Transforming Health Care through Innovative and Impactful Research

Peg Ford is a living example of two things that now have become her passion: early detection of ovarian cancer and timely referral of physicians into the care of a gynecologic oncologist (as one recently saved her life). Before her encounter with ovarian cancer, she had turned most of her adult life to alternative healing methods. This was to change dramatically when she was diagnosed with ovarian cancer requiring a major relationship with western medicine.

After taking a harsh tumble on a sidewalk in 2006, Peg struggled with immense problems which she felt had been caused by the fatigue she was feeling at that time. Although she believed the fatigue was normal as she was getting older, post menopausal, highly stressed about getting a book published, and simply just doing too much " all this was draining her. During her recuperation from the fall, she experienced increased fatigue which she believed was just a normal symptom of the injury. X-rays had shown two hair-line fractures in her left shoulder, with both her wrist and hand badly sprained. As she did during menopause, she began receiving acupuncture treatments.

Shortly thereafter, she began having abdominal discomfort which she attributed merely to healing from her fall. Although she began spotting, she just believed her ovaries had been jarred in the fall; however, her fatigue was increasing regardless of how much sleep she was getting, and her abdomen was starting to swell. Coupled with this, she began to experience indigestion and constipation, which she related to the pain medicine prescribed after her injury. However, the discomfort progressively worsened, and her spotting turned to two weeks of bleeding. She soon realized that her clothes started fitting tighter and tighter, but she felt this was obviously due to her inactivity after the fall. Heartburn would come and go, which she very rarely had in the past, and this came along with backache and continued fatigue.

Three years earlier, just before her 57th birthday, Peg had walked 60 miles for the Three Day Breast Cancer Walk with no problems, so this new fatigue worried her. When pain joined the symptoms, she sensed some serious help was needed. By the end of December, the symptoms had worsened and she could no longer delay going to see a doctor. Turning to the Western medical profession was a new experience. To add to this, Peg was divorced, living on her own, self-employed, and struggling as an artist with no medical insurance " needless to say, this foremost concern was causing a delay.

Thankfully, Peg was able to pay to see a gynecologist. After the doctor examined her and performed a pap smear, she underwent a pelvic and transvaginal ultrasound the very next day. Shortly afterwards, the doctor's terrifying call spoke of a huge mass in her abdomen requiring surgery as soon as possible, but she did add that her pap smear was clear. Peg breathed a sigh of relief, for she felt that certainly indicated no cancer.

The doctor referred Peg to a surgeon who wanted to perform the surgery sooner than later, with an oncologist assisting. Although she had no idea what an oncologist was, Peg never bothered to ask. The doctor kindly guided her to start the process to obtain medical coverage. Although the process of obtaining treatment through county, state, and federal funds was arduous, Peg counts her lucky stars that the system worked for her. She was immensely fortunate the system did not stop nor hamper her from getting the best care available. However, when the doctor received the CA-125 report, she referred her immediately to a gynecologic oncologist who had Peg in his office two days later.

By the time Peg arrived at the surgeon's office, with little if any insurance, the mass had completely filled her abdomen and was pressing on her lower breastbone. Although he was booked for six weeks, he did not hesitate to locate an operating room and arrange for her to enter the hospital right after the weekend. Furthermore, the surgery was scheduled at 4:30 p.m. for an anticipated 6-8 hour operation. This, Peg believes, shows the character of the man as well as the surgeon.

The sheer size of the mass concerned the surgeon, and he believed she could very well end up in intensive care. At this point, everything stopped as Peg had known it, and the Western medical world she had so long avoided engulfed her. The surgeon drained about 6-1/2 liters of fluid; decompressed, the tumor was between 30 and 35 centimeters. Although it had completely encompassed her left ovary, thankfully it had not metastasized. Peg is a living example of the importance of timely referral from the physician into the care of a Gynecologic Oncologist. In Peg's situation, it was a very rare sex-cord stromal tumor that shows up in approximately 5% of cases.

After removal of the large tumor, and per concern on her surgeon's part that there could be a recurrence due to the large size of the mass, he prescribed chemotherapy as a precautionary measure. Chemotherapy! When she heard this word, Peg realized for the first time that she had cancer!

