“We were given no roadmap.
No response plan.
So we built one.”
— Steve and Claire Holmes

We built a patient response culture

Then we built what was missing —
a pathway between lived-experience and the newly diagnosed on the frontline.

Care became Response —

Response inspired survival.

There was no plan — so we forged one under fire.

Rooted in lived experience that survived— this can not be debated — just delivered.

Treatment is just half the solution — patient response, empowered by lived experience, is the other.

We test everything with one question:
“Does this help today’s patient — today?”

If not, we cut it.
That question is our North Star.

We built a How We Win culture — not just to survive,
but to help others respond, adapt, and win.
This isn’t branding. It’s execution.
Anything else is theatre — and in the way.

We break things down to understand, then respond — fast and clearly.

If we can’t break it down, we can’t understand it.

If we can’t understand it, we can’t act.

Seeing it clearly is where survival begins.

That’s how we break cancer’s grip.

We don’t campaign for attention.

We build what patients need — then execute it.

Fast. Focused. Survival-first.

No patient stays captive to their diagnosis.

But instead, we help them become the force that responds to it.

This system was not designed in theory — it was forged under fire on a cancer battlefield.

We turned response into a culture — a living structure, a survival system of steps —

Context sets direction → Candour sharpens it → Culture scales it → Approach executes it → Philosophy guards it.

Each step strengthens the next. Each survival fuels the next.

Until survival becomes a machine.

We build culture that is a survival system — rooted in response and lived experience,
enhanced by science and designed to work under pressure.

No distractions.
Just what works.
That’s how we win.

When survival is the goal, the patient must lead.
Not wait. Not hope. Not defer.

Because even the smallest act of leadership — especially under pressure — sends a signal.
People respond to that signal.
Not just to cheer them on, but to help them win.

That’s the power of humanity:
We rally around those who lift themselves above their circumstances.
When the patient signs the freedom contract, the rest will sign on.
Patients can be those leaders.

Everyone has a role:

• Patients lead.
• Caregivers activate.
• Clinicians adapt.
• Scientists accelerate.
• Funders remove friction.
• Policy clears the path.

You’re either part of the system that responds — and part of the success equation — or part of what delays it.  What you do now — today, must help today’s patient — not someday, but today.

That’s how we build a culture that wins.

Most models are built for clean hands.

Money in. Risk managed.

Looks good on paper —

But they’re detached from the fight.

We’re not.

We don’t optimise for perception.
We optimise for execution.

We hold every action to a single test:
“Does this help today’s patient — today?”
That’s the only measure that matters.

With patients, caregivers, clinicians, researchers, and industry:

● Breaking Cancer Apart

● Writing the strategies

● Building the systems

● Leading the science

● Living the response — and leading it

We weren’t given a roadmap — so we built one.

Not a traditional charity.

A patient-led system, built from the ground up.

Engineered to execute.

We don’t raise for awareness. We raise to act — now.

We must move the needle — fast.
That’s what today’s survival demands.
There’s no time for posturing.
No room for self-indulgence.
Only real action. Real execution.
That’s what it takes to save lives.

We don’t fund symbolism.

We fund systems that act.

• Light Australia Green.
• Cholangio Challengers.

Each of these community initiatives engages the entire community across Australia.
Each one delivers what patients and their support teams need — today.

We don’t chase donations.
We fund systems that act — fast.

Every dollar drives tools, teams, and turnaround.
Change takes execution.
Execution takes money.

That’s how we build what works.

This isn’t theoretical.
The people writing the strategies, building the tools, and leading the research have lived what others missed.

They know the stakes. They know the gaps.
That’s why the system works — because it was built by those who paid the price.

A system that learns from itself — and builds forward.
This shift wasn’t cosmetic. It was necessary:

→ HEALTHCARE: Passive. Delivers care.

→ HEALTH-RESPONSE: Proactive. Seeks solutions.

→ PATIENT-RESPONSE: Integrates patients and families — and scales through lived experience, and innovation not just care and resources.

