High triple bilirubin is not cancer. The three bilirubins are total bilirubin, direct bilirubin and indirect bilirubin. Elevated direct bilirubin is usually the result of obstructive bile duct disease, a condition that could be cancer. Biliary tract obstruction can be bile duct cancer, but it can also be obstruction caused by gallstones, which are not necessarily cancerous. Hepatocellular jaundice is present when both direct and indirect bilirubin are elevated. In advanced hepatocellular carcinoma, this change can occur. Also in acute hepatitis, both direct and indirect bilirubin can be elevated. But if only indirect bilirubin is predominantly elevated, it is hemolytic jaundice. So, three elevated bilirubin is not necessarily cancer.