Bile Duct Cancer (Cholangiocarcinoma)


marijuana for bile duct cancer
Those living with bile duct cancer know the debilitating symptoms it produces. Not only does cancer itself impact everyday living, but the treatments for it do as well.

Often, bile duct cancer can be challenging to treat. Treatments like chemotherapy, radiation and invasive surgery can wreak havoc on your body. But what about the benefits of medical marijuana for bile duct cancer? Research has shown cannabis not only helps to alleviate the symptoms of cancer and cancer treatments, but it may also stop cancer cell growth.

What Is Bile Duct Cancer?

Bile duct cancer is cancer of your bile duct, where it first originates. Your bile duct is a four- to five-inch-long thin tube transferring bile fluid to your small intestine from your gallbladder and liver. When the fluid gets to your small intestine, it works to digest fat from the foods you consume.

Doctors also refer to bile duct cancer using the medical term cholangiocarcinoma. It tends to affect men more than women and develop in individuals between the ages of 50 and 70 years old. For some individuals, certain treatments can destroy this cancer, but for others, it doesn’t go away completely.

Types of Bile Duct Cancer

Cancers may occur in any area of your bile duct system. Depending on the area where they grow, doctors classify them as:

  1. Perihilar or hilar bile duct cancers
  2. Intrahepatic bile duct cancers
  3. Distal bile duct cancers

Each type may cause a different set of symptoms.

Perihilar, or Hilar, Bile Duct Cancers

These occur via the hilum, the spot where your right and left hepatic ducts connect and exit your liver. Doctors also refer to them as Klatskin tumors. They group them as extrahepatic bile duct cancers with distal bile duct cancers.

Intrahepatic Bile Duct Cancers

Intrahepatic bile duct cancers develop inside your liver inside smaller bile duct branches. They’re occasionally mixed up with cancers forming in liver cells known as hepatocellular carcinomas, but doctors treat them in the same manner.

Distal Bile Duct Cancers

You find these closer to your small intestine, further down your bile duct. They’re extrahepatic bile duct cancers, like perihilar cancers, since they develop outside your liver.

Medical Marijuana & Bile Duct Cancer

Bile Duct Cancers by Type of Cell

You may also divide bile duct cancers into kinds determined by the appearance of cancer cells under a microscope. Regardless of type, physicians refer to almost all bile duct cancers as cholangiocarcinomas. Most are adenocarcinomas where the cancers begin via glandular cells. Adenocarcinomas start mucous gland cells lining the inner part of your duct.

Less-common bile duct cancers are:

Benign Bile Duct Tumors

Bile duct tumors aren’t all cancerous. A couple examples of non-cancerous (benign) tumors are bile duct adenomas and bile duct hamartomas.

History of Bile Duct Cancer

Cholangiocarcinomas are a distinct set of tumors speculated to develop in the biliary tract epithelium within the biliary tract or the liver. It’s hard for doctors to diagnose these types of cancers since it’s poorly understood how they develop, and their dim prognosis has led to a disorderly management approach.

cancer diagnosis

The two primary clinical phenotypes are within the liver, or intrahepatic, large ductal tumors and mass-forming tumors. The most prevalent of ductal cancers are liver hilum lesions. The clinical presentation, risk factors, management and natural history of the two cholangiocarcinoma types are different. Various challenges of coming up with effective management of these tumors affect efforts to improve the prognosis of these diseases in patients.

Symptoms of Bile Duct Cancer

Similar to other types of cancer, symptoms of bile duct cancer don’t occur in the disease’s earlier stages. Since your bile duct is situated deep inside your body, doctors can’t easily detect tumors during routine physical examinations.

