The Mercaldo Family
Our Story
In 2021, my husband James barely survived a massive stroke at the age of 50 leaving him partially paralyzed and unable to speak. He fought to live and then spent the next year fighting to regain function and mobility. Unable to work from disability, we closed our business, the sole source of our income, and I become his 24/7 caregiver.
In 2022, James got very sick within a matter of weeks and was diagnosed with cholangiocarcinoma or bile duct cancer, considered not only rare but aggressive, chemo resistant and therefore incurable. He underwent a horrible surgery called a Whipple procedure and was told they removed everything early, he was cured.
Two months later a pet scan revealed the cancer had metastasized to his liver. He was changed to stage 4 and offered palliative care as he was not a candidate for liver resection or transplant.
We refused to give up or accept the 7 month survival prognosis he was given. Two and a half years later, James is still fighting. From the onset of this diagnosis, we told oncology we would only accept a cure - our goal was to kill this monster.
October 2023, the FDA approved use of histotripsy for liver lesions. This remarkable procedure uses ultrasound to violently shake and obliterate cancer lesions. The body then flushes the immediately killed tumor through the kidneys. The liver is not damaged and the integrity of liver tissue is maintained, allowing it to regrow into the empty cavity. The tumor is killed on contact so there's no risk of metastasis. There is no limit to how many times you can do this procedure.
This is the first treatment that has successfully killed cholangiocarcinoma tumors in the liver which is the ONLY place my husband has cancer residing in his body!
Cholangiocarcinoma is considered incurable because the shell of the cancer cell is impervious so the body's immune system cannot read the inner DNA and learn how to fight/kill it. By shattering the tumor with histotripsy, the DNA is finally exposed and the body has a chance to develop immunity to it! An actual chance for a cure!
Few clinics offer this technology - insurance denied coverage. First, for the Category 3 code deeming histotripsy as new and emerging technology. Insurance twisted the interpretation to mean "experimental" and "not medically necessary". Upon appeal, we were informed that James' state disability waiver is funded by a Medicaid expansion and Medicaid prohibits the coverage of any Category 3 procedure. Until the FDA changes the procedure code, we have no appeals option left and insurance will continue to deny coverage. Not that it means much as privately funded insurance patients are receiving across the board "experimental and not medically necessary" denials also.
Not to be deterred, we found a hospital in California that has been doing these procedures for nearly 18 months and have done over 300 in the past year alone! They understand this is the last hope for many people and are compassionate, urgent and aggressive.
We are in an impossible situation so we started this fundraising campaign to pay for this life saving, life altering, life giving treatment while it is still within the realm of a curative possibility.
With the support of Help Me Bounce and hundreds of donors, we were able to raise the $50K needed for his first histotripsy procedure and May 4th James had the procedure. In 4 hours' time, 1/3 of his cancer was completely and permanently killed!!! He took Tylenol and flew home the following day. But our battle doesn't end here.
The reason this specific clinic is pertinent to James' outcome is that they are the only facility in the entire United States allowed to treat pancreatic lesions as part of a closed trial. James' largest lesion presses the liver into the pancreas. He was the fourth person in the world to receive histotripsy on this type of lesion.
However, this lesion is large and it could not be completely killed in one pass. The kidneys can only filter out so much debris without harm or failure. James requires at least one more histotripsy treatment, probably two.
Hospitals are realizing the value of these treatments and the high demand from patients globally. Their original offer of a 40% discount on subsequent procedures has increased to $35K each procedure. Without insurance coverage, we have no option but to raise more money.
They suck. So does cancer. We can't do anything about either of these factors but we can keep fighting. A cure is within our sight. Two more treatments will get us there.
We've already paid out $50K from our raised donations to the hospital for the May procedure. We have $25K remaining which is $10K short of the needed amount for a second procedure next month and we still have to raise another $35K for a third procedure this fall.
Can you help us to raise the remaining funds that we are lacking? 45, 000 generous donors giving just $1 provides the funds for his two final treatments! We are rushing to raise this and pay the hospital before they raise the rates again.
Even if you can't donate, please share our situation with everyone you know. Someone, somewhere is able to help. We need you to connect us with those individuals.
Thank you for reading this far. Thank you for caring and sharing. Many blessings to all of you! #NEGU
Family Updates
SO VERY HAPPY - HERE'S WHERE WE ARE AND WHAT'S COMING UP SOON
We spoke to Dr. B this past Sunday and got a report on the histotripsy results. The treated areas are dead. They show on the scan as black areas of cavitation which will eventually fill in with new, healthy liver tissue. We are thrilled for these results.
