Bile duct cancer - Preventing bile duct cancer

There are no guaranteed ways to avoid getting bile duct cancer, although it is possible to reduce your chances of developing the condition.

The three most effective steps to reduce your chances of developing bile duct cancer are:

• giving up smoking (if you smoke)
• drinking alcohol in moderation
• minimising your exposure to the hepatitis B and hepatitis C viruses

Stopping smoking

Not smoking is the most effective way of preventing bile duct cancer, as well as other serious health conditions, such as stroke, heart attack and lung cancer.

It is particularly important to stop smoking if you have the liver condition known as primary sclerosing cholangitis (PSC). If you have PSC, smoking will significantly increase your chances of developing bile duct cancer.

Your GP can advise on how to give up smoking. They can also recommend and prescribe suitable medication. You can also get more information and advice from the NHS Smokefree website.

Read more about stopping smoking.

Alcohol

If you are a heavy drinker, reducing your alcohol intake will help prevent liver damage (cirrhosis). This may in turn reduce your risk of developing bile duct cancer. Reducing your alcohol consumption is particularly important if you have a pre-existing liver condition, such as PSC or hepatitis B or C.

The recommended maximum levels of daily alcohol consumption are:

• three to four units of alcohol for men
• two to three units of alcohol for women

A unit of alcohol is equal to about half a pint of normal-strength lager, a small glass of wine or a pub measure (25ml) of spirits.

Visit your GP if you are finding it difficult to moderate your alcohol consumption. Counselling and medication are available to help reduce the amount you drink.

Read more about alcohol and alcohol misuse.

Hepatitis C

In England, those most at risk of getting a hepatitis C infection are people who regularly inject illegal drugs, such as heroin.

If you regularly inject drugs, the best way to avoid getting hepatitis C is to never share any of your drug-injecting equipment with others. You shoud also avoid sharing any object that could be contaminated with blood, such as razors and toothbrushes.

There is less risk of getting hepatitis C by having sex with someone who is infected. However, as a precaution, it is best to use a barrier method of contraception, such as a condom, with a new partner.

Read more about preventing hepatitis C.

Hepatitis B

A vaccine is available that provides immunisation against hepatitis B. However, hepatitis B is a relatively rare condition in England, so the vaccination is not given as part of the routine childhood vaccination schedule.

Vaccination would usually only be recommended for people in high-risk groups, such as:

• people who inject drugs or have a sexual partner who injects drugs
• people who change their sexual partner frequently
• people travelling to or from a part of the world where hepatitis B is widespread
• healthcare workers who may have come into contact with the virus

Pregnant women are also screened for hepatitis B. If they are infected, their baby can be vaccinated shortly after birth to prevent them also becoming infected.

Read more detailed information about hepatitis B vaccination.

The liver fluke

The liver fluke is a major cause of bile duct cancer in Asia. It is a parasite which, after infection, damages the tissue of the bile duct and, in some cases, triggers the onset of bile duct cancer.

The liver fluke is widespread in Thailand, making bile duct cancer cases a hundred times more common in Thailand than in England. Other countries where the liver fluke can be found include:

• Cambodia
• Laos
• Vietnam

Infection occurs after eating raw or undercooked fish contaminated by fluke eggs.

Therefore, always ensure any fish you eat is cooked thoroughly when travelling in these countries.