Gallbladder Cancer Survivor
- Experienced abdominal pain and mild nausea off and on for months
- Diagnosed with gallbladder cancer at age 56
- Treated with surgery and chemotherapy
Margie Sladek has always been physically active and considers herself to be a healthy person. She tries to eat right and exercise regularly. In 2010, at age 56, she had several brief episodes of pain in the upper right quadrant of her abdomen. She thought she might have gallstones and decided to carefully avoid high-fat foods because a diet high in fat increases gallstone risk.
“My family enjoyed a great backpacking trip down the Grand Canyon in March 2010,” Margie said. “I had no more pain and figured good exercise was the key.”
Later that year, however, between November and December, she started having steady, low-grade nausea that became constant. She saw her doctor in January 2011. “I felt the nausea had lasted too long,” Margie said.
Getting a Diagnosis
Her doctor ordered an abdominal ultrasound, which showed irregular thickening of the gallbladder walls. “They couldn’t rule out carcinoma,” Margie said, so she had a computed tomography (CT) scan. “The radiologist reported that it could be inflammation but also could not rule out carcinoma.”
Margie’s doctor sent her to a local general surgeon. “He reassured me that cancer was highly unlikely,” she said. “He had done thousands of gallbladder surgeries and had never seen gallbladder cancer. He said, ‘It is very rare, and if that were the case, you would probably be dead by now,’ which reassured me, too. But I told him I wanted it out anyway because if there was any chance at all, I wanted that thing out.”
Gallbladder cancer is rare with only about 3,000 cases in the United States per year. “The [survival] statistics are not pretty because it is frequently found in later, less curable, stages,” Margie said.
Seeing a clear delineation between Margie’s gallbladder and liver, the surgeon felt comfortable there wasn’t any cancer. But when he removed her gallbladder laparoscopically in February 2011, the news wasn’t good. “Unfortunately, the pathology came back showing T2 gallbladder cancer,” Margie said. The surgeon had also removed a cystic duct lymph node that turned out to have isolated tumor cells as well, which meant Margie would need a follow-up surgery. The surgeon who removed her gallbladder recommended she see a hepatobiliary surgeon, one who specializes in complex surgery of the liver and biliary system.
Treating Gallbladder Cancer
Margie met with three different surgeons: one at Virginia Mason Hospital in Seattle, one at Oregon Health & Science University Hospital in Portland, and one at University of Washington Medical Center (UWMC) in Seattle. Though all three were skilled in the operation Margie needed, she had the most confidence in James O. Park, MD, a premier gastrointestinal surgeon from UWMC with extensive experience in hepatobiliary surgeries.
“He did an excellent job of explaining the procedure, including the risks,” Margie said. “That first appointment lasted one hour, and he was very calming during this difficult time. The statistics for gallbladder cancer are not very reassuring. I went into surgery hoping to live two years,” Margie said.
“For gallbladder cancer that has penetrated the muscular layer T1b or beyond, we recommend further removal of the liver tissue where the gallbladder was situated and the lymph nodes that the gallbladder would drain into. This is done to provide a complete staging of the disease and local control,” Dr. Park said.
In March 2011, Margie had a five-hour operation in which Dr. Park removed two segments of her liver and 10 lymph nodes. She spent one night in the intensive care unit at UWMC and was discharged from the hospital four days later. All of the removed organs were negative for cancer cells. “But I was told that doesn’t necessarily mean there aren’t any cancer cells there,” she said.
Opting for Chemotherapy
Though there are no definitive data on the best chemotherapy or radiation therapy to treat gallbladder cancer, Margie’s oncologist recommended chemotherapy to eradicate any stray cancer cells in her body.
“Given the cancer involvement of the cystic duct lymph node, Margie, her oncologist, and I had lengthy discussions regarding the utility of systemic chemotherapy or radiation therapy, reviewing all of the retrospective data [from studies conducted after patients have been treated] that were available. Eventually, Margie decided on chemotherapy alone,” Dr. Park recalled. “We try to deliver personalized medicine to our patients, and it was fitting for Margie, who is quite healthy, to be aggressive in her adjuvant treatment.”
After she recovered from surgery, Margie received chemotherapy in Tacoma between May and September 2011—six cycles of gemcitabine (Gemzar) and cisplatin (Platinol), two weeks on and one week off.
“Chemotherapy was not fun and required significant anti-nausea medication before and after each infusion,” she said. “My hair got straw-like and stringy. But I survived it. My goal was to kill cancer cells, to leave no cancer cell behind.”
Margie’s husband and three children were very supportive during her treatment. “My husband was a bulldog for me in the background, trying to make sure I had the best of care,” Margie said. Her son took time off of work to be with her during some of the infusions. “It was really hard emotionally,” Margie recalled. “I believe in Western medicine. But I know we don’t have all the answers. I had to make peace with my mortality.”
Margie retired from her position as a nurse practitioner feeling that, with an uncertain future, she should have the chance for a little retirement in her lifetime. But six months later, after chemotherapy and a clear CT scan, Margie went back to work. “I found I really did enjoy work, and I got bored at home. I feel I have something to offer by returning to work,” she said. She now works three days per week at an endocrinology clinic in Tacoma.
Life After Cancer
Like many cancer survivors, Margie suffers from “scanxiety.” She has anxiety before she gets a regular follow-up scan and again before the results are revealed. She gets a regular magnetic resonance imaging (MRI) scan several times a year, which she sends to Dr. Park, who takes it to the UW tumor board meeting to be evaluated by the SCCA and UW gastrointestinal care team.
“I feel if a whole team can’t see anything, then that is a good sign. I have had five scans looking for a recurrence. So far, so good,” Margie said.
“During chemotherapy, I did not meet anyone else with gallbladder cancer, but there are other stories out there and from many different places in the world,” Margie said.
Since her diagnosis and treatment, she has found a community of other gallbladder cancer survivors through the American Cancer Society. While reading statistics about the disease was not reassuring, connecting with other survivors’ stories has been comforting to Margie.
“We as individual people are not statistics. I appreciate life. With each clear scan, I like to plan a new vacation or goal,” Margie said. “My husband and I went with three couples on a Caribbean cruise in 2012. We also enjoyed a birding trip for the warbler migration to Michigan and Canada. I love the out-of-doors. It cleanses my soul, refreshes my spirit, and helps me feel closer to God. I’m getting back to my old self.”