James' CA numbers have dropped again - another 1000 points. And something really special for us - he usually follows a predictable pattern during treatment. Somewhere around his 8th infusion, he has a fever spike. Like big spike that lasts for a couple of days and he is physically depleted. Then suddenly, he snaps out of it takes a turn for the better. He gets more energy, his labs look better and soon after, we get the news that the lesions are no longer visible. We are only TWO infusions into this third round and he had the fever spike - less than a week after the histotripsy procedure. We are praying this is the abscopal effect we so desperately seek.
James' body is showing positive signs to treatment and.....he is back to the gym pool! It's only for 30 minutes, 2-3 times a week. His body is weary and the only exercise he can tolerate is half an hour of gravity free movement but he hasn't done any movement/walking in a year! This is HUGE and we hope he can restart outpatient therapy in the very near future. We praise God for these encouraging developments and for this to continue and accelerate. Now....he still has visible cancer. We already knew this because we couldn't treat all of it BUT it is treatable. In fact, the remaining lesions significantly shrunk after histotripsy and only one infusion.
We unexpectedly got the news that this next procedure is 40% OFF not 40% OFF which is an unexpected difference of $10k. When arranging for the scans to be read, we were told it raised again to $35K.....this is incredibly disappointing to us.
We will be fundraising again as we are now short $15K and the next treatment is slated to be in six weeks. This is one prayer request - we know God will get us there some way, somehow. We will have to purchase more plane tickets so we are mentally preparing for this upcoming hurdle and restart those efforts soon.
WE ARE ASKING FOR PRAYER ON ANOTHER RELATED FRONT. This procedure has the potential to save hundreds of lives. Probably thousands. It isn't a stand alone treatment but in combination with traditional treatments, many people are in complete remission and/or cured. We believe James will eventually be one of them and now our medical team is FINALLY acknowledging James is in a different treatment category today than just six weeks ago! They're rapidly getting on board with our mission having seen James' own results for themselves.
We have been incredibly blessed by all of YOU. Your support, prayerfully and financially, carried us to this point. So many others do not have this opportunity because their insurance won't cover it and they have no funds. Furthermore, it is not unexpected that if James' cancer rears its head years from now, we will need to do another histotripsy procedure to kill it. We cannot lean on donations forever. It's just not realistic.
I'm reaching out to multiple agencies, media sources and politicians to change this for our future and those who need an advocate to break the insurance barrier. We won't make the necessary changes in time for James' treatments that he needs now. The bigger the organization the bigger the battle. We are in one heck of a fight.
Although God is holding and healing James, not everyone is this blessed. Some gravely affected people NEED this procedure and NOW. I'm sick thinking of those needlessly dying. Please pray for us to make a case for histotripsy coverage to the right people at the right time and it be well received. Pray that we are able to create a situation that raises awareness and pleads the case for all cancer patients. Pray that we receive a favorable decision and that the outcome sets a new precedent for others to have the same opportunity as James.
We are so appreciative of your prayers. I want to update more so these posts aren't so long but time escapes me. Our days are packed with so much bureaucracy, appointments and a mission. Thank you for praying for us and with us. We are fighting both a physical and spiritual battle and God is tipping the scale in our favor. We pray for complete victory and for it to come soon.
Our love to all of you! #TogetherWithJames
WE DID IT! Friday, May 2nd we flew to Sacramento, Saturday we did our prescans and Sunday was the big day - histotripsy!
What a special treat! The VP of Histosonics AND the inventor of this technology were both present for James' procedure and worked with the dr. to treat him. Wow, wow, wow! We are so honored to have such VIP treatment and they did not disappoint.
Three of his largest lesions were completely obliterated. The fourth, a troublesome and threatening lesion near the pancreas, was close to organs, lungs and a vein. So they got up in there and killed the nucleus of it and then pierced the hard shell in 7 places to allow the body's immune system to learn it and kill it. It's exactly what we needed and wanted to accomplish!
James is really sore but he traveled home to Virginia on Monday like a trooper! We had chemo on Wednesday and blasted him with lots of stem cell production in three hyperbaric oxygen sessions. We are throwing everything at this to make it all the most successful outcome possible.
We are so excited to have donations still coming in. We are so close to our goal of funding the remaining two treatments we are told he will need. In light of what we have seen, we have no doubt that we are looking at curative not just palliative care and we are ecstatic!
A HUGE thanks and all our love to every single one of you for propelling us to this moment! You, YOU, have saved a life - you all are incredible to me. I love every one of you and your generous, compassionate hearts. Thank you for letting me keep my husband. Thank you for letting our children have their father. Thank you!
Thank you to everyone who came out to Taco Tuesday at Duck Dive Tavern! Nate Sacks played some great tunes and there were plenty of hugs and smiles to go around. A much needed night of fun. We are grateful to Liza Manny and the staff for spreading the word about our fundraiser and Nate, who donated his entire night of tips! You all are so generous and such incredible people. Thank you for letting us get to know you and hang out!