Cholangiocarcinoma: what to look for

As part of Cholangiocarcinoma Awareness Month (February 2013), Dr George Webster, a consultant in gastroenterology and hepatology, explains what cholangiocarcinoma is, and the signs and symptoms everyone should be aware of.

Cholangiocarcinoma (also known as bile duct cancer) is a rare form of malignancy that arises from the bile ducts, either within the liver or after the main bile duct leaves the liver and links the liver to the duodenum. It may affect anybody, but usually occurs in those over the age of 60. Although in most cases there is no clear underlying cause for cholangiocarcinoma, it may sometimes occur in association with other chronic bile duct conditions, such as primary sclerosing cholangitis.

Symptoms of cholangiocarcinoma may include jaundice (yellow eyes – and often in association with dark urine or pale stools), a pain or ache under the right ribs, unexplained weight loss and general fatigue. Although urgent assessment is needed for these symptoms, most people with them will not be found to have a cholangiocarcinoma and the clinical features may be mimicked by benign (non cancerous) conditions.

Prompt and expert investigation is vital, as making a clear diagnosis is often difficult, and may involve blood tests, scans (including CT and MRI) and specialist endoscopies (such as endoscopic ultrasound, ERCP and cholangioscopy). Harley Street at University College Hospital is one of the only units in the UK that has all these diagnostic facilities on one site, as well as consultants who are highly experienced in the management of cholangiocarcinoma.

A very careful assessment and review of all investigations needs to be performed within a specialist multidisciplinary team of physicians, surgeons, radiologists, pathologists and oncologists, in order to decide if surgery is possible. Surgery may involve removal of a segment of the bile duct, or even part of the liver as well. Additional treatments may involve bile duct stenting (inserting a tube into the duct to ensure good drainage of bile from the liver) or chemotherapy.

The consulting team at Harley Street at University College Hospital has specialist expertise in all aspects of the care of patients with suspected cholangiocarcinoma, including endoscopy, diagnosis, surgery and chemotherapy, and is also actively involved in improving patient care in all these areas through research and publications.

Dr George Webster BSc MD FRCP has been a consultant in gastroenterology and hepatology since 2003. He has a specialist interest in all aspects of hepatopancreatobiliary medicine and interventional endoscopy.

Harley Street at University College Hospital offers the full range of diagnostic and treatment services for people with cholangiocarcinoma. We are proud to work with a team of internationally renowned specialists such as Dr Webster and to treat all types of cancer in a safe and modern environment containing the world’s most advanced technology. There are no waiting lists and appointment times can be arranged to suit you.