4 min readNew DelhiAug 11, 2026 05:56 PM IST
Influencer Sydney Towle, who documented her journey with stage 4 cholangiocarcinoma on social media, has died at the age of 26. According to a BBC report, Towle was diagnosed with the rare bile duct cancer at just 23 after seeking medical attention for what initially seemed like a hernia. An ultrasound instead revealed a tumour, leading to the diagnosis of cholangiocarcinoma — a rare and aggressive cancer that is most commonly seen in people over the age of 50.
Her story has drawn attention to a cancer that can go undetected until it reaches an advanced stage because its early symptoms may be subtle or mistaken for common digestive problems. But how unusual is bile duct cancer in someone in their 20s? What symptoms should raise concern, and can someone with no obvious risk factors still develop the disease?
According to Dr Sachin Wani, Consultant Surgical Gastroenterologist, KIMS Hospitals, Thane, cholangiocarcinoma in young adults is highly unusual, but age alone should not rule it out when symptoms persist.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
How rare is bile duct cancer in young adults?
“Cholangiocarcinoma is rare in young adults. It typically affects those over 50, so a diagnosis in someone’s early 20s is very unusual,” says Dr Wani.
There is currently no strong evidence to suggest that bile duct cancer is becoming increasingly common among younger people. However, improvements in medical technology mean that rare cancers may be identified more accurately than before. “We have improved our ability to find and diagnose rare cancers thanks to better imaging, endoscopy, and molecular testing,” Dr Wani explains.
He adds that being young should not automatically lead doctors or patients to dismiss symptoms that are persistent or unusual. “A young age should not completely rule out the possibility if symptoms are persistent or unusual,” he says.
What are the warning signs?
“Yellowing of the eyes or skin, dark urine, pale stools, persistent itching, unexplained weight loss, abdominal pain, fever, or loss of appetite should prompt medical attention, especially if they last,” says Dr Wani.
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Jaundice — yellowing of the skin or whites of the eyes — can be particularly significant because a tumour may obstruct the flow of bile from the liver.
“Cholangiocarcinoma can develop quietly and might not cause clear symptoms until the tumour blocks bile flow or spreads,” Dr Wani explains.
This relatively silent progression is one reason why some patients are diagnosed only after the disease has advanced. “This is one reason why many patients are diagnosed at a later stage,” he adds.
What causes cholangiocarcinoma?
There are several recognised risk factors for bile duct cancer, although having one does not necessarily mean a person will develop the disease.
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“Established risk factors include primary sclerosing cholangitis, certain bile duct abnormalities or cysts, chronic liver disease, and some parasitic infections,” says Dr Wani.
Primary sclerosing cholangitis, or PSC, is a chronic condition that causes inflammation and scarring of the bile ducts. Structural abnormalities affecting the bile ducts can also increase risk.
However, the absence of these conditions does not guarantee that someone is protected. “Many patients lack any identifiable risk factor or family history,” Dr Wani says.
Therefore, someone with no known liver or bile duct condition and no family history can still develop cholangiocarcinoma. “Not having liver or bile duct disease does not completely eliminate the chance of cholangiocarcinoma,” he adds.
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Who should be monitored more closely?
“Since there is no routine screening for bile duct cancer, people with conditions like primary sclerosing cholangitis or structural bile duct abnormalities may need closer monitoring,” says Dr Wani.
For people who develop persistent symptoms such as jaundice, unexplained weight loss or prolonged abdominal discomfort, doctors may use imaging and other diagnostic procedures to investigate the underlying cause.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.