The disease is notoriously challenging to diagnose early, and is usually advanced because of its late presentation and the lack of effective non-surgical therapeutic modalities
It is important to get an accurate diagnosis of CCA so that your condition can be treated appropriately. Your doctor will ask questions about your medical and family history, lifestyle habits and perform a physical examination.
The simplest imaging study of the liver is an ultrasound. There is no radiation risk and can be done on a regular basis, especially in individuals who are at risk of cancer, for e.g. hepatitis C carriers. It is however not always accurate and or very specific.
A CT scan is a better way of detecting CCA and is crucial for treatment planning. This would be the basic imaging that will be done to detect and plan a treatment strategy. In certain cases, a CT scan may not be enough or is inconclusive, and additional investigations like MRI/ MRCP or a PET scan may be performed.
A blood test that measures the level of a tumour markers called Carbohydrate antigen 19–9 (CA 19-9) is associated with CCA but it should not be used in isolation or as a routine screening test. Other tumour markers that are associated are carcinoembryonic antigen (CEA) and CA-125.
A small amount of bile duct tissue or cells may be sampled via a needle procedure (liver biopsy) or via endoscopy brushing, this may be required to guide management and/or if the diagnosis is unclear.
Other scans or investigations may be required if necessary for diagnosis, staging and/or to guide treatment strategy.