In this episode of the @CancerInterviews podcast, host Bruce Morton hears from Melinda Bachini, who survived cholangiocarcinoma, a form of bile duct cancer. Doctors removed two thirds of her liver, but three months later, the cancer returned, and she was put on a chemotherapy regimen of gemcitabine and cisplatin. The chemotherapy had terrible side effects, and Melinda fought to get on a clinical trial of tumor infiltrating lymphocyte therapy. The clinical trial led to survivorship.

A paramedic from Billings, Montana, in 2010, Melinda began to experience shoulder pain and upper gastric pain. At first, she thought those were tied to the rigors of her job, but when the pain got worse, she sought medical attention and underwent a CT scan and an MRI. That led to a biopsy, which confirmed Melinda had cancer, but doctors could not immediately determined what type of cancer it was. Three weeks after her diagnosis, they concluded it was cholangiocarcinoma. Melinda said for many diagnosed with bile duct cancer, the cancer spreads from the liver. In her case, the cancer was confined to her liver, and she underwent surgery to have two-thirds of her liver removed. After the procedure, doctors confirmed the cancer was cholangiocarcinoma.

There is a high rate of recurrence for cholangiocarcinoma. Three months after Melinda’s surgery, a post-operative checkup revealed there were signs of tumors in her lungs, so the cancer had spread. That’s when for the first time she had heard the words, “Stage IV terminal.” At age 41 and the mother of six, she wasn’t ready to give up. The cancer soon spread from her lungs back to her liver, so doctors put her on another chemotherapy regimen, this time with a drug called taxotere. That didn’t work, either, so Melinda was ready to stop the chemotherapy because of its nasty side effects and just to live as long as she could.

Melinda had learned of a clinical trial at the National Cancer Institute, applied to be accepted in the trial and was accepted. Because the Maryland-based NCI is federally-funded, it covers all related expenses. The trial was called GI-TIL, which stands for Tumor Infiltrating Lymphocite therapy. She was the ninth person to enter into this type of trial and the first with cholangiocarcinoma.

As Melinda Bachini began the trial, she had tumors on both lungs and her liver, and figured she probably had only a few months to live. However, not long after the trial began, she thought it was working because a cough she had had, went away. She was in the hospital three to four weeks and she said it was an aggressive treatment. She said they surgically pull tumors. She said they grow T-cells into the billions, then put them back into her to fight the cancer. Melinda returned about 18 months later, and doctors had pinpointed which type of T-cells could best attack the cancer. The cancer started growing again, but the continued combination of GI-TIL therapy and a drug called pembrolizumab, kept the cancer at bay, and her final treatment was in March 2017.

Melinda has gone on to work to help others diagnosed with this rare cancer. She began as a volunteer with the Utah-based Cholangiocarcinoma Foundation, and is now its Chief Patient Officer.

Additional Resources:

The Cholangiocarcinoma Foundation: https://www.cholangiocarcinoma.org