Las Vegas woman chooses to go in peace rather than fight ovarian cancer

Maybe now Ginger Fisher has found some peace.

Tormented by disabling treatments, debilitating pain and relentless collection agencies, she told me last year that the interventions to keep her alive caused problems she wished neither she nor her family had to deal with.

So the financial planner decided to do nothing to stop the ovarian cancer eating away at her body.

When she knew the end was near, she left Las Vegas for her home state of Missouri.

Only 39 when she was diagnosed with terminal cancer, she was 42 when she died recently. Doctors didn't associate her symptoms with ovarian cancer until it was too late.

What prompted our first meeting was the Review-Journal's issue on breast cancer. Though impressed by women who were fighting hard to stay alive, she asked whether I would do a piece on someone who decided that the medical treatment of cancer only reduces the quality of life at the end.

"How you live out your life when you're terminally ill is a highly personal decision," she said in that story. "I think it is just as honorable that some people … decide to let nature take its course, who believe the treatment and all that it does is worse than the disease."

She was right, of course. If there's a wrong way to cope with a terminal illness, it's following someone else's prescription for how to spend what precious time you have left instead of your own heart.

Fisher also asked me to write about ovarian cancer, which accounts for more deaths in the United States than any other cancer of the female reproductive system, with nearly 14,000 women dying of it annually.

That piece noted how the risk for a woman acquiring ovarian cancer, about 1 in 71, is far less than the risk of getting breast cancer, which hits about 1 in 8 women. But ovarian cancer has a higher mortality rate.

Most women so stricken die of the disease. The problem is that 20 percent of ovarian cancers are found at an early stage. When the disease is found at a localized stage, about 94 percent of patients live longer than five years after diagnosis.

But most women present in stage 3 or stage 4 of the disease, when the cancer is far along. Unlike breast cancer, where mammograms can detect the disease early, ovarian cancer doesn't have a good screening test.

Early cancers of the ovaries cause symptoms -- abdominal bloating, feeling full quickly, having to urinate often -- that are more commonly caused by other things.

"I only wish there was a better way to connect the dots on these common symptoms," Fisher told me.

Well, thanks to the Ovarian Cancer National Alliance, Fisher's wish has turned into reality.

Earlier this month, the alliance released a free app, software that can run on a computer, phone or other electronic device, that guides a woman through a short list of questions about risk factors related to ovarian cancer.

The woman can then use the program to keep a daily record if she experiences bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, having to urinate urgently and often.

If a woman feels any of those symptoms and records them for 14 days in a given month, the app sends her an email suggesting she visit a doctor and be tested for ovarian cancer.

"Too often, the symptoms of ovarian cancer are mistaken for other things," said Karen Orloff Kaplan, CEO of the Ovarian Cancer National Alliance.

The Ovarian Cancer Symptom Diary app can be accessed at http://diary. ovariancancer.org.

If only there was an app so that anyone with a terminal illness -- even if not heavily insured -- could die with dignity and peace. I'll never forget how Fisher sobbed when she told me she had found it impossible.

"How can you when you're being harassed by collection agencies for money for services that doctors and health care facilities say aren't covered by your insurance? I was under-insured just like so many working people. I put my daughter down as an emergency contact, so now she gets my collection calls. Do you know how that makes a mother feel?"

Paul Harasim is the medical reporter for the Las Vegas Review-Journal. His column appears Mondays. Harasim can be reached at pharasim@reviewjournal.com or 702-387-2908.