Biliary Cancer

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Expert Care and Treatment for Pancreatic and Biliary Cancers

The Pancreas and Biliary Tumor Center includes professionals who have experience with all stages of pancreatic and biliary diseases.

Your care team will collaborate to develop a comprehensive, personalized treatment plan that offers the most advanced therapies and an array of supportive resources. 

Pancreas and Biliary Tumor Center

What Is Biliary Cancer?

Biliary cancers are malignancies in the organs of the biliary system, which includes gallbladder and bile ducts. While gallbladder cancer and bile duct cancer are separate diseases, they are both part of the biliary drainage system and tend to be cancers that begin in glandular cells in tissue that lines the biliary tract. 

Cancer of the bile ducts and the gallbladder are relatively uncommon: Roughly 10,000 Americans are diagnosed with cancer of the biliary tract each year, and unfortunately, most patients usually are not diagnosed until the cancer has advanced to the point where it has spread. 

  • Biliary tumors are sometimes discovered during imaging studies (MRI or a CT scan) for another condition, or for screening for familial cancers. 
  • Gallbladder cancer is associated with gallstones in more than two thirds of patients, and bile duct cancer can also be associated with other conditions such as Caroli's disease, ulcerative colitis, and cysts of the bile duct. 

If you or a loved one has biliary cancer, the dedicated caregivers at the Pancreas and Biliary Tumor Center at Dana-Farber Brigham Cancer Center are here to help. Our internationally recognized team of experts works together to provide comprehensive, compassionate care and personalized treatment for each patient, utilizing the full range of therapies and services of Dana-Farber Brigham Cancer Center. 


Approximately 10,000 Americans are diagnosed with cancer of the biliary tract each year. The incidence of biliary tract cancer increases with age; the typical patient is between 50 and 70 years old. It is more common in Caucasians than in African-Americans. 


Risk Factors and Management 

The main risk factors for biliary cancer are: 

  • Primary sclerosing cholangitis (PSC), an inflammatory condition in the bile duct that is strongly associated with inflammatory bowel disease. Nearly 30 percent of biliary cancers are diagnosed in patients with PSC. 
    • If you have PSC, we will conduct an MRI of the bile duct and perform a specialized ERCT endoscopic procedure, in which suspicious areas are biopsied through small, sophisticated tools inserted through the mouth. If there is no evidence of cancer or blockages, you will likely be monitored. 
  • Biliary cysts: These cysts have about a 15 percent risk of becoming cancerous. 
  • Gallstones: Gallstones are present in 70 to 90 percent of patients with gallbladder cancer. 

Other risk factors include: 

  • Biliary cysts 
  • Cirrhosis of the liver 
  • Fibropolycystic liver disease 
  • Congenital abnormalities of the biliary tree 
  • Hepatitis C virus infection 
  • Chronic disease of the biliary tree 
  • Parasitic infections of the liver and biliary tree 
  • Gallbladder polyps, chronic gallbladder inflammation, and gallstone disease (for gallbladder cancer) 
  • Toxic exposure: the radiologic contrast agent Thorotrast 
  • The genetic disorders Lynch syndrome and biliary papillomatosis 
  • Diabetes 
  • Obesity 
  • HIV infection 

Genetic Risk Assessment for Biliary Cancer 

Genetic screening for biliary cancer is still in its early stages. Our dedicated genetics team has expertise evaluating and managing patients who are at high risk for developing biliary cancer. In select cases, identifying a genetic syndrome impacts the course of cancer treatment. 

Genetic screening is available to all of our patients and is particularly important if you have family members who were diagnosed with biliary cancer at a young age, a strong family history of biliary cancer, or other cancers. 

If you have a family history of cancer, you may wish to meet with one of our gastroenterologists, as well as a genetic counselor, for an in-depth risk assessment

The risk assessment includes: 

  • A detailed family lineage analysis 
  • Genetic evaluation using state-of-the-art molecular tests 
  • Tailored cancer screening and prevention recommendations for you and your family members 

If we find a genetic syndrome that could contribute to developing biliary cancer, we can coordinate a screening regimen. 

Evaluations are provided by the Center for Cancer Genetics and Prevention.

Signs and Symptoms 

Biliary tumors are often detected at an advanced stage, as the disease is often asymptomatic at earlier stages. When biliary cancer is found early, it is often because patients are being examined for another reason. When it's caught early, there is a better chance of recovery. 

Usually, the main symptom is a constant pain in the upper part of the abdomen that radiates toward the back. Other symptoms include: 

  • Jaundice (a painless yellowing of the skin and in the whites of the eyes) 
  • Dark yellow urine 
  • Pain in the upper or middle part of the abdomen and back 
  • Unexplained weight loss 
  • Loss of appetite 
  • Vomiting, diarrhea 
  • White stool and general itchiness caused by a blockage in the bile duct 

Find out more about gallbladder cancer and bile duct cancer from the National Cancer Institute. 

Bile Duct Cancer: A Patient's Journey

A bile duct (cholangiocarcinoma) patient and her doctor, Dana-Farber's Douglas Rubinson, MD, detail the ups and downs of her journey as well as the latest research into bile duct cancer. 

Why Choose Us

At the Pancreas and Biliary Tumor Center at Dana-Farber Brigham Cancer Center, our team of experts work together to provide compassionate, comprehensive, and highly coordinated care for people with biliary tract cancer (which includes the gallbladder and bile ducts). 

Our highly specialized center includes leaders in the field who provide patients with the highest level of care in state-of-the-art facilities, perform basic scientific and clinical research, and offer the full spectrum of care including targeted therapies when appropriate, with the full range of support services from a top-ranked hospital and leading cancer center. 

We provide comprehensive services to patients with these cancers, including: 

  • Advanced diagnostics to understand each patient’s tumor at the molecular level and provide sophisticated therapies tailored to your tumor 
  • Access to an expansive portfolio of clinical trials
  • Multidisciplinary care delivered by specialists from Dana-Farber Cancer Institute and Brigham and Women’s Hospital