34 – When Bile Duct Cancer is Found at Stage 1A: Melissa’s Story

Shawnda (00:00)
Welcome to The Cancer SIGNAL, a podcast by GRAIL where we share the stories behind multi-cancer early detection. I’m your host, Rayshawnda Madison, Director of Culture, Community & Engagement at GRAIL. On today’s episode I will be speaking with Melissa, a cancer survivor who is an annual user of the Galleri multi-cancer early detection test. 

Shawnda (00:05)
Welcome to the Cancer Signal, Melissa. Before we talk about your health journey, I would love for you to tell us a little bit about yourself. Who is Melissa outside of this story? Where do you live? What do you enjoy? And what’s important to you?

Melissa (00:21)
You bet. So I am married and have two children. My husband and I split our time between Coeur d’Alene, Idaho and Scottsdale, Arizona. So we just go back and forth as often as we can. While we’re here in Coeur d’Alene, we just really enjoy the outdoors. We love boating, golfing, any kind of outdoor recreation. 

We love to cook together, entertain, bring all our friends and family together and you know, really family is probably what I would say is most important to me. We have great friends and family and we love to get together.

Shawnda (01:01)
I love that. I love that. I mentioned in our intro that you are a cancer survivor. What does that phrase mean to you today?

Melissa (01:10)
You know, to be honest, even just saying the word cancer survivor, it’s pretty surreal to me. I feel incredibly fortunate and obviously my situation is still pretty fresh. I still think about cancer every day. But I would say for me, I just have a really newfound sense of gratitude. I’m thankful for every day, every minute. When you go through something like this, you get a new focus and just really realize how precious life is. 

You know, I also think when people say, gosh, you’re a cancer survivor. And for me, it’s just very top of mind that I found the cancer really, really early and was really lucky enough to be treated. And I know that a lot of people haven’t been that fortunate. And I think that’s probably one of the reasons that being a survivor, I almost feel a sense of responsibility to tell my story. I just know that sharing what I’ve gone through and what I experienced just would even have one person be proactive about their health so that they can have an early detection like I did and save them from a serious cancer situation is really important to me.

Shawnda (02:29)
Yeah, a hundred percent. What was your experience with cancer, if any, before you yourself faced a diagnosis? Did you have any family or friends, et cetera, in your network that had experience with cancer?

Melissa (02:42)
Yeah. I have. I definitely have a lot of friends and even some family members that have battled cancer. I’ve always felt like, well, cancer’s something that happens to someone else. I never in a million years would have thought that it would happen to me. I’ve always been really healthy and I just never really even had any symptoms that would have made me think that I had cancer. And that’s probably one really important part of my story is I’ve never felt sick.

I’ve always had normal blood work. My visits with my doctor have always gone well. And I was never searching for anything when I had the Galleri test done. I again, I just never would have guessed that I had cancer. And I think that probably one thing that I’ve taken away from this is that just feeling healthy and being healthy, I learned aren’t necessarily the same thing. I never in a million years would have guessed that I had an issue.

Shawnda (03:46)
Yeah. When did you start taking the Galleri tests? And what motivated you to make it a part of your annual wellness plan?

Melissa (03:57)
Yeah. So a couple of years ago, the primary care physician that I go to, I do annual physicals and she was just very proactive about health screenings. She introduced my husband and I to the test. Again, neither one of us were concerned about cancer, but we thought, well, this is just another proactive tool that we can use to monitor our health. You know, for me, I’ve just treated it kind of like my annual mammogram that every year you take a test and you get a baseline so that, you know, God forbid something comes up and you find that you have an issue, you’ve got that groundwork and you know, well, okay, I didn’t have it last year and now I have an issue. And so you get a little better sense of how long have you maybe had an issue. 

I have taken the Galleri test twice. My first time there were no cancer signals detected and you know, thank goodness I continued to take the test again because the second case, as you probably know, is when I found out that I did have the cancer. So for me the consistency of having this test was really critical.

Shawnda (20:16)
Melissa, I do understand that you and your husband took the Galleri test. What was that experience like? Taking it with, you know, your rock, your partner. 

