Symptoms of Cholangiocarcinoma
Bile duct cancer does not usually cause signs or symptoms until later in the course of the disease, but sometimes symptoms can appear sooner and lead to an early diagnosis. Symptoms gradually worsen. Abdominal pain may become increasingly severe and constant. The stool may become paler. People feel tired and uncomfortable. They may feel a mass in their abdomen.
Early symptoms of Cholangiocarcinoma include the following:
Jaundice is yellowing of the skin and eyes. Normally, bile is made by the liver and released into the intestine. Jaundice occurs when the liver can’t get rid of bile, which contains a greenish-yellow chemical called bilirubin. As a result, bilirubin backs up into the bloodstream and settles in different parts of the body. This can often be seen in the skin and the white part of the eyes. Jaundice is the most common symptom of bile duct cancer.
Excess bilirubin in the skin can also cause itching. Most people with bile duct cancer notice itching.
Bilirubin contributes to the brown color of bowel movements, so if it doesn’t reach the intestines, the color of a person’s stool might be lighter.
If the cancer blocks the release of bile and pancreatic juices into the intestine, a person might not be able to digest fatty foods. The undigested fat can also cause stools to be unusually pale. They might also be bulky, greasy, and float in the toilet.
When bilirubin levels in the blood get high, it can also come out in the urine and turn it dark.
Abdominal (stomach/belly) pain:
Early bile duct cancers usually do not cause pain, but more advanced cancers may cause abdominal pain, especially below the ribs on the right side.
Loss of appetite and weight loss:
People with bile duct cancer may not feel hungry and may lose weight (without dieting).
Weakness or worsening fatigue:
A decline in muscle strength and easily tiring when performing regular tasks.
Nausea and vomiting
These are not common symptoms of bile duct cancer, but they may occur in people as a result of bile duct blockage. They are often seen along with a fever.
Fever and chills
Some people with bile duct cancer develop fever and chills.
Bile duct cancer is not common, and these symptoms and signs are more likely to be caused by something other than bile duct cancer. For example, people with gallstones may have many of these same symptoms. There are many far more common causes of abdominal pain than bile duct cancer. For these reasons cholangiocarsinoma is often mistaken for another disease and may continue to go undiagnosed or be mis-diagnosed. If you have any of these problems, it’s important to see your doctor right away so the cause can be found and treated, if needed.
- American Joint Committee on Cancer. AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer; 2010: 201-205; 219-230.
- National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Hepatobiliary Cancers. V.2.2014. Accessed at
- National Cancer Institute. Physician Data Query (PDQ). Extrahepatic Bile Duct Cancer Treatment. 2014. Accessed at