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Bile Duct Cancer and Liver Fluke Infection

Bile duct cancer (cholangiocarcinoma) is cancer of the biliary duct system. It is a rare cancer but becomes more common as you grow older.

The biliary duct system includes:

  • Gallbladder

  • Bile ducts

  • Certain cells inside the liver

close up view of liver fluke next to a ruler where it measures 1 cm in length.
Liver fluke

One risk factor for bile duct cancer is past infection with tiny parasitic worms called liver flukes. These worms are found in the fresh waters of Southeast Asia. You can become infected by eating fish that have these parasites. Once eaten, the liver flukes grow to adulthood inside your biliary duct system. The irritation and scarring caused by liver fluke infection can lead to bile duct cancer.

Two of the most common parasites are:

  • Opisthorchis verrini which is found in Southeast Asian countries, including Thailand, Lao People’s Democratic Republic, Vietnam, and Cambodia

  • Clonorchis sinensis which is common in rural areas of Korea and China

Veterans who ate raw or undercooked freshwater fish during their service in Southeast Asia, such as Vietnam War Veterans, might have been infected. However, VA is not aware of any studies that show that bile duct cancer occurs more often in U.S. Vietnam War Veterans than in other groups of people.

Other risk factors for bile duct cancer are:

  • Primary sclerosing cholangitis (disease of the bile ducts)

  • Chronic ulcerative colitis

  • Cysts in the bile ducts

  • Cirrhosis of the liver

  • Hepatitis B or C virus

  • Diabetes

  • Obesity

  • Genetic factors

Symptoms of Bile Duct Cancer

Symptoms of bile duct cancer include:

  • Jaundice (yellowing of the skin and the whites of the eyes)

  • Pain in the abdomen

  • Dark urine

  • Light or clay colored stool

  • Fever

  • Itchy skin

  • Nausea and vomiting

  • Unexplained weight loss

If you are concerned about bile duct cancer, please talk with your healthcare provider.

Tests for Bile Duct Cancer

Your healthcare provider will use your medical history, a physical exam, and tests to diagnose bile duct cancer. The tests can include: a variety of blood tests and medical imaging, such as X-rays, CT and MRI scans, and/or ultrasound. Your healthcare provider may also consult with specialists to make a diagnosis.

Tests for Liver Fluke Infection

Your healthcare provider can also test your stool for an ongoing liver fluke infection. If the infection happened years ago, the test may not show the presence of liver flukes. Currently, there is no test available if you had a previous (resolved) liver fluke infection. 

Health Concerns

If you have any abdominal (belly) issues and ate raw or undercooked fish in Southeast Asia, you should tell your healthcare provider.

Contact your healthcare provider at your local VA Medical Center to get more information about military exposures and health. Or contact your VA Environmental Health Coordinator to connect you to a healthcare provider.

Healthcare Benefits

VA offers a variety of healthcare benefits to eligible Veterans. Not enrolled in the VA health care system? Find out if you qualify for VA healthcare. And find out about VA benefits for which you may be eligible. 

For more information, click here.

Author: StayWell Custom Communications
Last Annual Review Date: 2/1/2018
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