a pathologist.
Read more about having an ERCP.
This is a type of X-ray of your liver and bile duct. Your doctor numbs an area of your tummy (abdomen) with local anaesthetic first. He or she then puts a thin needle through your tummy and into your liver. A dye is injected into your bile duct so that your doctor can see any blockages on the X-ray. The doctor may take a sample of tissue (biopsy) during this test. The sample will be examined under a microscope by a pathologist.
Your doctor passes a thin, flexible tube through your mouth and down into your stomach and bowel. A device called a probe is then put through the tube. This uses sound waves to look at organs near to your bile duct, like your pancreas.
Read more about having an EUS.
Your doctor makes a cut in your tummy (abdomen) to check for abnormal changes. A laparoscopy can sometimes lead to more surgery, depending on what your doctor finds. For example, removing your bile duct.
Read more about having a laparoscopy.
The tests you have can help to:
- Stage your cancer. This means finding out the size and position of the cancer.
- Grade your cancer. Grading describes how quickly the cancer may grow and spread and how it might respond to treatment.
Some tests may be used see how you are responding to treatment.
Staging is important as it helps your medical team decide on the best treatment for your cancer.
Waiting for test results
While some results may come back quickly, others may take a few weeks. Waiting for results can be an anxious time. It may help to talk things over with your doctor or nurse or with a relative or close friend. You can also call our Support Line on 1800 200 700 or visit a Daffodil Centre to speak to a cancer nurse.
What are the stages of bile duct cancer?
Staging means finding out how big the cancer is and if it has spread to other parts of your body. Staging will help your doctor to plan the best treatment for you.
TNM staging system
The staging system normally used for intrahepatic bile duct cancer and distal extrahepatic bile duct cancer is called TNM. This stands for:
- Tumour (T): The size of the tumour.
- Node (N): Is there cancer in your lymph nodes? N0 means there are no lymph nodes affected.
- Metastasis (M): Has the cancer has spread to other parts of your body? M0 means it hasn’t spread to other parts.
Number staging
Your doctor often uses the TNM information to give your cancer a number stage – from 1 to 4. A higher number means a more advanced cancer.
For perihilar bile duct cancer your doctor may use a staging system called the Bismuth-Corlette staging system. This is based on where exactly in the perihilar area the cancer is situated. For example, type 1 is when the cancer is in the common hepatic duct; type 2 is where it is in the common hepatic duct and also in the area where the left and right hepatic ducts join.
Knowing the stage of your cancer helps your team to plan the best treatment for you.
What are the grades of bile duct cancer?
The grade of a cancer describes the tumour cells and can give your doctors an idea of how quickly it might grow and spread. Low-grade cancers are usually slower growing, and high-grade cancers have a greater risk of spreading.
Staging and grading can be hard to understand, so ask your doctor and nurse for more information if you need it.
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