What is cholangiocarcinoma?

February is Gallbladder and Bile Duct Cancer Awareness Month and World Cholangiocarcinoma Awareness Day. In everyday life, most of us understand terms like melanoma and lymphoma, but another form of cancer, cholangiocarcinoma, usually draws a blank.

Cholangiocarcinoma is cancer of the gallbladder or bile ducts. It is a rare form of cancer that affects approximately 1,300 Australians each year.

The gallbladder is a small pear-shaped organ located in your upper abdomen next to the liver. The role of the gallbladder is to store fluid called bile. The liver produces bile to help digest and absorb fats in the small bowel (or small intestine). Bile duct cancer affects the tubes that transport the bile produced by the liver into the small intestine. There are two bile ducts that come from the liver and one from the gallbladder. These tubes connect to form the common bile duct that connects to the small intestine. When food is being digested, bile stored in the gall bladder is released and passed through the bile ducts into the small intestine.

Like many GI cancers, cholangiocarcinoma is most effectively treated when it is found early, but this can be difficult as it often does not cause symptoms in its early stages. However, some people with cholangiocarcinoma may notice symptoms that include:

  • jaundice (yellowing of the skin and whites of the eyes)
  • unexplained nausea and vomiting
  • unexplained weakness
  • unexplained loss of appetite and weight loss
  • fevers and chills
  • pain in the right side of the abdomen
  • darkened urine
  • pale bowel movements
  • itchy skin.

As this cancer is rare and difficult to treat, only around 1 in 5 people diagnosed survive beyond five years. One of the reasons that survival rates are lagging behind those of some other cancers is a lack of awareness of this cancer that could lead to more funding for clinical research. Research into rare cancers also takes longer as reaching a large patient population can be challenging.

The GI Cancer Institute has conducted a trial called ACTICCA-1, led by Dr Jenny Shannon. Dr Shannon believes that the results of ACTICCA-1 could improve the survival outcomes for people with cholangiocarcinoma. The trial is investigating treating patients with chemotherapy after surgery. It will help researchers to know if this treatment prevents cancer from returning after it has been removed.

“I hope that this trial will give people with cholangiocarcinoma the opportunity to access more effective treatment, and to improve patient outcomes in the future,” Dr Shannon says. If it is successful, the results of this trial will provide a lifeline to people experiencing cholangiocarcinoma.

If you notice any of the symptoms listed above or changes in your digestion, please contact your GP.

What is a rare cancer?

In Australia, a rare cancer is defined as one which has fewer than 6 diagnoses per 100,000 people. Another term used to refer to cancers is ‘less common’, which is defined as one with fewer than 12 diagnoses per 100,000 people. Other rare and less common GI cancers include oesophageal cancer, liver cancer, neuroendocrine tumours (NETs), gastro-intestinal stromal tumour (GIST), small bowel cancer and anal cancer.