Melissa (20:33)
Right. Sure. Yeah. In fact, Keith went in and we both took the test the first year and you know, I think we did them the same day. And then the second year, he was like, I went and had my Galleri done, and I was like, I gotta get in and get mine. So he really encouraged and reminded me to get after and get it done. For him in both situations, you know, he’s never had a cancer signal detected. And so you know, I think we were both pretty surprised to hear when I did have a detection. And he was just very supportive with me all the way. 

Shawnda (21:44)
Yeah, absolutely. I love that you both took it together. You got your results together and that, you know, even in spite of you getting a positive, he was like, We’re we’re in this together. Let’s do it.

Melissa (21:48)
Yeah. Absolutely. Yep. And we will both continue to get it every year. And doing it together I think helps. It encourages and reminds us to go get it. Just make it part of our regular routine.

Shawnda (05:09)
Yeah. Can you walk us through the second year you took the test? Cause, you took it twice. When you received a Cancer Signal Detected result, what did you learn and what did your doctor recommend following the results?

Melissa (05:15)
Yep. Right. So I remember exactly where I was. I was actually on vacation in Arizona and my doctor called and just said, Hey, you know, we got the results back from your test and there was a cancer signal detected and she said it’s in the liver and the bile duct area. And I mean I was really shocked and my initial reaction was, this has to be one of those false positives. I’m active, I’m healthy. I’m not a big drinker. Again, I didn’t have any symptoms. It just, I was really surprised. I thought there’s no way. But I’m also very proactive. And I thought, well, I mean, I took this test for a reason, so let’s look into it. And I would say that it was probably within the next day or two that my doctor helped me go ahead and get a next test scheduled and then I had a CT scan.

Shawnda (06:21)
Awesome. Awesome. What was going through your mind when you first received those results?

Melissa (06:30)
Well, I would say I was probably more than anything just a little bit scared and wondered, I’m not really sure what to do next, but I was motivated to learn more and I just really tried to focus one step at a time and I figured let’s just let’s go figure this out. I’m gonna do whatever tests are necessary to get to the bottom of this.

Shawnda (06:52)
Yeah. I wanna go back and return to the CT scan. When you got the CT scan, what were the results there? What was that experience like?

Melissa (06:58)
Yep. So I had the CT scan and the results came back clear. And so, you know, at first it was reassuring because I thought, okay, good. But in the back of my mind, I was like, mm, this just doesn’t match up. There’s something in that Galleri test that’s showing up that is causing the signal. And so I want to just double check. And so from there I visited with my doctor and we discussed that, you know, I could, the next step would be to take an MRI. And so that’s what I did. And ultimately that’s where we learned that I did have a mass on my tumor, or a tumor on my liver. And so yeah, it was again a shock because I thought, I’m clear from the CT scan, but then the MRI showed something totally different that the CT scan didn’t catch. 

Shawnda (07:40)
Many people, you know, might have stopped after hearing that the CT scan was clear, right? And even going back to when you first took this test and you didn’t have a detection, right? Many people would have stopped at that. I wanna know what gave you the confidence to keep asking questions and to continue looking for answers. 

Melissa (08:45)
Right. I think I’ve always just been someone who asks a lot of questions and again it just sat in the back of my mind, well, what if there is something? And we all know that the earlier you catch something, the more the better chance you have of getting the situation fixed. And so when I got the results from my MRI, the radiologist reviewed the report and just said, you know, your results are kind of inconclusive. It doesn’t necessarily look like cancer, but we can’t tell, we’re not really sure. 

And I said, Well, now what? And from there they said, Well, you really have two options. You can just wait and watch and just monitor it and see. Or you can get a biopsy. But as everyone knows, there are risks with biopsies. And so for me, it just wasn’t an option. I wanted to know more. I wanted to get to the bottom of it. I also wanted to make sure and align myself where I thought, gosh, let’s just say the worst thing that could happen is, comes true and it is cancer, I wanna have myself situated where I’m at a cancer facility so that if the biopsy comes back poorly, I’m just on that path to the next step. 

