Health information to help you understand symptoms. It isn't a diagnosis.
Check symptoms

Bile duct cancer (cholangiocarcinoma)

Also called: Klatskin tumor, Biliary cancer

A rare cancer of the bile ducts. Painless yellow skin with itching and dark urine is a common first sign.

Typical ageOver 65
Key signPainless jaundice

Overview

Cholangiocarcinoma can start inside the liver or in the ducts outside it. Tumors outside the liver often block bile flow early.

Surgery offers the best chance of cure when possible. A stent can relieve the blockage, and chemotherapy, immunotherapy, and targeted drugs (based on tumor gene tests) are used for advanced cancer.

Symptoms

Common signs:

  • Yellow skin or eyes without much pain
  • Itching
  • Dark urine and pale stools

Less common

  • Belly pain on the upper right
  • Weight loss
  • Fever

Look up a symptom: Itching · Losing weight without trying · Pale, greasy, or floating stools · Upper right belly pain (under the right ribs) · Yellow skin or eyes · Yellow skin or eyes without belly pain, with itching, dark urine, or pale stool

When to get medical care

Call 911Trouble breathing, heavy bleeding, a seizure, sudden confusion, or fainting: call 911.
Get care todayFever during cancer treatment, or new or quickly worsening symptoms.
See a doctor soonSymptoms lasting more than 2 to 3 weeks.

Causes

Changes in a cell's genes that make it grow out of control. Most happen by chance; some are linked to the risk factors below or to inherited genes.

Does it spread or run in families?

  • Cancer isn't contagious. You can't catch it from someone.

Who is more likely to get it

  • Primary sclerosing cholangitis
  • Bile duct cysts
  • Liver fluke infection
  • Hepatitis B or C and cirrhosis

Diagnosis

Tests look for the cause. Many people checked for these symptoms turn out not to have cancer.

Questions you may be asked

  • When symptoms started and whether they're getting worse
  • Family history of cancer
  • Past illnesses, treatments, and exposures

The exam

A physical exam, focused on where the symptoms are.

Tests

Tests, if needed:

  • Liver blood tests and CA 19-9:
  • Ultrasound, CT, or MRI (MRCP):
  • ERCP with brushings or biopsy:

Treatment

Treatment depends on the type, stage, and your overall health. A cancer care team makes a plan with you.

Self-care

  • Write down symptoms and when they started
  • Bring someone with you to appointments
  • Ask for copies of test results
  • Ask about clinical trials: they can offer new treatments
  • Quit smoking: it helps at every stage

Surgery, stents, chemotherapy, immunotherapy, targeted drugs, or radiation.

Prevention

To lower risk or find it early:

  • Prevent hepatitis B (vaccine) and treat hepatitis C

Which doctor treats this

  • Start with your primary care provider (family doctor or internist).
  • They may send you to an oncologist (cancer doctor), often working with surgeons and radiation doctors.

Living with it

  • Keep a simple notebook of symptoms, medicines, and questions for visits.
  • Ask for a survivorship care plan when treatment ends.
  • Gentle activity, like walking, can ease tiredness.
  • A cancer diagnosis can affect mood. Tell the care team if you or your family feel down or anxious.

Support groups and helplines

Back to school, work, or sports

  • Many people keep working during or after treatment.
  • Ask about changes that help, like flexible hours. Workers may be covered by the ADA.

Pregnancy and breastfeeding

  • If you're pregnant or planning to be, tell your cancer team. Some treatments can harm a baby.
  • Ask about saving eggs or sperm before treatment if you may want children later.

For caregivers

  • Go to visits when you can and take notes.
  • Keep a list of medicines, allergies, and doctors in one place.
  • Learn the warning signs that need fast care, like fever during treatment.
  • Take breaks and ask for help. Caregivers need care too.

Outlook

Outlook depends on the type and stage. Cancers found early are usually easier to treat, and treatments keep improving.

Support is available: ask about social workers, nutrition help, and support groups.

Getting ready for your visit

Bring a list of symptoms and medicines.

What to bring

  • A list of medicines and supplements
  • Notes on when symptoms started
  • Past test results and scans

Questions to ask

  • Can it be removed with surgery?
  • Do I need a stent to relieve the blockage?
  • What stage is it, and what are the treatment options?
  • Are there clinical trials for me?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Bile duct cancer (cholangiocarcinoma)

Sources

Last updated 2026-11-13.