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Do What You Can to Ease Side Effects of Treatment for Bile Duct Cancer

Do What You Can to Ease Side Effects of Treatment for Bile Duct Cancer

You will likely have physical concerns since your cancer may cause symptoms and your treatment may cause side effects. The side effects depend on your treatment. In this section, you will learn more about how to respond to some of the most common side effects and symptoms from bile duct cancer.

Depending on the situation, bile duct cancer may be treated with surgery, radiation, and/or chemotherapy. We have listed some common side effects from these treatments and how to ease them. They are listed in alphabetical order so that you can find help when you need it.

Anxiety and depression

Many people may feel blue, anxious, or distressed after being told they have cancer. These feelings may continue or come back during treatment. Taking these actions may ease your mental stress:

  • Talk with your family or friends.

  • Consider joining a cancer support group or finding a cancer “buddy” who can help you cope.

  • Ask your doctor about medications for depression and anxiety.

  • Talk with a mental health professional if symptoms persist or worsen. Consider family therapy to help everyone manage the stress of a cancer diagnosis.

Bleeding

Throughout your treatment, your doctor will take small samples of your blood for testing. One thing he or she is checking is your platelet count. Chemotherapy can cause low blood platelets. This condition is called thrombocytopenia. Without enough platelets, your blood may have difficulty clotting. Although it is rare that a platelet count drops low enough to be dangerous, you should be aware of bruising, bleeding gums, or nosebleeds and report them to your doctor. They could be signs that your platelet count is too low.

If your doctor tells you that your platelet count is low, take these actions to avoid causing injuries that could lead to uncontrolled bleeding:

  • Protect your skin from cuts, scrapes, and sharp objects.

  • Use assistive devices, for example, a walker or cane, if you are weak and at risk of falling.

  • Shave with an electric razor.

  • Use a soft toothbrush to prevent bleeding gums.

  • Take steps to prevent constipation, which can lead to hemorrhoids.

  • Call your doctor if you develop a rash, bleeding, or bruising.

Constipation

This may be a side effect of some pain medicines and certain types of chemotherapy. Constipation, which includes difficult or infrequent bowel movements, can range from mildly uncomfortable to painful. The steps below will help prevent constipation or give you relief if you are already constipated:

  • Drink plenty of fluids, especially water and prune juice.

  • Eat foods high in fiber, such as cereals, whole grains, fruits, and vegetables.

  • Exercise. Even short, 20-minute daily walks can be helpful. 

Take stool softeners or a laxative only as prescribed by your doctor.

Diarrhea

Diarrhea includes loose or frequent bowel movements, or both. It may be a side effect of radiation therapy. Many chemotherapy drugs can cause bowel changes, too. Diarrhea may lead to dehydration if you don’t take these precautions:

  • Avoid milk and milk products if you don’t tolerate dairy products well.

  • Avoid gas-producing vegetables, dried fruit, fiber cereals, seeds, popcorn, nuts, corn, and dried beans.

  • Eat low-residue, low-fiber foods, such as those included in the BRAT diet (bananas, rice, applesauce, and toast).

  • Drink more fluids, such as water and broth, to prevent dehydration.

  • Ask your doctor about medications that may help.

Hair loss (alopecia)

Not all chemotherapy causes hair loss. When it does, losing your hair can be upsetting because baldness is a visible reminder that you are being treated for cancer. Keep in mind that your hair will probably grow back after treatment.

Try these coping tips:

  • Consider cutting your hair before treatment starts.

  • Think about getting a wig, hat, or scarf before your hair loss starts. That way, you can get a wig that matches your hair and you will be ready with head coverings, if you choose to use them.

  • Because your scalp may be more sensitive to temperature and sun, protect it with sunscreen and hats or scarves.

Increased infections

Throughout your treatment, your doctor will take small samples of your blood for testing. One thing he or she is checking is your level of white blood cells. White blood cells help fight infection. Both radiation and chemotherapy can cause a reduction in your white blood cell count, called neutropenia. Without enough white blood cells, your body may find it hard to fight infection.

If your doctor tells you that your white blood cell count is low, take these extra steps to stay healthy:

  • Avoid crowds or people with colds.

  • Avoid young children who have had recent vaccinations with live viruses.

  • Wash your hands often throughout the day to kill germs.

  • Be extra careful to avoid cuts and open sores that could become infected.

Call your doctor right away if you have any of these signs of infection: a temperature of 100.5 degrees Fahrenheit or higher, severe chills, a new cough, pain, a burning sensation during urination, or any sores or redness.

Mouth sores (stomatitis)

Sores in and around the mouth are a common side effect with certain drugs that are used in chemotherapy. The best way to address this problem is with good oral hygiene and choosing foods that do not irritate the sores. These steps can help prevent sores or lessen your discomfort:

  • See your dentist to have your teeth cleaned before treatment starts.

  • Brush your teeth often with a soft toothbrush.

  • If you have dentures, make sure they fit well.

  • Eat soft foods, such as applesauce, cottage cheese, and scrambled eggs.

