Chemotherapy uses anticancer medicines to kill cancer cells. The medicines are made to attack and kill cancer cells that divide rapidly. While cancer cells divide rapidly, so do some normal cells. Because of this, chemotherapy can also affect those rapidly dividing normal cells in the body, which can lead to side effects.

Chemotherapy may be used for these reasons: 

• After surgery, often with radiation therapy, to try to lower the risk that the cancer will come back

• Before surgery to make tumors smaller and easier to remove

• To help shrink tumors to relieve symptoms, if you can't have surgery or if you have advanced cancer that has spread

The anticancer medicines are injected into a vein or given by mouth. They then enter the bloodstream and reach all areas of the body. This is called systemic treatment.

Sometimes chemo is given right into the main artery that goes into the liver. This focuses the chemo on the tumors in the bile duct, and then the healthy liver gets rid of most of it. This limits the amount of chemo that goes to the whole body. Chemo is not commonly given this way, but it may help people who can't have surgery live longer.

 These are medicines that are used most often for bile duct cancer. They are given either alone or in combination:

• Fluorouracil, 5-FU

• Capecitabine

• Gemcitabine

• Cisplatin

• Oxaliplatin

 Researchers are looking at new types of chemotherapy for the treatment of bile duct cancer. Ask your doctor if you should consider a clinical trial.

Side effects are common with chemotherapy. But it's important to know that they can often be prevented or controlled. The side effects usually go away over time after treatment ends. Side effects depend on the type and amount of medicines you’re taking. They vary from person to person.

Some common side effects include: 

• Nausea and vomiting

• Diarrhea

• Skin irritation or rash

• Loss of appetite

• Fatigue

• Hair loss

• Mouth sores

• Increased chance of infection

• Increased chance of bleeding or bruising

It's important to know which medicines you're taking. Write your medicines down, ask your healthcare team how they work, and what side effects they might have.

Talk with your healthcare providers about what signs to look for, and when to call them. Be sure you know how to get help any time, including after office hours and on weekends.

It may be helpful to keep a diary of your side effects. Write down physical and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your medical team to make a plan to manage your side effects.