That’s the shift OPR delivers.
That’s the response patients needed — and now have.

OPR stands for the Optimal Patient Response.
It’s a survival system — built from lived expertise, executed with precision, and designed to move fast.

It was forged under pressure, shaped by what works, and built for precision patient execution — not organisational awareness.

Treatment alone doesn’t work — not when survival is the goal.
OPR transforms care into a fast, focused, adaptive response.

OPR delivers what care can’t:
• Necessity — the force that drives real innovation
• Resilience — built through lived experience
• Precision — executed under pressure

It doesn’t complete care.
It corrects and elevates it.

OPR fills the layer care never addressed — the one that scales not through policy, but through people.

It integrates what others treat as optional:

• Lived experience
• Patient-designed strategies
• Tools tested under real-world pressure
• Survival culture that teaches and adapts

These aren’t extras.
They are infrastructure.
They are essential. Survival depends on them.

We don’t wait for innovation. We build it.

OPR is powered by tools that make precision practical — and fast:

→ NGS Integrations –
Embedding genomics earlier in the journey, where it matters most

→ Mutational Translator –
Translating complexity into patient-ready language

→ Mutational Matchmaker –
AI-driven trial matching by mutation — fast, targeted, precise

These tools aren’t aspirational.
They’re real, tested, and already in use.

When patients face confusion, time loss, or disconnection —
OPR delivers speed, clarity, and connection:

• Navigator Journal Series
  Helps patients respond with clarity and confidence. Simplifies complexity and provides a clear, step-by-step roadmap—bridging science, medical care, and personal action.
• Next Steps Program
  The first 30 minutes post-diagnosis can shape the next 72 hours. This program embeds patient navigation at the point of diagnosis to maximize early response capacity and engagement.
• Patient-Endorsed Medical Professionals Registry
  An AI-assisted system that accelerates access to clinicians with specific expertise and high-flow experience in cholangiocarcinoma.
• Second Opinion Project
  Connects patients directly to leading expertise and high-flow experience for second or third opinions—without pressure, delays, or barriers.
• Patient & Caregiver Symposiums
  Creates space for shared learning and innovation between patients, clinicians, and researchers.

These are not just navigation tools.
They are decision tools — built to move fast when it matters most.

OPR doesn’t replace care.
It strengthens what care alone can’t deliver.

It integrates the critical missing layer —
lived experience, innovation, precision tools, response teams —
into a system that holds under pressure.

This is how we scale what works.
Not someday — now.

That’s the rarest thing in cancer:
A system that responds.
A system that adapts.
A system that works.

That’s rare.
That’s how we win.

OPR is the system. This is the engine.
These are the people who didn’t just face their diagnosis — they built the response.

A cancer diagnosis doesn’t erase capability.
It isolates it.
Healthcare sidelines that talent.
We don’t.

We built a structure to redirect unused expertise — to solve, build, and execute in real time.

Talent Teams are not support groups.
They’re execution units — led by engineers, strategists, caregivers, and patients with a reason to act.

This is how experience becomes strategy.
And how strategy becomes survival.

Built to act. Designed to deliver.
Execution units powered by real-world skill and lived urgency.

No titles. No hierarchy.
Just patient-led strategy in motion.

Structured. Shared. Scalable.
Every OPR initiative is powered by these teams.

This is how survival becomes a system.
And response becomes real.

Execution units that deliver results.
Every OPR initiative is powered by a Patient Talent Team.

They’ve lived the gaps.
They’ve felt the delays.
They feel the pain.
They know the urgency.
And they’ve turned that experience into execution.

These aren’t symbolic groups.
They’re real-time survival teams — structured to act.

From living the cancer fight,
to building the system that fights back.

Every initiative below was or is being built by a Patient Talent Team —
people with lived experience, real-world expertise, and a reason to act.

They didn’t wait for solutions.
They built them — and deployed them inside the OPR system.