  • Avoid spicy, salty, or coarse foods and foods with acid, such as tomatoes or orange juice.

  • Avoid alcohol and mouthwashes containing alcohol because they can irritate the sores.

  • Avoid tobacco.

  • Ask your doctor about medications you can put on the sores to relieve the pain.

Nausea or vomiting

Nausea or vomiting as a result of chemotherapy or radiation treatment for cancer may range from barely noticeable to severe. It may help you to understand the different types of nausea:

  • Acute-onset nausea and vomiting. Occurs within a few minutes to several hours after chemotherapy. The worst episodes tend to be five to six hours after treatment, and the symptoms end within the first 24 hours.

  • Delayed-onset vomiting. Develops more than 24 hours after treatment.

  • Anticipatory nausea and vomiting. Learned from previous experiences with vomiting. As you prepare for the next dose of chemotherapy, you may anticipate that nausea and vomiting will occur as it did previously, which triggers the actual reflex.

  • Breakthrough vomiting. Occurs despite treatment to prevent it. It requires additional treatment.

  • Refractory vomiting. Occurs after one or more chemotherapy treatments. Essentially, you are no longer responding to antinausea treatments.

To help prevent nausea, take these actions. Most nausea can be prevented:

  • Ask your doctor about getting a prescription medicine to control nausea and vomiting. Then make sure you take it as directed. If you are vomiting and cannot take the medicine, call your doctor or nurse.

  • If you have bothersome nausea and vomiting even though you are taking your medicine, call your doctor or nurse. Your medicine can be changed.

To help ease nausea or vomiting if you have it, try these tips:

  • Try eating foods and drinking beverages that were easy to take or made you feel better when you had the flu or were nauseated from stress. These might be bland foods, sour candy, pickles, dry crackers, ginger ale, flat soda, or others.

  • Do not eat fatty or fried foods, very spicy foods, or very sweet foods.

  • Eat room-temperature or cold foods. The smells from hot foods may make your nausea worse.

  • Ask your doctor or nurse if he or she can help you learn a relaxation exercise. This may make you feel less anxious and more in control, and decrease your nausea.

  • Ask your doctor or nurse about using acupressure bands on your wrists, which may help decrease your nausea.

Pain

Surgery causes temporary pain in the area of the operation. You may be uncomfortable during the first few days after surgery. If you receive radiation directed at your abdominal area, you may also have stomach pain. You may also have pain from the cancer itself. Pain can usually be controlled with medication, so be sure to talk with your doctor or nurse about pain relief:

  • Take your pain medications regularly. Do not wait for your pain to become severe. (Take steps to avoid constipation, a common side effect of pain medications.)

  • Change your activity level. See if you feel better if you rest more or move around more--either may help.

  • Distract yourself with music, funny videos, or computer games.

  • Use relaxation techniques, such as yoga or meditation, or guided imagery exercises. Ask your doctor or nurse where you can learn more about these.

Skin dryness or irritation

This may be a side effect of radiation therapy. You may also experience skin rashes on your hands and feet from chemotherapy. In addition to trying these tips, ask your health care team how best to treat them:

  • Protect your skin from sun exposure by covering it up or wearing sunscreen of at least 15 SPF.

  • Ask your doctor or nurse what kind of lotion you can use to moisturize and soothe your skin. Do not use any lotion, soap, deodorant, sunblock, cologne, cosmetics, or powder on your skin within two hours after treatment because they may cause irritation.

  • Wear loose, soft clothing over the treated area. Cotton underwear can help prevent further irritation.

  • Do not scratch, rub, or scrub treated skin. After washing, gently blot dry.

  • Do not bandage skin with tape. If you must bandage it, use paper tape, and ask your nurse to help you place the dressings so that you can avoid irritation.

  • Do not apply heat or cold to the treated area. Bathe only with lukewarm water.

  • If you must shave the treated area, use only an electric shaver, which irritates skin less. Don’t use lotion before shaving. Do not use hair-removal products. Both can irritate skin.

  • Keep your nails well-trimmed and clean so that you do not accidentally scratch yourself.

Tiredness

You may feel tired or weak after surgery. The length of time it takes to recover from an operation is different for each person. Tiredness is also a very common symptom and side effect from chemotherapy and radiation treatments. You may feel only slightly tired, or you may suffer from extreme fatigue. Fatigue can last four to six weeks after treatment ends. Taking these actions may increase your energy level:

  • Take short rests when you feel tired. Avoid long naps during the day so that you can sleep well at night.

  • Add mild exercise, such as walking, to your daily routine. It may help you sleep better.

  • Save your energy for important tasks.

  • Drink plenty of fluids. Dehydration leads to increased fatigue.

  • Take action to treat a poor appetite because eating improperly can make you tired.

  • If your fatigue is severe or chronic, ask for help with routine tasks that can drain your energy, such as grocery shopping or housework. Some people reduce their hours at work.

If your family or social support is limited, ask your health care team about community resources that may be able to help you with activities, such as housecleaning, shopping, or yard work.

 
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