Bile duct cancer symptoms may include:

  • Itching: Itching is a common symptom of this cancer and typically occurs when you have extra bilirubin in your blood that reaches your skin.
  • Jaundice: Yellowing of your skin and the white of your eyes.
  • Bloating feeling/enlarged abdominal mass: The tumor causes pressure on nearby organs leading to bloating.
  • Weight loss: Often combined with decreased appetite
  • Fever and nausea: A side effect of a build-up of bilirubin or abnormal liver function, fever and nausea could also occur due to a bile duct blockage causing cholangitis, or infection.
  • Abdominal pain: Abdominal pain tends to appear in the disease’s advanced stages.
  • Changes in urine or stool: You may have dark urine and light-colored stools. Bilirubin contributes to your stool’s color, and when there’s a lack of bilirubin, it causes your stool to be chalky or lighter in color. As you release bilirubin through your urine, it turns your urine a darker shade.

Effects of Bile Duct Cancer

When you receive a bile duct cancer diagnosis, you experience both physical and mental effects.

Physical Effects of Bile Duct Cancer

Blockage of your bile duct may result in cholangitis, or infection of your bile drainage system.

You may develop cirrhosis when you have bile duct cancer. This could be the result of the tumor blocking your bile duct, leading to liver scarring and cell destruction. Patients who have primary sclerosing cholangitis are particularly susceptible. Both sclerosing cholangitis and cirrhosis increase your risk for bile duct cancer.

You may experience other complications, such as adverse consequences of procedures the doctor performs to diagnose and treat your cancer, stemming from:

The farther away your tumor is from your liver hilum, the better your prognosis. Certain aspects of cell type and shape within the tumor also affect your outcome. If your tumor has lymph node involvement, attacked your adjacent tissues or has spread to distant areas of the body, your prognosis could be worse.

Mental Effects of Bile Duct Cancer

After receiving a cancer diagnosis, you may have social and emotional effects along with physical effects. These may include having to cope with emotions like managing your level of stress, your anger or your anxiety. Some patients may find it difficult to express their feelings to their loved ones.

cancer emotional effect

While you’re going through treatment and after, you might feel overwhelmed with many types of emotions. Many people do, and it’s normal. For instance, after receiving a cancer diagnosis, you may feel:

  • Distraught
  • Stressed
  • Anxious
  • Blue
  • Depressed

You may continue experiencing these feelings during treatment. You might begin thinking about dying. You might become more aware of how your cancer affects your loved ones or your career. Your relationship with others may change. Unexpected problems may occur and spark concern. For example, financial problems as a result of your treatment may cause you stress. Any of these changes may cause you anxiety.

Many factors affect how well you do both physically and mentally after you receive a diagnosis of bile duct cancer. These include:

  • The location of your tumor
  • How much your cancer has spread
  • Your underlying general health
  • Your support group
  • Your outlook

Bile Duct Cancer Statistics

Facts provided by the American Cancer Society include:

  • Around 8,000 Americans receive a bile duct cancer diagnosis each year.
  • Bile duct cancer mainly affects older people, but it may occur at younger ages.
  • Seventy years old is the average age Americans receive their intrahepatic bile duct cancer diagnosis — 72 years old for extrahepatic bile ducts.

average diagnosis age

Current Treatments Available for Bile Duct Cancer and Their Side Effects

Your doctor will sit down with you and go over all your treatment options once they’ve found and staged your bile duct cancer. Take the time to absorb the information your doctor presents to you and carefully consider your choices. Some factors you should take into consideration when choosing a treatment plan include:

  • The extent and location of your cancer
  • Whether the surgeon can remove your cancer by surgery
  • Your overall health
  • The treatment’s possible side effects
  • The likelihood of relieving symptoms, curing cancer or extending your life

Your primary bile duct cancer treatment options may include the following.


With bile duct cancer, there are two basic types of surgery:

  1. Palliative surgery
  2. Potentially curative surgery

If your doctor thinks there’s a good chance the surgeon can perform a successful resectable surgery based on results of earlier operations or imaging tests, they may recommend using potentially curative surgery.

If not, your doctor may suggest palliative surgery, where the surgeon performs surgery to relieve your symptoms or prevent or treat complications like a bile duct obstruction. The surgeon performs palliative surgery when they can’t completely remove the tumor because it’s too widespread. Palliative surgery doesn’t “cure” your cancer — it helps you feel better and may extend your life.

