Cholangiocarcinoma: An Interview with Mrs. Cramer

Tamara Tracz (‘25) & Pranav Soleti (‘26)

Last year, Mr. Mark Cramer, a renowned English Special Education teacher, battled against a cancer called cholangiocarcinoma, and all of the Lawrence community rallied around him and Mrs. Eileen Cramer. We sat down with Mrs. Cramer to gain some more knowledge about this type of cancer and how we can work together to raise awareness.

Are you able to share anything about cholangiocarcinoma that may help us understand it better?

Cholangiocarcinoma is a very rare cancer. It’s diagnosed in about 8000 people a year. It’s typically diagnosed in white men who are over the age of 70. It is cancer that develops in your bile duct, and your bile duct helps with digestion and it is attached to your liver. There are two types of cholangiocarcinoma—the cancer in the bile duct outside of the liver, and an even rarer form which is inside of the liver. So it is within the bile duct in that portion of the bowel duct inside of the liver, and that’s the form my husband had. There are no symptoms in the early stages of cholangiocarcinoma. Cholangiocarcinoma is known as a deadly cancer. The majority of people who are diagnosed with it do not survive it. My husband was having pains in his lower left side probably related to digestion, and we saw a very very good gastroenterologist and the gastroenterologist ordered a series of tests and didn't find anything. And he said, ‘you know, I'm gonna order an MRI to be sure.’ And when he read the MRI the radiologist found evidence of cancer on his right side (your liver is on the right side of your body), so that's how it was diagnosed. 

How has this diagnosis and treatment affected you and your family?

What we've learned about living with cancer is that everyone has a cancer story; everyone knows somebody who has either had cancer or who has been affected by cancer. And what we discovered because we chose to be open and share our story is that a lot of people have stories that they choose not to share, including people who work in this building or who are students here who are currently fighting cancer and choose not to share that information.

Have you encountered others with cholangiocarcinoma since the diagnosis, and if so, what has that been like?

We became involved with a group through social media: Cholangiocarcinoma Warriors in Delaware. There is a woman there whom I admire—she's just a powerhouse. Her mother passed away of cholangiocarcinoma and now she is currently fighting it too. And so she hosted a dinner and we were able to meet families and survivors, people currently undergoing treatment for cholangiocarcinoma.

What is something you wish people knew about cholangiocarcinoma?

I think what I really wish people knew about cholangiocarcinoma is that like other cancers that have no early symptoms, the way the doctors find those types of cancers are through annual checkups. So as you get older you'll hear about tests that maybe your mom and dad and grandparents have had to take. You will hear about things like a colonoscopy. And it sounds funny and it sounds scary to have the doctors examine your colon but in all honesty keeping up with these regular medical checks—whether it's mammograms, self-exams, a colonoscopy, even going to the dentist—that's how the cancer is found. So for cancers that have no symptoms that's why it's so important to keep up with your regular appointments and your regular checkups. Without that, my husband’s cancer would not have been found, and there's a chance that it would have been too late to treat. If he had waited and delayed going for his regular medical checkups he might not be here right now.

Is there anything else you’d like to add?

I think what is really interesting about certain cancers and research is certain cancers we don't know where they come from and we don't know what causes them, and cholangiocarcinoma is an example of that. Other cancers, for example, like skin cancer, we know that we can do things to prevent skin cancer. Other cancers—and we do know that a healthy diet, healthy lifestyle is definitely beneficial—but I did meet a young woman in her 30s who has cholangiocarcinoma who was maintaining very good health standards. So there are these outlier cancers that we don't really know what causes them, and so I do think for that reason that it's important to be in the know about the different parts of your body and to know if something doesn't seem right then you need to ask your doctor about it. For example, one of the common symptoms for a lot of different cancers is bloating, so you know, if something in your body isn’t working right, then you need to tell your doctor. I think it's so important to not be embarrassed by whatever it is. So if it's bloating it could be gas or it could be cancer. But if it's going on for an extended period of time you need to tell your doctor about it and not be embarrassed about it. Just say ‘you know what, doc, I’ve got terrible gas and I don't know what to do about it.’  Because I'm gonna guarantee whatever your most embarrassing thing is that you don't want to share with the doctor they've heard something a thousand times more embarrassing, so please do not delay because of something you think is embarrassing. For example if a woman finds a lump in her breast, or if a man finds a lump in his testicle, obviously that’s scary but its so important for you to go ahead and talk to your doctor, talk to your healthcare provider, and you know, it could be an ingrown hair. You just don't know, but by talking to a medical professional you can alleviate all of your concerns and worries, and if it is cancer they're gonna be able to treat it as soon as possible.

The t-shirt worn last year by hundreds of staff and students to raise awareness of Cholangiocarcinoma.