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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed With Malignant Neoplasm, Intrahepatic Bile Duct Carcinoma, Had Gallstone Pancreatitis. Pallative Treatment, Morphine Sulphate. Next?

Hi,
My mother hase been diagnosed with 'malignant neoplasm, intrahepatic bile duct carcinoma', which unfortunately involves the hepatic vessels to too great a degree and is therefore inoperable. The treatement is therefore 'pallative' treatment and she is due to meet an oncologist on Wed 8th May to discuss chemotherapy options. As things stands i'm not sure if she will be strong enough. She has undergone multiple operations involving bilary stents and has been released from hospital. She is incredibly tired and in pain which i'm aware is part of the illness, treatment medications etc. I'm increasingly worried that she won't be able to have chemotherapy to prolong her life and would like to know roughly how long she has left. She has been very ill since Dec 2012 when it was initially felt she had gallstone pancreatitis. Whilst no one has provided the actual stage she is at, I assume it is the last stage or stage 4? Each day brings something else and at the moment she has severe pain from her ankle all up her side. 2 doses of oral morphine sulphate initially did not work but gas made the pain subside. Is this a normal occurence pre chemotherapy or is this an indcation that the illness has metastases and is spreading to other areas, bones?
Kindest regards in advance for your advice and response
Mon, 17 Jun 2013
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Radiologist 's  Response
Hello,
Its unfortunate that your mother is battling intrahepatic bile duct carcinoma with lots of pain. I hope you and doctors treating her are doing their best to reduce her pain.
I have served in a cancer hospital for 3 years and with my experience, I would like to add that the severe pain from her ankle can be a manifestation of deep vein thrombosis, however it can be confirmed only after performing Doppler examination. In this condition the blood in the leg veins get thrombosed (clotted) and needs to be treated under supervision. Though my suspicion is a possibility, the can be other causes also. Please discuss her leg pain with your doctor.

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Diagnosed With Malignant Neoplasm, Intrahepatic Bile Duct Carcinoma, Had Gallstone Pancreatitis. Pallative Treatment, Morphine Sulphate. Next?

Hello, Its unfortunate that your mother is battling intrahepatic bile duct carcinoma with lots of pain. I hope you and doctors treating her are doing their best to reduce her pain. I have served in a cancer hospital for 3 years and with my experience, I would like to add that the severe pain from her ankle can be a manifestation of deep vein thrombosis, however it can be confirmed only after performing Doppler examination. In this condition the blood in the leg veins get thrombosed (clotted) and needs to be treated under supervision. Though my suspicion is a possibility, the can be other causes also. Please discuss her leg pain with your doctor. Hope this helps.