So I actually had gone to MD Anderson in Houston to do the biopsy, where I really just had an amazing team there. Again, they didn’t necessarily think that there was anything either. In fact, from my labs, everyone just said, why again would you think you have this issue? And we talked about the Galleri test and the team was amazing and said, let’s go forward with the biopsy and see how things go. And unfortunately, you know, what I’d feared came out to be true. And they called me the next, you know, couple of days after they got the results from the pathology of the biopsy and said, You have cholangiocarcinoma, which is bile duct cancer. 

Shawnda (10:47)
What was it like hearing those words, right? Because now you’ve had several appointments that kind of were really on the fence about this, that were, you know, and the other part that I really enjoy about your story is you also bringing along these physicians you know, here’s the test and here’s what it does, and then being like, okay, let’s let’s do some more tests.

Melissa (11:17)
Sure. I would say overwhelming is probably a good word just because there was so much uncertainty. And unlike a lot of other cancers, cholangiocarcinoma, it’s somewhat rare. And because it’s an asymptomatic type disease, typically I mean, I’m gonna be really candid. There’s not a lot easy way to sugarcoat this, but most people don’t find out about it until it’s just way too late. And so when you read everything online.

You get bile duct cancer and just get ready to put your affairs in order. You know, most people just don’t make it. And so I mean that was, that’s a hard thing to read. Yeah. So I was scared. but all I could do is just think about my family and you know for me I just wanted time. 

Shawnda (12:11)
Yeah, a hundred percent. Once you received the diagnosis, tell me more about what you learned about it, because you definitely did some research. You found out that most people don’t find out till really late. What were the doctors’ reactions?

Melissa (12:26)
Right. Well, again I had a really great team and they were encouraging and they did remind me. They said, Melissa, you really have to understand that most people do find out about bile duct cancer when they’re at a stage four or or whatnot. And it’s typically spread through their body, through your lymph nodes. And so, yes, a lot of the things that you’re reading about are gonna be scary, but let’s be optimistic here. You detected this so early, and so you know, let’s be positive and see what we can do here. And, you know, fast forward, once we determined what I had and everything, we immediately put a schedule into play and I had a full liver resection. And so the doctors were able to go in and remove this cancer. And when they did all the pathology reports, they found that we got this cancer at Stage IA. And it’s just really very, very unusual to be able to detect something so early.

Shawnda (13:30)
Wow. Yeah, absolutely. Can you tell me a little bit more about your treatment and how your health is today?

Melissa (13:37)
Sure. So again, it was last year, the end of the year, I did the full liver resection. So they basically got the tumor and then they took about 10 to 15% of my liver. The pathology was really encouraging afterwards. So they had me meet with my oncology team, and right now I’m still completing some treatment where I do an oral chemotherapy. But other than that, I mean, I feel great.

At about four months, I was given the all clear to be able to go out and I’ve been golfing and out on the boat and enjoying time with my family. I’ve already had a six month screening that I did out at MD Anderson and I got an all clear, so there’s no cancer in my body right now. And, you know, knock on wood, it’s just been going in the right direction.

Shawnda (14:22)
Beautiful. Yeah, I love that. I love that. And I love how much of a just advocate for yourself you’ve been through this entire journey, even before you found out about the cancer. That is a trait that I think a lot of people hope to have, right? When you’re in the face of something scary, being brave enough to be curious and ask more questions. I wanna ask you about, you know, what really helped you get through treatment, whether it was family, friends, your care team or even just your own mindset.

Melissa (15:16)
Yeah, I’d say for me, my family for sure. They’re my foundation. My husband Keith was really a rock through all of this. The surgery was pretty extensive. And I’m gonna be honest, the recovery was a lot harder than I would have thought it would be. But Keith was there. He literally helped every step of the way, whether it was helping with my medicines or helping me shower or get ready to go for the walks that I needed to do and even the little things. Like I remember the first time where they showed me my surgical scars and, you know, my eyes were as wide as they could possibly be. It was a lot more extensive than I thought. 

