Signs and Symptoms of Bile Duct Cancer

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. If the cancer is diagnosed at an early stage, treatment might work better.

When bile duct cancer does cause symptoms, it's usually because a bile duct is blocked. Symptoms tend to depend on whether the cancer is in ducts inside the liver (intrahepatic) or in ducts outside the liver (extrahepatic), and include:

Jaundice

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. Jaundice can often be seen as a yellowing of the skin and in the white part of the eyes.

Jaundice is the most common symptom of bile duct cancer, but most of the time, jaundice isn't caused by cancer. It's more often caused by hepatitis (inflammation of the liver) or a gallstone that has traveled to the bile duct. But whenever jaundice occurs, a doctor should be seen right away.

Itching

Excess bilirubin in the skin can also cause itching. Most people with bile duct cancer notice itching.

Light-colored/greasy stools

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.

Dark urine

When bilirubin levels in the blood get high, it can also come out in the urine and turn it dark.

Abdominal (belly) pain

Early bile duct cancers seldom cause pain, but bigger tumors may cause belly pain, especially below the ribs on the right side.

Loss of appetite/weight loss

People with bile duct cancer may not feel hungry and may lose weight without trying to do so.

Fever

Some people with bile duct cancer develop fevers.

Nausea and vomiting

These are not common symptoms of bile duct cancer, but they may occur in people who develop an infection (cholangitis) as a result of bile duct blockage. These symptoms are often seen along with a fever.

Keep in mind: Bile duct cancer is rare. These symptoms are far more likely to be caused by something other than bile duct cancer. For example, people with gallstones have many of these same symptoms. And there are many far more common causes of belly pain than bile duct cancer. Also, hepatitis (an inflamed liver most often caused by infection with a virus) is a much more common cause of jaundice.

Still, if you have any of these problems, it’s important to see a doctor right away so the cause can be found and treated, if needed.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

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Patel T, Borad MJ. Carcinoma of the biliary tree. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2015:715-735.

Last Medical Review: July 3, 2018 Last Revised: July 3, 2018

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