Gallbladder Cancer (California)

[Cindywain]

Hello! I was diagnosed Jul 2015 with Gallbladder Adenocarcinoma at age 67, I went to the emergency room with abdominal pain, thinking I was having a heart attack but after tests they found Gallstones and a 2 cm polyp in my gallbladder: they recommended Laparoscopic Cholecystectomy with no mention of cancer. After I got home from the hospital, curious about gallbladder polyps, I did google research and discovered about 1% of GB Polyps are cancerous, so was not worried at all when I went to the followup appointment in July. Was totally unprepared for him to tell me I had cancer! He told me I needed more surgery, and referred me back to my Primary care doctor to decide what to do next. My Family Practice Doctor was of little help in deciding what to do, it was like she never heard of this kind of cancer! She referred me to an Oncologist & a Surgeon. While waiting for the appointments I did more internet research and discovered how grim having Gallbladder cancer was. Mine was discovered early: stage 2 Nx Mx, but even when discovered early the stats were terrible. The pathology report said that the polyp had grown through the gallbladder wall and formed a small nodule on the out side of the gallbladder so there was a great deal of concern that the cancer had spread, surgery and more tests would be needed to find out. I considered City of Hope and Loma Linda. With so few cases of gallbladder cancer, I decided that I would go to the closest one which had a good reputation and where I would not have too many transportation issues since my husband is no longer driving. The Oncologist said I needed more surgery and probably chemo and radiation, but since I already had an appointment with a surgeon he said he would wait until the outcome of that appointment to make recommendations. The Surgeon explained the surgery I needed (which he did not do), and the urgency of going to a large cancer center as soon as I could. I called a cancer navigator nurse at Loma Linda Univercity Medical Center who I e-mailed a copy of the Pathology report and a release of information. Within days I had an appointment with a Cancer surgeon. He told me the stats but also told me I was not a statistic I was a human being and he would make his recommendations based on my heath status not on the stats. He would do all he could do to provide me with a good outcome and good quality of life, he would not do any surgery unless he thought it would benefit me. He presented my case to the Tumor Board before every procedure so it was like I had a team of doctors advising me. He did a laparoscopic exploratory/staging surgery in Sep 2015. The plan was to proceed to a liver resection that day but some of the frozen sections came back inconclusive. If the cancer had invaded other organs, he would have to upstage me and we would need a different treatment plan. Final report-no cancer in the frozen sections. Oct 2015 the liver resection (he took sections IVA and V and 13 lymph nodes-biopsies of my diaphragm, peritoneum and section 8 of my liver-produced a 6 page pathology report)-went home after only 5 days in hospital and recovered well. Final report-no cancer, clear margins. Tumor board recommended we follow an adjuvant treatment protocol in a recently published national Phase II Trial (SWOG S0809) completed in 2014 which had excellent outcomes for OS (they gave me a copy of the report) so I agreed to 4 cycles of Gemzar with oral Capecitabine (Xeloda) followed by Chemoradiation using Proton Radiation therapy for 28 factions along with oral capecitabine 7 days a week during the radiation treatment. Goal is to get any cancer cells left behind. That little nodule on the outside of the gallbladder was still causing great concern that unseen cancer cells may be somewhere else in my body. Expected end date of the therapy is April 1 2016. The surgeon plans to follow me for 2 years, don't know what the other doctors plan yet.