Survivor Stories — Peggy Heller

         
Just before my diagnosis with Ovarian Cancer State IIIC in 2007, I was working double overtime as a senior executive of a thriving healthcare public relations and communications firm - putting in 50 hour weeks, traveling across the country, dealing with clients, managing staff. In 15 years, I had taken only a handful of sick days--to have my wisdom teeth pulled and to repair a hernia. In short, I was a robust, healthy mid-life woman who managed her health mostly by letting nature take its course. Yes, I had annual physicals and routine mammograms, I had a pretty laissez faire approach to health. I believed that if something was wrong with my body, it would speak up, I would know it.

Well, I was wrong.

With my schedule, I had little time to notice or pay attention to subtle bodily changes. I did begin to notice a small bulge in my upper abdomen, the exact site of a hernia repair four years earlier. I assumed it was a reappearance of the hernia. This time, I thought, I would plan to get a tummy tuck too. The bulge didn't hurt so I was in no hurry-- until it began to get larger and impact the fit of my clothes. I finally went to my GP and suggested the hernia diagnosis. She wasn't convinced because it didn't feel herniated and ordered a CT scan. I wasn't worried.

Within six hours of the scan, my doctor called and asked me to come in. Although it was after 5:00, she said she would wait for my husband and me. She was quite direct with us. I had advanced ovarian cancer, she told me, with a visible tumor in each ovary and acites in my abdomen. She said I would need surgery and chemo. We left in total shock and disbelief.

As you can imagine, from the moment of diagnosis, everything changed both personally and professionally. The world and my place in it was altered forever. I was no longer the busy executive looking at health with the detachment of a businessperson. I was suddenly, for the first time, a patient whose view of healthcare was life and death.

I elected to have surgery at a large teaching hospital in Philadelphia. When I explained to the doctor that there must be some mistake, that I have NO cancer in my family (we all die of heart disease), no risk factors (I nursed three babies) and no symptoms, his response was a nod, "yes, that's typical."

I looked quite pregnant (I'm 61 years old!!) by the time I headed into surgery two weeks later. I knew that first line chemo would be taxol/carbo and I wanted IV/IP if I was lucky enough to be optimally debulked. The surgeon said he would do his best. I awoke with a port in my abdomen that I took as a good sign. He was able to remove all but a small, less-than-1cm fragment on my omentum. I was stage III C - not a surprise.

Recovery from surgery was rocky. It wasn't the surgery itself, but the bowel recovery. I had a "lazy ileus" causing me to vomit bile anytime I ate. Next step was a NG tube inserted through my nose and down my throat - by far the worst and most uncomfortable part of the experience. Then we waited a week for the bowels to "wake up".

Prior to leaving the hospital, the doctor suggested I consider a dosing and toxicity clinical trial for the taxol/carbo IV/IP protocol. That chemo combination, while very effective, is also difficult to tolerate so women often do not complete full treatment. I agreed to participate and travel to Philadelphia every three weeks for six rounds.

Fortunately, the chemo experience, although difficult, was tolerable. I was fatigued and had some pain in my abdomen the third day after treatment, but otherwise I felt well enough to resume working and even travel to France for a long-awaited family vacation. I went equipped with masks and strict instructions about staying out of crowds and away from fresh fruits and vegetables--a tall order in France. After the first round, my CA125 went from 175 to 35.

During the course of treatment I lost my hair. I didn't think it would be a big deal but it was. Treatment ended in September 2007 with my CA125 at 6 and a clear CT scan. No matter what the statistics suggested, I knew I had beaten this disease.

But just to hedge my bets, I studied my options for consolidation treatment and found online a phase II/III vaccine trial (abagovamab) with an endpoint to delay recurrence. I was an ideal candidate and joined just in time, working with a team at Memorial Sloan Kettering in NYC. I would be on the trial for four years unless I had a recurrence. I was convinced I was getting the vaccine, not the placebo, because I developed a small red lump, a soreness and occasional fever after administration.

Six months later, my second CT scan showed various sites with inflammations and tiny implants. The cancer was back and I was precluded from the trial. It was devastating. But then I took a deep breath and recalibrated my expectations.

Doxil was next, but didn't work for me. The disease continued to grow. It was followed by protocols using avastin/cytoxin, carbo/gemzyne, topotecan, another trial with taxol/ ferlatuzamab, more avastin and other drugs. Most regimens worked for a time and then stopped, with CT scans showing disease "progression." Each time I was placed on another drug.

I've been on continuous chemo for almost four years and expect to remain in treatment indefinitely. Cure is not in my vocabulary; a remission is unlikely. I'm working on stable disease that will allow me to continue to live a comfortable and active life.

Happily, I've been able to travel extensively and maintain a busy social schedule over the last four years. It's not always easy, but if I don't push, I miss out.

The loves of my life are my family -immediate and extended, dear friends who encircle me, and the ovarian cancer advocacy community that has surfaced since my diagnosis. I am active with two organizations that provide educational panels to medical/nursing students, residents, chaplains and community groups. And I am now honored to serve on the Board of KOH where I hope to make a meaningful contribution.