Dr. Leon Yoder: Diagnosis of bile duct cancer sometimes is difficult early because there are no symptoms until the bile ducts begin to close off, and then the bile can't get out of the liver and normally into the small intestine. The bile then backs up and the symptoms that you might have include pain in your right side over your liver, or more often, you’ll have jaundice. That means your skin will turn yellow. That is usually the very first sign is painless jaundice. Then further investigation may include a CT scan, a MRI, ERCP, one of those, or an ultrasound are going to be helpful in diagnosing a bile duct tumor. Oftentimes, it's very helpful to have an ERCP where we put a brush up into the bile duct and take brushing of the bile duct, and then we can see the cancer cells. Thereby, we can make the diagnosis of a cholangiocarcinoma or a bile duct tumor.