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cancer of the bile duct with liver mets, controlling sickness

MrsL23
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Hi, my mum was diagnosed with Cholangiocarcinoma with liver mets last month, she has been passed straight to palliative team and we have been managing at home for 4 weeks now, but got to a point where we arer struggling to control her sickness. She was initally eating little and often but is now only having 2 of the altraplen drinks a day, she has no apetite at all and is scared to try as she is being sick most days. We have been giving the cyclizine 3 times a day for 3 days now but still being sick every day. She is managing to swallow her medication, I'm wondering if we should be asking the nurses to be giving the injection for the cyclizine to stop the sickness? And is there food we should avoid or encourage to try and help her? She was enjoying ice cream but now we are wondering if dairy is best avoided as whenever she has milk she's sick within the hour? Right now she doesn't want anything but if we could get the sickness under control I think maybe she could get to enjoy a few bits of whatever she fancies? Bowels are generally opening every day or every other day so that's a good sign it's just this sickness and I feel awful ringing GP again, also one of the receptionists was awful last time it's put me off ringing unless mum is really bad. 

Any advice would be amazing

Thank you

 

  • Hello MrsL23,

    Thank you for contacting Macmillan. My name is Denise, and I am one of the Macmillan Cancer Information Nurses on the helpline. I can see you have joined other forums on the helpline, and I hope you find it helpful.

    I am sorry to read about your Mum’s Cholangiocarcinoma with liver metastases diagnosis and that she is now on palliative pathway. I understand from your message she is struggling with her symptoms and the oral Cyclizine is not very helpful. This must be a very difficult time for you and her loved ones to see her struggle.

    As we do not have access to NHS records it is difficult for us give specific advice. Please do not feel awful ringing the GP. Your Mum’s symptoms clearly need addressing and the GP is the first point of call. You can also ask the community palliative nurses if they can arrange for you to speak to her Palliative Care Consultant for further guidance. It is possible to have anti-sickness medication administered as an injection or in some cases it is appropriate to have a syringe driver for continuous administration of pain and anti-sickness medications. However, these need to be prescribed by the GP so the district nurses can administer it.

    Sickness can be a sign of blocked bile duct. In those cases, it may be necessary to have a stent inserted. Please find the link to symptoms to blocked bile ducts here. As your mum has one of these symptoms, please seek medical help as soon as possible.

    Cholangiocarcinoma can cause Bile Acid Malabsorption (BAM). Milk containing high amounts of fat can cause digestive symptoms. Her GP would be in the best position to address this. You can find some information on nutrition on the AMMF The Cholangiocarcinoma Charity website by clicking here. The website also has a video presentation on Nutrition for the CCA Patient. Please find link here.

    I am sorry to read you have difficulties when calling your Mum’s GP surgery, but it is fine to be assertive to get help for your Mum. Once a person is discharged to be cared for in the community it is the GP who needs to be contacted or 111 for out of hours GP service. You can ask the palliative team if they provide out-of-hours services too.

     

    I hope you find this information helpful. Please do get in touch with us if you have more questions. You can call us free of charge on 0808 808 0000 or you can chat to us or email us. We are here every day from 8am to 8pm.

    Best wishes,

     

    Denise

    Macmillan Cancer Information Nurse Specialist

     

    Ref: DK/SF

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