i'm sure it is the chemo that is making your mother so tired and run down. my mother was the same way. my mother's doctor wanted her to enter a clinical trial, thank God my mother and her doctors colleagues were against it. i realize that the only way to know the effects of these drugs on humans, are to test them on humans but you have to know when enough is enough. your mother sounds a lot like mine, a true fighter. when all of this started, my mother said i will do whatever they say, i want to live. her doctor told her that she couldn't cure her but she could treat her. when my mom went on her second round of chemo, she was fighting with her doctor to get off it. my mother said what's the point of feeling lousy if they can't cure me. of course moms doctor wants to hammer her with chemo until the end, so now she's at battle to stay off. i feel so bad for your mom, i guess you only need to hear one doctor say " i can cure you" and that's all you will hear. your mothers doctor sounds like a snake oil salesman. it's too bad that she won't give herself a break and let her body build back up. she would probably stand a better chance by doing that, than with chemo which is just toxic poisoning which can cause additional cancers and even death. bile duct cancer does not always image and does not always show up on blood tests. it's tough to detect and even harder to treat. was your mother's cancer advanced when they found it? how did they find it, if you don't mind me asking. my mother was t3 n1 m0 when they found it and not completely resectable. ca19-9 was not elevated. how are your mothers liver labs doing with all of this chemo?