Controlling symptoms of advanced bile duct cancer

Advanced bile duct cancer means that the cancer has spread outside the bile ducts into lymph nodes or organs near the bile duct. Or that has spread to another part of the body such as the lungs (secondary or metastatic bile duct cancer).

The most common symptom of advanced cancer is feeling tired. Other symptoms depend on where the cancer is in the body. For advanced bile duct cancer, symptoms might include:

• yellowing of skin and whites of eyes and itchy skin (jaundice)
• abdominal (tummy) pain
• feeling or being sick
• unexplained weight loss
• mood changes

Treatment such as chemotherapy might help to shrink or control the cancer, and reduce symptoms. You can also have other medicines to help relieve symptoms, such as painkillers and anti sickness medicines.

Symptom control team or palliative care team

There are symptom control teams in most cancer units. They can help you to stay as well as possible for as long as possible. They are also in hospices and many general hospitals.

Most symptom control teams have home care services so they can visit you at home.

Relieving symptoms of a blocked bile duct

Bile duct cancer can often block bile from flowing into the small bowel. This causes jaundice which can cause yellowing of the skin and whites of the eyes and itching.

To help the bile drain into the small bowl again, your doctor might put a small tube (stent) into the blocked duct. Or they might do an operation to bypass the blockage.

Controlling pain

You might have pain in your abdomen (tummy). Let your doctor or nurse know if you have pain. They can give you painkilling drugs. The right type and dose of painkillers can help manage the pain for most people.

Coping with tiredness

Tiredness is a common symptom of advanced cancer. It can feel a bit overwhelming and as though you don’t have any energy. 

Let your doctor or nurse know if you’re very tired as they might be able to prescribe medicine to help or other treatments. For example, a blood transfusion can give you more energy if you’re tired due to anaemia (low red blood cell levels).

Resting

It’s important to rest a few times throughout the day. Resting regularly can help you feel less tired and more able to cope. You don't have to sleep during these times. Just sitting or lying down will help. 

Exercise

Exercising can be hard when you feel very tired. Research has shown that daily light to moderate exercise can give you more energy. Going for a gentle walk is enough. Gentle exercises in bed or standing up can help if you can’t move around easily. 

Your physiotherapist or palliative care team might be able to help you plan exercises that suit your needs.  

Sleeping

You might feel more tired if you have trouble sleeping at night. It can help to change a few things about when and where you sleep.

Controlling sickness

The best way of controlling sickness depends on what is causing it. There are many different anti sickness medicines.

A blockage in your bile ducts can also cause sickness. Your doctor usually puts in a tube (stent) to open up the blockage, which helps to relieve symptoms

Coping with loss of appetite and weight loss

You might not feel like eating and may lose weight. It is important to eat as much as you can.

Tips:

• Eating several small meals and snacks throughout the day can be easier to manage.

• Ask your doctor to recommend high calorie drinks to sip if you are worried about losing weight.

• Eat whatever you feel like eating rather than what you think you should eat.

• Eat plenty of calories when you can to make up for times when you don’t feel like eating.

• Drink plenty of fluids even if you can't eat.

• Don't fill your stomach with a large amount of liquid before eating.

• Try to eat high calorie foods to keep your weight up.

Coping with mood changes

You might find it difficult to cope when you are diagnosed with advanced cancer.

It is common for people with advanced bile duct cancer to feel sad or become depressed. You may find it helpful to understand this as a part of your illness. Talk to your specialist nurse about how you are feeling. They can arrange for more support if you need it.