Tests revealed multiple lesions in her liver and a large tumor in the left hepatic lobe. A biopsy followed, and on May 3, 2023, she received a diagnosis that turned her world upside down – intrahepatic cholangiocarcinoma (a form of bile duct cancer). For Milada, it was a devastating shock. “It was the worst diagnosis I could have imagined. I had to come to terms with it very quickly. My family was my greatest support – they never left me alone for a moment,” she recalls.
What followed was an intensive treatment regimen – chemoimmunotherapy with a combination of gemcitabine, cisplatin, and durvalumab. During this first-line treatment, molecular-genetic testing was conducted at FN Brno using next-generation sequencing on a previously collected tumor sample. This testing revealed a mutation in the IDH1 gene – for which a targeted treatment, ivosidenib, is available in the Czech Republic. The IDH1 mutation is present in 14% of patients with this type of cancer. This special therapy can be administered as a second-line treatment once the first fails. However, repeated requests for coverage of this advanced targeted therapy were denied by the insurance company, despite clear evidence of its effectiveness. “It was incredibly frustrating to see a clearly indicated treatment being rejected, even though it could significantly help,” she says.
Eventually, Milada decided to take matters into her own hands. Thanks to a fundraising campaign organized through the charitable platform Znesnaze – initiated by a former university classmate – she managed to raise the necessary funds to access the treatment as a self-paying patient. “I was overwhelmed by people’s solidarity. Not just from friends and family, but also from complete strangers. Thanks to them, I can keep fighting.”
Although the treatment brought physical side effects – fatigue, nausea, and allergic reactions – Milada never gave up on living her normal life. She continued working as a veterinarian, caring for her children, and being as present at home as possible. “I wanted things to function as normally as they could. I wanted to keep being a mom and a doctor, just like before.” Fortunately, the ivosidenib therapy has been successful, and she has now been stable on this oral treatment for over 9 months – and continues.
The illness brought with it a profound re-evaluation of her values. Milada began to focus more on herself and the things that bring her joy – sports, the mountains, climbing, swimming, and ski mountaineering. She also embraced alternative approaches such as traditional Chinese medicine and Ayurveda. She learned to listen to her body and allow herself to slow down. She speaks very positively about her experience at FN Brno: “The medical staff and doctors were always empathetic and professional. I truly felt that they cared about their patients. My attending physician, Dr. Michal Eid, has been an incredible source of support and care.”
And what would Milada like to say to other patients facing similar challenges?
“Don’t be afraid to ask questions, to ask for help – and don’t forget yourself. Every small step toward self-care matters. Even in illness, it is possible to find strength and hope.”