Janice Paulshock is a busy woman. The 58-year-old resident of Harford County, a Maryland suburb, works full-time; is a committed mother and grandmother; runs to keep in shape; participates in charity bike rides to raise money for multiple sclerosis, from which her husband suffers; and volunteers to support current patients and medical students at Johns Hopkins. As if her schedule isn’t full enough, she’s been busy fighting cancer for the past twenty years.
Since the age of 38, Janice has beaten back an aggressive and advanced form of ovarian cancer not once, not twice, but five times. When her odyssey began, she was a wife and mother of three young children. Initially, she underwent standard chemotherapy and surgery at a community hospital. Afterwards, as a standard protocol, she received followup. About two years after her original diagnosis, her tumor markers started escalating. Her physician told her not to worry. Instead, Janice took action.
She contacted Johns Hopkins and, within one week, underwent a PET-CT scan in which a two-centimeter tumor was discovered. Shortly afterward, at Hopkins, she underwent surgery followed by intraperitoneal chemotherapy, which delivers drugs directly into the abdominal cavity.
The next few years were a blur of cancer recurrence, chemotherapy, surgery, and remission. Throughout it all, Janice continued to live a normal life despite the side effects of chemotherapy. Friends and family provided meals and offered to take her to chemo sessions and injections at the hospital. “It was hard on all of us, but staying strong and making our lives as normal as possible was my goal,” Janice observes.
In 2009, says Janice, Dr. Deborah Armstrong, director of Johns Hopkins’ Breast and Ovarian Surveillance Service, suggested that she get tested to see if she carried the inherited BRCA2 genetic mutation, which increases the risk of breast cancer. Because children of individuals who are BRCA2-positive have a 50 percent chance of inheriting the mutation, Janice wanted to be able to share this information with her own kids if she tested positive.
Janice did get tested, and learned she was BRCA2-positive. She’s monitored every six months by Dr. Armstrong. And while there’s naturally some anxiety leading up to her periodic bloodwork thus far they also have brought relief—if temporary. “I have six months not to worry about it,” she says of the period between check ups. In the interim, Janice stays busy. A significant portion of her time is spent educating others on the travails, and triumphs, of survivorship.
As a volunteer with Survivors Teaching Students Program, a nationwide program run through the Ovarian Cancer Research Alliance, Janice meets occasionally with third-year Johns Hopkins medical students to share her story. “They’ll ask questions like: ‘How did you tell your children? How do you feel about end of life decisions? How do you give patients hope?’” Janice says. These are challenging questions, ones to which survivors like Janice selflessly respond as best they can, thereby giving doctors-in-training important insight that can better prepare them to communicate with their future patients on sensitive topics.
Janice also volunteers with Woman to Woman, a program that pairs newly diagnosed patients with a survivor, facilitating a peer-to-peer source of support. The Johns Hopkins program is run by Nancy Farruggia, R.N., and Paula Silverman, survivorship program coordinator, through the Kelly Gynecological Oncology Service in the Department of Gynecology and Obstetrics with grant support from the Ovarian Cancer Research Alliance. The program affords survivors of GYN cancers an opportunity to act as a support system for current patients.
Volunteers with Woman to Woman receive training to support the emotional needs of patients in the program, with whom they converse via monthly teleconferences on various topics related to cancer treatment and survivorship. While not intended to replace mental health professionals, the survivors—because of their own personal experiences—can readily empathize with the more recently diagnosed patients and their challenges.
“I wish someone had been there for me like this. I was young,” says Janice. Now, with twenty years of experience behind her, she exudes confidence. “There are new drugs out there—PARP inhibitors, immunotherapy. There’s always something to try,” says Janice, sounding like the expert that she is.