Bile duct cancer is an aggressive form of cancer that can be difficult to treat. Many people with the cancer are diagnosed in its later stages.

Also known as cholangiocarcinoma, bile duct cancer starts in the bile duct. These thin tubes start in the liver and enter the small intestine, carrying a fluid known as bile which helps digest food. There are three types: perihilar, distal, and intrahepatic.

The speed with which bile duct cancer spreads varies from person to person, but generally, it is considered an aggressive cancer. A person’s outlook and survival rate depend on the stage of cancer when it is diagnosed.

Read on to learn more about how fast bile duct cancer spreads, its stages, and where it spreads.

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Bile duct cancer is rare and aggressive. This suggests that the progression of bile duct cancer is relatively rapid. According to a 2019 study, the average survival time after surgery for those with intrahepatic bile duct cancer, which makes up 5–10% of cholangiocarcinoma, is about 12.4 months.

The risk and progression of disease might be higher in people with certain risk factors. These include:

Experts classify bile duct cancer into stages. These indicate whether the cancer has spread, and if so, how far. It helps the doctor to determine the seriousness of the disease as well as suitable treatment approaches.

The stages range from 0–4 and vary slightly depending on the type of bile duct cancer. This section explains the stages for intrahepatic, originating in the bile ducts, or distal, which starts closer to the small intestine.

The stages of intrahepatic bile duct cancer are:

  • Stage 0: Also known as carcinoma in situ, abnormal cells appear in the innermost tissue that lines the intrahepatic bile duct.
  • Stage 1: A tumor is present but is relatively small and has not spread.
  • Stage 2: There may be multiple tumors or one that has spread to blood vessels.
  • Stage 3: The tumor has spread to the outer lining of the liver or nearby tissues and organs.
  • Stage 4: Cancer has spread to other parts of the body.

The stages of distal bile duct cancer are:

  • Stage 0: Also called carcinoma in situ, abnormal cells appear in the innermost lining of the distal bile duct.
  • Stage 1: Cancer has spread less than 5 millimeters (mm) into the wall of the distal bile duct tube.
  • Stage 2 Cancer has spread into the bile duct wall and 1–3 lymph nodes.
  • Stage 3: Cancer has spread to 4 or more lymph nodes and surrounding blood vessels.
  • Stage 4: Cancer has spread to other parts of the body.

The stages of perihilar bile duct cancer are:

  • Stage 0: Also called carcinoma in situ, abnormal cells appear in the innermost lining of the perihilar bile duct.
  • Stage 1: Cancer has spread into the muscle layer of the perihilar bile ducts.
  • Stage 2: Cancer has spread through the bile duct walls into the liver or fatty tissue.
  • Stage 3: Cancer has spread to blood vessels or 1–3 lymph nodes.
  • Stage 4: Cancer has spread to more than 4 lymph nodes or other organs and tissues.

Advanced bile duct cancer can spread locally to nearby tissues or different parts of the body (metastatic).

Locally advanced bile duct cancer can spread to:

  • small intestine
  • liver
  • pancreas
  • nearby blood vessels

Metastatic cancer can spread anywhere in the body, but it commonly extends to:

  • lungs
  • brain
  • bones
  • the lining of the abdomen

People should consult a healthcare professional if they have symptoms such as:

  • jaundice
  • abdominal pain
  • dark urine
  • itchy skin
  • vomiting and nausea
  • weight loss

Doctors might recommend several diagnostic tests that help to determine whether these symptoms occur due to bile duct cancer or other health conditions.

Bile duct cancer is a rare, aggressive form of cancer. It can spread to nearby tissues as well as organs in other parts of the body.

The stage of a person’s cancer determines how quickly it will spread, and each type of bile duct cancer has a different staging system.