<s>[INST] my brother was diagnosed with stage 4 bile duct cancer May 26, 2012 and now he has this burning in his chest when he drinks, eat ice or food, he says that it burns so bad that he has to throw it up. The liquid coming out of him after everything he eats or drinks is dark and resembles old blood . Why does he have this burning? [/INST] Hi and welcome to ChatDoctorI am sorry about your brother and his very serious disease. Unfortunately stage 4 is inoperable and this is one of the worst types of cancers which spreads fast to surrounding tissue, liver,pancreas and stomach. Obviously it infiltrated stomach and causes bleeding and obstruction, and pain as well. His therapy is palliative now. He can have blood transfusions and strong painkillers. Some surgical procedure such as gastrostomies may be performed, but it is questionable would he survive it. Everything else isn't in your hands. Encourage him and be supportive. Prognosis is very bad, but try to make him easier to go through all this. Wish you good health. </s>