Controlling symptoms of advanced bile duct cancer

Advanced bile duct cancer means the cancer has spread outside the bile ducts. It might have spread into lymph nodes or organs near the bile duct (locally advanced bile duct cancer). Or spread to other parts of the body like the lungs, bone or brain. This is called secondary or metastatic bile duct cancer.

Symptoms of advanced bile duct cancer

Feeling tired is the most common symptom of advanced cancer. Other symptoms depend on where in the body the cancer has spread.

Unfortunately, most people have advanced bile duct cancer when they are diagnosed. This is because bile duct cancer usually doesn’t cause symptoms early on. When the cancer is advanced you may:

• have yellowing of your skin and whites of your eyes (jaundice) - this can also make your skin itchy

• have abdominal (tummy) pain

• feel or be sick

• lose your appetite and lose weight

Treatments such as cancer drugs might help to shrink or control the cancer. This can reduce the symptoms. You can also have other medicines or procedures to help relieve symptoms. These include painkillers and anti sickness medicines. And having a procedure to unblock the bile duct. This can help relieve jaundice.

Symptom control 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.

They may also be called the symptom control and palliative care team.

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 arrange 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.

Relieving symptoms of a blocked bile duct

Bile duct cancer can often stop bile from flowing into the small bowel. This causes jaundice.

To help the bile start draining 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

Advanced bile duct cancer might give you pain in your abdomen. Let your doctor or nurse know if you have pain so they can give you painkillers. You should also tell them how well the painkillers are working.

The right type and dose of painkillers can help manage the pain for most people.

Controlling sickness

Treatment for sickness depends on what is causing it. Sickness when you have advanced bile duct cancer can be caused by lots of different things. This includes the cancer itself and some painkillers. A blocked bile duct can also cause sickness.

There are different ways of controlling sickness to make you feel more comfortable. Talk it over with your doctor or nurse so you can get the treatment you need. They can also tell you about other ways of managing it.

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.

How you might feel

It can be difficult to talk about how you are feeling and to ask for support. Especially as you might think the cancer and how you feel physically is the most important thing. But it is ok to ask for emotional or mental health support when you have cancer. And you can ask at any time.

Everyone needs different levels of help and support. Speak to your healthcare team if you are finding your feelings difficult to cope with. They can tell you what support and mental health services are available locally.

There are also a number of charities and organisations that can help. You can find out more information in our section on mental health and cancer.