And he was right there with me, you know, encouraging and like, Yay, those are your battle scars and you look amazing and just a lot of love and support. and as I mentioned, I have two kids. They both flew into town. They’re, you know, fairly young in their careers. They don’t have a lot of vacation time, but they took that time to come out and spend and be with me. And I just thought, man, I have really amazing kids. And so it was just awesome to have them there. That really helped me get through the treatment and get my mind in a place to, I’m gonna battle to spend time with them.

Shawnda (16:27)
Yeah, absolutely. What do you tell people about annual testing and the impact being consistent can make?

Melissa (16:42)
Sure. You know, one day I think people are gonna look back in awe that there was ever a time that we didn’t just always have the Galleri test. You know, I liken it to, I think about my kids who kind of laugh and can’t imagine a world without a cell phone. And I think that that’s what these tests are gonna hopefully be like someday, so that eventually a test like the Galleri is just gonna be the norm and the standard and the way I look at it, is why wouldn’t it be? 

Why wouldn’t we always want to learn about any of these kind of serious health issues? It’s just as soon as you possibly can. You know, I’ve talked about this a few times before, and I know there’s always the naysayers out there that worry about, well, what if there’s a false positive? And I really challenge those people to rethink their perspective, particularly having gone through what I’ve gone through. I can guarantee you that anybody would rather have that day or two of maybe a little bit of anxiety if you’re worried about a false positive than just having to experience that one day that you find out, my gosh, I have a late stage cancer with few treatment options. And so I just think we want to do as much proactive annual testing as possible.

Melissa (18:08)
You know, in my case, when I got the results from my Galleri test, it was very pinpointed. We knew exactly where to go. I mean, within a week, I’d already, you know, found out where my tumor was and had a biopsy done shortly thereafter. And just within a couple of short months, I’d had a full surgery. So it was a pretty short period of time that gosh, I mean, it’s so exciting that I was able to get after it so fast. And I really do have to credit the Galleri for this early detection. I’ll say that the office that I work in, I think probably everyone I know, when they’ve heard about this, they’ve gone in and gotten the test as well. And it really it does give you a great peace of mind because again, now we’ve got the baseline. 

Okay, did you have it one year? Did you not? So I know a year ago I didn’t have it. And very encouraging just to get on top of the matter. You never want to hear that you have cancer, but if you are gonna have it, you’d rather know about it as soon as you can.

Shawnda (18:44)
Yeah. I literally have goosebumps all over my body. I’m trying to keep myself from crying on this, but you are incredible and so strong. It is such a privilege to be here with you today, Melissa. And I’m so happy that you’ve had such a great support system along the way. Thank you so much for joining me today, Melissa. It truly was an honor.

Melissa (19:24)
Thank you.

Shawnda (19:14)
And thank you all for listening to this episode of the Cancer Signal Podcast. Subscribe so you don’t miss an episode, and I’ll see you next time.

 

Important Safety Information
The Galleri test is recommended for use in adults with an elevated risk for cancer, such as those age 50 or older. The test does not detect all cancers and should be used in addition to routine cancer screening tests recommended by a healthcare provider. The Galleri test is intended to detect cancer signals and predict where in the body the cancer signal is located. Use of the test is not recommended in individuals who are pregnant, 21 years old or younger, or undergoing active cancer treatment. Results should be interpreted by a healthcare provider in the context of medical history, clinical signs and symptoms. A test result of No Cancer Signal Detected does not rule out cancer. A test result of Cancer Signal Detected requires confirmatory diagnostic evaluation by medically established procedures (e.g. imaging) to confirm cancer. If cancer is not confirmed with further testing, it could mean that cancer is not present or testing was insufficient to detect cancer, including due to the cancer being located in a different part of the body. False positive (a cancer signal detected when cancer is not present) and false negative (a cancer signal not detected when cancer is present) test results do occur. Rx only.

Laboratory/test information
The GRAIL clinical laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and accredited by the College of American Pathologists. The Galleri test was developed—and its performance characteristics were determined—by GRAIL. The Galleri test has not been cleared or approved by the Food and Drug Administration. The GRAIL clinical laboratory is regulated under CLIA to perform high-complexity testing. The Galleri test is intended for clinical purposes.