Learning you have any life-threatening illness can be devastating. But coping with a diagnosis of biliary tract cancer can be especially difficult. The more advanced the disease when it's discovered, the less likely the chance of complete recovery. As a result you may feel especially overwhelmed just when you need to make crucial decisions. Although there are no easy answers for people dealing with biliary tract cancer, some of the following suggestions may help:

Learn everything you can about gallbladder and bile duct cancers — how the diseases progress, your prognosis and your treatment options, including both experimental and standard treatments and their side effects. Be sure you understand whether a particular approach is used to treat cancer or provide palliative care. Don't be afraid to seek a second opinion and to explore treatments available through clinical trials. You will have many decisions to make in the weeks and months ahead. The more you know, the more active a role you can take in the decision-making process.

Studies show that strong relationships are crucial in dealing with life-threatening illnesses. Although friends and family can be your best allies, in some cases they may have trouble dealing with your illness. Or you may not have a large social network. If so, the concern and understanding of a counselor, medical social worker, pastoral or religious counselor, or even a formal support group can be helpful. Although support groups aren't for everyone, they can sometimes be a good resource for practical information about your disease. You may also find strength and encouragement in being with people who are facing the same challenges that you are.

If you're interested in learning more about support groups, talk to your doctor, nurse, social worker or psychologist. He or she may be able to put you in touch with a group in your area. Or check your local phone book, library or a cancer organization.

Coming to terms with your illness may be the hardest thing you've ever done. For some people, having a strong faith or a sense of something greater than themselves makes this process easier. Others seek counseling from someone who understands life-threatening illnesses, such as a medical social worker, psychologist or chaplain. Many people also take steps to ensure that their end-of-life wishes are known and respected.

• counseling

In fact, the greatest fear of many people with a life-threatening illness is being subjected to treatments they don't want, being a burden to their family, or spending their last weeks or months in a hospital away from loved ones and familiar surroundings. The welcome news is that many more choices now exist for people with a terminal illness.

Hospice care, for example, provides a special course of treatment to terminally ill people. This allows family and friends — with the aid of nurses, social workers and trained volunteers — to care for and comfort a loved one at home or in hospice residences. It also provides emotional, social and spiritual support for people who are ill and for those closest to them. Although most people under hospice care remain in their own homes, the program is available anywhere — including nursing homes and assisted-living centers. For those who stay in a hospital, palliative care specialists can provide comfort, compassionate care and dignity.

Although it can be extremely difficult, discuss end-of-life issues with your family and medical team. Part of this discussion will likely involve advance directives — a general term for oral and written instructions you give concerning your medical care should you become unable to speak for yourself.

More and more people are interested in nontraditional approaches to healing, especially when standard treatments produce intolerable side effects or aren't able to provide a cure. In general, alternative medicine refers to therapies such as mistletoe or coenzyme Q-10 that may be used instead of conventional treatments. Complementary or integrative medicine, on the other hand, usually means therapies used in conjunction with traditional treatments.

Rather than simply addressing a problem with the body, complementary and alternative treatments often focus on the entire person — body, mind and spirit. As a result, they can be especially effective at reducing stress, alleviating the side effects of conventional treatments such as chemotherapy and improving quality of life.

• chemotherapy

• counseling

Gallbladder cancer > 1 > 2 > 3 > 4