Potential side effects and risks of surgery may include:

  • Infections
  • Blood clots
  • Anesthesia complications
  • Bleeding
  • Pneumonia
  • Death in rare cases

You will likely have some pain in the area of your incision. Your doctor can prescribe you pain medication to control this pain.

Radiation Therapy

The surgeon uses high-energy rays in radiation therapy to destroy the cancer cells. To treat bile duct cancer, they may perform radiation in different settings, such as:

  • Before surgery, if there’s a chance they can remove the cancer
  • After resectable cancer surgery
  • As part of your primary therapy for advanced cancer
  • As palliative therapy

In some cases, the doctor may give you chemotherapy along with radiation therapy, which is called chemoradiation and helps radiation therapy work better.

Side effects from radiation therapy may include:

  • Skin problems
  • Fatigue
  • Shortness of breath
  • Nausea and vomiting
  • Diarrhea
  • Rectal bleeding in men
  • Changes in menstruation in women


With chemotherapy, the doctor prescribes you anti-cancer drugs you either take orally by mouth or receive an injection through your vein. The chemo medications enter your body through your bloodstream and spread through all areas of your body. It’s a systemic treatment if your cancer has spread beyond the bile duct to other organs. Although chemo is effective for some people with this type of cancer, doctors find its effects for bile duct cancer limited.

The surgeon may use chemotherapy after resectable bile duct cancer surgery to lower the risk of a recurrence. Sometimes they combine it with radiation therapy. Side effects caused by chemo may include:

  • Hair loss
  • Nausea and vomiting
  • Fatigue
  • Infection
  • Easy bleeding and bruising
  • Constipation
  • Appetite changes
  • Anemia

Palliative Therapy

Palliative therapy helps reduce or control your symptoms when your cancer is in an advanced stage. Palliative therapy doesn’t cure your cancer. Doctors recommend palliative therapy when your cancer has spread too far for the surgeon to remove it. Palliative therapy prevents potential complications of your cancer and helps to improve your quality of life.

Potential side effects of palliative therapy may include:

  • Fatigue
  • Pain
  • Nausea or vomiting
  • Loss of appetite
  • Insomnia
  • Shortness of breath

Side effects of palliative therapy aren’t as harsh as those from chemo, radiation and other treatments.

Research on Cholangiocarcinoma and Marijuana

Cholangiocarcinoma (bile duct cancer) is a cancer that develops in the slender tubes in the liver that carry digestive fluid. It’s formed by mutated epithelial cells.

A 2010 scientific study based out of the Faculty of Pharmacy at Rangsit University in Thailand explored how THC could be used to treat cancer cells caused by cholangiocarcinoma. Their report is entitled “The dual effects of delta(9)-tetrahydrocannabinol on cholangiocarcinoma cells: anti-invasion activity at low concentration and apoptosis induction at high concentration.” Their hypothesis was that since cholangiocarcinoma cells contain cannabinoid receptors, they would benefit from THC treatments.

They found that THC had the following effects on cholangiocarcinoma cancer cells:

  • Inhibited the reproduction of cancer cells
  • Prevented cancer cells from migrating or invading
  • Induced cancer cell death

Their findings suggest that marijuana-based medications could be used to treat cholangiocarcinoma (bile duct cancer), along with other forms of cancer.

How and Why Marijuana Can Be an Effective Treatment for Bile Duct Cancer

Your liver is a central detoxification organ of your body. It filters all your blood, making it especially vulnerable to certain types of cancer. However, some research shows cannabinoid therapy could stop the progression of cancer, based on many anecdotal reports by patients.

hcc marijuana help

In 2015, in a cell line study, researchers found cannabinoids stopped hepatocellular carcinoma (HCC) cells effectively. HCC causes the majority of deaths from liver cancer, making the potential therapeutic impact of cannabis treatment vast and promising.