→ Patient-Endorsed Registry
Built by a patient data specialist. AI-powered. Trusted.
Connects patients to real experts — fast.

→ Second Opinion Project
Solves the system’s biggest blind spot.
Delivers matched expertise without delay.

→ Histotripsy Submission
Fast-tracked scalpel-free tech to national review.
Startup-trained patient-caregiver team behind it.

→ Trial Evaluation Teams
Lived-experience participants capturing signals, side effects, and real-time feedback.
Built for speed, clarity, and community confidence.

→ Genomic Mutation Teams
Patients grouped by shared driver mutations.
Monitor news flow, trial relevance, treatment updates, and deliver peer-to-peer educational insights and upskilling within each mutation community.

→ Post-Surgical Nutrition
Created by patients who lived the recovery gap.
Now setting the new standard for healing.

→ Bile Health & Early Detection
Led and engineered by Steve Holmes, who saw what was missed.
Prototyping tools to prevent the next cancer — including BILEflow, a bile health initiative focused on detecting chronic precancerous conditions and engineering the optimal bile composition.

These aren’t ideas.
They’re responses.
And they’re working.

Awareness is not the goal. Strengthening today’s frontline is.

Community-led action isn’t symbolic — it’s strategic. When patients move, systems follow. And when we move together—with structure and urgency — outcomes shift. This isn’t support. It’s infrastructure. Powered by people. Directed by our “How We Win” doctrine.

→ Light Australia Green
Year-round. Patient-led. System-focused.
A national initiative that activates public response and channels coordinated funding. It connects, educates, and aligns patients, clinicians, researchers, and industry — not for visibility, but for real-time survival strategies and execution.

Every dollar raised fuels tools, teams, and outcomes — not optics.

→ Cholangio Challengers
Cholangio Challengers provides a pathway — and an opportunity — for those who can, to act for those who cannot.
It converts personal effort into collective survival.
Every day, action becomes direct, targeted funding — fueling the systems patients rely on.

Not just participation — contribution.
Not just awareness — outcomes.
Not just effort — inspiration that strengthens the patient will to win.

This isn’t awareness for awareness’ sake.
This is survival culture — activated, resourced, and built to deliver under pressure.

This isn’t charity.
It’s culture — executed.

The Human Origins
Where it really began — in crisis

From the ICU.
From the frontline.
From lived experience.
Tested under pressure.

From the expertise that passed the test.
And from those like Ben Kikuchi— who sacrificed unselfishly, and didn’t make it.

We built a system out of them. A system designed to win — today.
Not just for one.
For all of us.

Strategic collaborations are vital — but only if they stay accountable to patient outcomes.

→ Research that leads to earlier detection or treatment breakthroughs

→ Industry that builds what patients need — today

→ Organisations that prioritise patient outcomes over commercial self-interest

No noise. No optics.
Just aligned momentum that delivers.

Cancer Australia & Cancer Council – Optimal care pathway for people with biliary Cancer

EWG: (Australia) – Controversies in the management of biliary tract cancer

ICRC – International Cholangiocarcinoma Research Community

A global think tank of clinicians, researchers, and patient organisations committed to advancing understanding and treatment pathways.

CCF – Cholangiocarcinoma Foundation (USA)
Active collaboration on patient programs, global advocacy, and data-sharing initiatives.

AMMF – UK & Europe
Partnership on research communication, shared awareness campaigns, and patient education.

C3 – Canadian Cholangiocarcinoma Collaborative (Canada)
Ongoing alignment on patient engagement strategies and research dissemination.

Spain & Italy
Cross-country engagement with research centres and patient organisations focused on clinical trial access and genomic pathways.

CancerDelta Global
An AI-powered Central Cancer Repository designed to:

• Centralise global cancer knowledge
• Deliver real-time, personalised answers — from patients to scientists

Graeme, you called with terrifying news:
You had cholangiocarcinoma.
You were scared. I was frozen.

I was your older brother.
You looked to me — and I could do nothing.
You passed.