However, Peg did not tolerate chemotherapy very well. On the fifth day of the first round, in the early morning, her pulse dropped to 29! Although all chemotherapy was stopped, the next morning her pulse dropped to 34. They kept her in the hospital four more days under observation and determined the chemotherapy drugs, possibly Cisplatin, could have been responsible for the relatively slow heart action she had experienced. Apparently, this serious side effect has been reported in only 1% of cases. Two days after her release from the hospital, her blood tests showed a white blood count of .8, prompting shots for five days straight to correct this issue. All these factors were strong indications of a severe reaction to the chemotherapy drugs, Cisplatin in particular. Peg read a paper where this is called "Platinum Hypersensitivity Reaction," and Registered Nurses and caregivers are being trained to be aware of this adverse reaction.

Six weeks later, Peg was diagnosed with malignant melanoma (a mole on her upper back left side) which had to be removed, followed by sentinel lymph node biopsy surgery. All of this happened within six months! Fortunately, as was the case with the ovarian cancer, her lymph nodes were clear.

Although Peg has been monitored by the Western medical world since her surgery, she again has turned to complementary alternative methods for healing; she actually has blended the two modalities successfully, and in February 2011 she will be celebrating her fourth year anniversary of dancing with "NED" (No Evidence of Disease)!

However, this is just the beginning of Peg's new path in life; while researching to understand the disease, she discovered the "Survivors Teaching Students: Saving Women's Lives" program, which is an Ovarian Cancer Education Program for medical students under the sponsorship of the Ovarian Cancer National Alliance (OCNA) www.ovariancancer.org. With the growing awareness of just how fortunate she was to be a living example of two things that have become her passion, Peg took action. In December of 2008, she launched the program at the University of California, San Diego School of Medicine for third-year medical students by taking ovarian cancer survivors right into the classroom to share their stories.

Further, she has teamed up with esteemed Gynecological Oncologist Dr. Afshin Bahador to present as part of his Grand Rounds at various Scripps Healthcare and Sharp Healthcare Hospitals in the San Diego area. Besides facilitating the Survivors Teaching Students program, her other volunteer advocacy efforts include serving as OCNA's representative as a consumer reviewer on the Department of Defense Congressionally Directed Medical Research Programs scientific review panel for the fiscal year 2009 (FY09) and FY10 Ovarian Cancer Research Program, which has assisted her tremendously in her advocacy efforts, and in preparing and working with survivors to participate in the Survivors Teaching Students program. Peg's participation has inspired her to pursue other avenues of scientific study available for patient advocates, as she hopes to continue to be selected as a consumer reviewer for the project.

Peg is also a member of the Core Planning Group (CPG) of the California Ovarian Cancer Network Program (COCNP), sponsor of the Teal Impact 2010 Ovarian Cancer Symposium in Sacramento in August 2010. She also feels very fortunate to have been selected as a 2010 scholar in the Research Advocacy Network's (RAN) "Focus on Research" course, which involved attending the American Society of Clinical Oncology (ASCO) annual meeting in Chicago in 2010. The purpose of "Focus on Research" is to prepare advocates to better understand research findings, and to disseminate those findings to a patient community that will influence patient care. Additionally, Peg is the Patient Advocate Member of the Editorial Board of The Oncology Nurse and Journal of Multidisciplinary Cancer Care magazines. As well, she serves as a Consumer Reviewer for The Cochrane Collaboration.

Why is it so important that Peg helps? Among the many reasons, the most significant is having the ability to make a difference by affecting change in how ovarian cancer is considered by medical doctors. As it was once very providential to be referred quickly into the care of a brilliant gynecologic oncologist at Stage I (which was unheard of in most cases), Peg's mission is now to provide this opportunity for all women! Until an accurate screening test exists for ovarian cancer, women must rely on the awareness of medical doctors in all fields. This should be a top priority rather than the last thing they consider, as early diagnosis is vital in saving more women's lives.

Peg believes, "We must also inspire women to be aware of their bodies and encourage them to be their own advocates to obtain medical care in a timely fashion."

She remains ardent in educating women about the disease and is compelled to tell her story whenever an opportunity presents itself. Ever dedicated to the field of cancer research, Peg will always consider serving as a guest speaker, facilitator, or writer for community outreach efforts.