The synthetic cannabinoid WIN55, 212-2 was used during this research. The drug is a man-made version of THC, the psychoactive chemical in weed. The researchers found it stopped the cancer cells from dividing and growing.

Since the main job of your liver is to filter all your circulating blood, it’s susceptible to picking up traveling cancer cells in your bloodstream.

According to a published January 2016 review, cannabinoids help prevent distant tumor masses from forming in animal models. Even though those whose cancer has already spread to their liver can’t benefit much from this, the information does show early administration of marijuana for bile duct cancer could help keep cancers from getting far worse.

What Side Effects and Symptoms of Bile Duct Cancer Can Medical Marijuana Treat?

Cancer is a qualifying condition for medical marijuana use in a growing number of states. Many patients report cannabis and bile duct cancer treatment is effective in treating their symptoms, such as:

  • Nausea and vomiting
  • Weight loss
  • Decreased appetite
  • Anxiety
  • Depression
  • Abdominal pain

Side effects of medications cannabis can help alleviate, particularly from chemo, include:

  • Nausea and vomiting
  • Fatigue
  • Appetite changes

Best Strains of Marijuana to Use for Bile Duct Cancer Symptoms and Treatment Side Effects

In most cases, aside from being able to inhibit tumor growth and stop cell production, cannabis strains are used to alleviate cancer symptoms either from cancer itself or from the treatments to fight cancer. Here are some ways cannabis for bile duct cancer treatment helps combat symptoms and the strains to use.

Reduces Pain

Medical weed can significantly reduce chronic pain. Pain is a common symptom associated with different phases of cancer. Suggested strains:

  • ACDC (Hybrid)
  • Blackberry Kush (Indica)

Battles Rapid Weight Loss

Medical marijuana can help combat rapid weight loss or cachexia caused by cancer effectively. Cannabis has a profound impact on helping to alleviate cancer patients’ eating habits to counteract rapid weight loss. Suggested strain:

  • Bubba Kush (Indica)

Stimulates sleep

Cancer often results in insomnia and sleep deprivation, which tend to exacerbate the disease further. Suggested strains:

  • Northern Lights (Indica)
  • Afghan Kush (Indica)

Helps With Mood

Marijuana for bile duct cancer uplifts patients’ mood, suppresses depression and creates emotional balance. Suggested strain:

  • Super Silver Haze (Sativa)

Counteracts Nausea

Cannabis can prevent nausea — a feeling often brought on by chemotherapy. Suggested strains:

  • Northern Lights (Indica)
  • Super Lemon Haze (Sativa)

Best Methods of Marijuana Treatment to Use to Treat Side Effects and Symptoms of Bile Duct Cancer

Smoking cannabis for bile duct cancer strains is not an appropriate approach since cancer patients have vulnerable immune systems. But cannabis oil, on the other hand, provides cancer patients with a pervasive approach and viable alternative. You may create cannabis oil using different blends of marijuana strains to achieve different effects. For instance, different levels of CBD and THC can be the difference between helping with pain relief and insomnia to providing nausea relief and giving you energy.

Oral ingestion of medical cannabis eliminates the downsides and contributing effects linked to smoking like inhaling harmful chemicals. Oral ingestion provides cancer patients with a safer option. It’s also a convenient approach since you can incorporate it into numerous delicacies and, after being digested, the herb enters your bloodstream.

Enjoy a variety of edibles like cookies, cakes, bars, spreads and beverages. Just be sure to start slowly since the potency of edibles is stronger than other marijuana consumption methods.

Learn More About Medical Cannabis for Bile Duct Cancer

Your next step after deciding to give medical marijuana for bile duct cancer a try to relieve your symptoms is to browse through our list of marijuana doctors and search for a cannabis dispensary. Marijuana Doctors provides you with a way to do both, and more.

You’ll have access to a whole list of qualified marijuana doctors and other cannabis professionals who can answer your questions and guide you through your next steps, including how to get a medical marijuana card.


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