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 daily levels of alcohol consumption are:

• 3-4 units of alcohol for men
• 2-3 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. This does not just apply to needles but anything that could come into contact with other people’s blood, such as:

• mixing spoons
• filters
• water used to dissolve drugs
• tourniquets (the belt sometimes tied around the arm to make the veins easier to inject)

Hepatitis C does not cause any noticeable symptoms for many years, so people may be unaware they are infected. It is therefore safer to assume anyone may have the infection.

It may also be possible to get hepatitis C by sharing banknotes or “snorting tubes” with an infected person to snort drugs, such as cocaine or amphetamine. These types of drugs can irritate the lining of your nose and small particles of contaminated blood could be passed onto the note or tube before being inhaled.

Even if you are not a drug user, you can take commonsense precautions to minimise your exposure to other people’s blood. 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.

Read more about getting tested and treated for 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 is usually only recommended for people in high-risk groups, such as:

• injecting drug users (including their partners and children and other people living with them)
• people who change sexual partners frequently (including men who have sex with men, and male and female sex workers)
• close family contacts of someone with a chronic (long-term) hepatitis B infection
• people who receive regular blood products and their carers
• people who have chronic kidney failure
• people who have chronic liver disease
• prisoners and some prison service staff
• people who live in residential accommodation for those with learning difficulties
• families that foster or adopt children who may have been at increased risk of developing a hepatitis B infection
• people travelling to, or going to live in, areas where there is a high or moderate incidence of hepatitis B, such as China

You should also be vaccinated if you have a job that increases your exposure to hepatitis B. At-risk occupations include:

• healthcare workers
• laboratory staff
• staff who work in residential care homes for those with learning difficulties
• morticians and embalmers
• some emergency services personnel

Visit your GP for advice if you are uncertain about whether you should be vaccinated against hepatitis B.