But you’ll be proud.
I’ve done something.
We’ve built a response system — for your children and others like you.

That’s how I carry your name.
That’s how we win — together.
— Steve

How We Win isn’t personal reflection. It’s a structured survival system — reverse-engineered under the pressure of a stage 4 cholangiocarcinoma diagnosis.

Most systems ignore the human components — because they can’t quantify or control them.
But in cancer, those components are foundational.
They shape decision-making.
They influence survival.
They must be understood.

So I broke them down — into a clear, concise framework.
One that teaches.
One that scales.
One that works under pressure.

I understood each component.
I understood their importance.
I understood their impact.
That’s why I took ownership — to build what patients actually need to survive.

Cancer begins biologically — when a cell’s DNA is damaged and repair fails.
But once diagnosed, it’s no longer just biological. It infiltrates the mind.
From that point forward, cancer is a whole-of-body disease.

If we can’t break cancer down into all its components — biological and mental — we can’t understand it.
If we can’t understand it, we can’t respond effectively.
If we can’t respond effectively, we can’t control it.
And if we can’t control it — it wins.

But once understood and structured into a response system — it can be scaled.
And it must be — because time is the one thing cancer steals first.

WHY THE STANDARD FAILS – AND HOW WE SET OURS

The Standard of Care is clinical. It treats the disease — not the human.

It disregards emotion, anxiety, and stress because they’re harder to understand, quantify, or control.
But those components aren’t noise — they’re foundational.
They shape how patients think, act, and survive.

This is why clinical treatment alone isn’t enough.
One cannot work without the other.
Treatment and response are interconnected.
They are interdependent.

The system doesn’t see this distinction. It wasn’t designed to.
It’s inflexible — built around clinical processes, not human instincts.

But the patient’s first response is always human:
To engage every available asset — mindset, emotion, community, story, intuition.

And that’s where the system breaks.
Because when patients respond outside the clinical script, it creates friction.
It pits instinct against protocol.
It quietly turns physician and patient into adversaries — when they should be standing shoulder to shoulder.

The enemy isn’t just the disease.
It’s the failure to respond — together.

That’s why we set a new standard.
Patient-centred is not patient-led.
There’s a critical difference. It matters.

Patient-centred is branding.
Patient-led is the real.
Lived experience can’t be copied — only respected and embedded.

Patient-centred isn’t lived experience.
It can’t lead — and it shouldn’t try.

The best clinicians — those with real experience — know where their expertise ends.
They don’t cross the line.
They don’t pretend.
That’s why they lead.
That’s why they’re trusted.

Patient-led. Expert-informed. Truth-aligned.
That’s the team we’ve built to win.

Why ‘How We Win’?
Because I’ve never met a newly diagnosed patient who wants to lose.

HOW DO WE WIN?
We shift the perception.
We change the angle of attack.
We change how we see.
We change how we approach.
That’s how we win.

We built the system. Now we need you.
Now we must scale it — not someday. Today.

Just yesterday, I was a person.
Today, I am a patient.
I must become the best patient I can be —
So I can become that person again.
— Steve Holmes

I didn’t set out to build a system.
I set out to survive.

But what I needed wasn’t there.
So Claire and I created what was missing — with others who understood what was at stake.

We didn’t start with funding or permission.
We started with pressure. And clarity.

What we’ve built wasn’t theory.
It was forged from lived experience.
And it works.

Now the ask is simple:
Don’t wait to be invited.
Pick up what’s here.
Use it. Build with it. Scale it.

Because what we do today determines who survives tomorrow.

This is the response.
This is how we win.
Together.

— Steve Holmes

Steve Holmes & Claire Holmes
Founders –
Cholangiocarcinoma Foundation Australia (2018)
www.cholangio.org

Steve 

• +61 415153522
• steve@cholangio.org
• Personal Story
  www.steveholmes.net.au

Claire

• +61 431180783
• claire@cholangio.org

Located

Main Beach, Queensland, Australia 

• All quotes on this page are from Steve’s patient diary.