“She was like the [Energizer] Bunny on crack her whole life,” said Cristina Martins Sinco about her mother...

As told by Cristina Martins Sinco and written by Camillia Lanham of the Santa Maria SUN
Vice President of Sharon Leigh Ovarian Cancer Foundation

Cristina Martins Sinco
Cristina Martins Sinco
Something wasn’t right: She couldn’t eat much. The little she did eat made her feel very full. Her stomach was constantly cramping. She felt sick too often. And she didn’t have any energy.

The short, sassy, big-brown-eyed Valentina Martins was never tired, and she befriended almost everyone she met. She was usually overflowing with vitality; that’s why it was weird.

Her daughter, Cristina Martins Sinco, said she remembers her mother as someone who never stopped moving. When Sinco was a child, her mother used to get these migraine headaches, but rather than rest, Martins would dunk a handkerchief in ice water, tie it around her head, and finish the household chores.

Martins moved to the Central Coast from Portugal with her husband and two children when Sinco was a child. Otherwise healthy, she started having issues in her late 60s.

Doctors couldn’t find anything wrong with her. They tested her blood, checked for stomach cancer and colon cancer, sent her to gastroenterologists, looking for anything that might indicate what the problem was. The symptoms made it seem like Martins had irritable bowel syndrome, but then the symptoms got worse.

“Every test came back negative. We knew something was very wrong; we just didn’t know what it was,” Sinco said. For two years, Martins went undiagnosed, reeling from whatever was making her ill. Martins was certain it was some kind of cancer.

She was right.

Sinco wears teal more often during the month of September than any other time of year. Blue-hued, beaded bracelets adorn her wrist, and she wears a small silver pin in the shape of a ribbon on her shirt. “Hope,” it says in block lettering.

Alana, a small, wiry-haired dog that protects the house like a beast when the mailman shows up at the door, has a dark teal fabric rose attached to her collar.

The hue of Sinco’s blue-green sweater contrasts with the red highlights in her hair, and the dark amber lipstick she’s wearing matches the paint on the walls of her family room. She has the same full face, perky cheeks, and bright brown eyes as her mother.

Valentina Martins
Cristina's mother Valentina Martins
Before her mom got really sick, Sinco was a full-time nurse at Marian Medical Center in Santa Maria. She’s spent much of her adult life working with people who have diseases, cancers, or chronic illnesses, but when her mother was diagnosed with ovarian cancer, she was shocked. The whole family was.

“Even when we were standing in the room, and her physician told us she had ovarian cancer, never in our wildest dreams did we think it could have been that,” Sinco said.

The color she wears so often in September—Ovarian Cancer Awareness Month—is the shade dedicated to that particular cause. Breast cancer has pink; colon cancer has blue; ovarian cancer has teal.

It’s the same hue that saturates many of the papers, pamphlets, and post-card sized fliers that are stacked opposite the coffee cups and sweets on Sinco’s kitchen table. She picks one up as she starts to talk about why she has them. The card she grabs has a list of symptoms on it, and some of them sound normal—well, normal for women to experience.

  • Bloating.
  • Constipation.
  • Pelvic or abdominal pain.
  • Back pain.
  • Fatigue.
These symptoms are uncomfortable things a woman generally wouldn’t think twice about. They’re unpleasant, but they’re also part of having a menstrual cycle, which can be a problem because the symptoms are often overlooked. But if they persist for longer than they should—say, two weeks or more—it could mean that something more significant is going on.

Sinco keeps the informational pamphlets and papers to hand out to other women with the goal of making them more aware of why they should pay attention to their bodies. She speaks at different women’s groups and Santa Maria Rotary clubs, helps out with events at Marian’s Mission Hope Cancer Center, and works with various nonprofits dedicated to the ovarian cancer cause. Since Martins passed away in 2012—less than two years after she was diagnosed—Sinco has become a sort of ovarian cancer awareness ambassador.

“She’s kind of the driving force. I feel like this is one of the things I have to be doing with my life,” Sinco said. “This is my mission. This is what I’m doing now. This is my job.”

Ovarian cancer is considered a rare cancer—accounting for a mere 3 percent of the cancers in women—but it causes more deaths than any other cancer of the female reproductive system, according to the American Cancer Society’s website. The society estimates that in 2014, about 21,980 women will receive a diagnosis of ovarian cancer, and approximately 14,270 women will die from it.

One of the reasons ovarian cancer has such a high mortality rate is because of how difficult it is to diagnose.

April Kennedy, an oncologist at the Mission Hope Cancer Center in Santa Maria, said approximately 70 percent of the cases are caught when ovarian cancer is already in the later stages of development, meaning the cancer is widespread—in the lymph nodes and potentially in the bloodstream. Of those women who are successfully treated, 75 percent will get the cancer again.

“Ovarian cancer is so very frustrating,” Kennedy said. “If you catch it in the early stages it’s almost always curable. … But it’s impossible to catch at the early stages.”

She clarified her statement, saying that the cancer is more responsive to treatment in the early stages and adding that once the symptoms become apparent, women are often already in the later stages of the cancer.

“That’s the problem,” Kennedy said.

And there’s no specific test for ovarian cancer. Conversely, doctors check for cervical cancer by performing a Pap smear and check for breast cancer by doing an annual breast exam.

There’s not a good marker used to detect ovarian cancer, either. Certain proteins found in blood are markers that doctors can use as indicators for certain kinds of cancer. Elevated levels of those specific proteins could mean that cancer is present. CA-125 is the marker associated with ovarian cancer, but Kennedy said it’s not always a good indicator.

“The CA-125 can go up with cancers of [the ovaries], but it doesn’t always,” Kennedy said. “So it’s a crummy test.”

Let’s recap: The cancer is hard to find, it’s hard to keep at bay, and women diagnosed with a later stage of it often succumb to the disease within five years of their diagnosis.

Kennedy said the women she treats start chemotherapy as soon as they’re diagnosed. After a couple of weeks of chemo, they head down to Santa Barbara to see a gynecological specialist, who performs a surgery to remove all of the cancer and reproductive organs and to scrape the lining of the pelvis. Women continue the chemo until the cancer’s gone and they’re in remission.

Kennedy said she’s currently treating five women who have ovarian cancer. Of those patients, two are participating in clinical trials of a drug called rucaparib, which specifically targets ovarian cancer cells. Mission Hope collaborates with UCLA in trials of drugs that are on the cusp of Federal Drug Administration approval and have been testing the new drug for about six months, Kennedy said.

“We don’t open trials until the medicine has been proven to be effective,” Kennedy said. “People aren’t guinea pigs—we know it works; it’s just something extra on top of the therapy we’re already giving them.”

Rucaparib is used in tandem with standard ovarian cancer treatment and as a sort of upkeep mechanism once someone is in remission. The drug is something that’s known as a PARB inhibitor, which basically prevents cells from repairing themselves. Chemotherapy targets rapidly dividing cells and breaks them down. Cancer cells generate quickly, but so do bone marrow and hair cells, which is why chemotherapy patients often lose their hair.

Kennedy explained that PARB inhibitors specifically recognize broken-down cancer cells. The goal of the treatment is to prevent those cancer cells from repairing themselves, which hopefully keeps the cancer from coming back.

Sinco said once her mother was diagnosed, everything moved quickly. The woman speaks at a rapid pace, recounting the way things happened. Martins’ abdomen had started swelling with fluid, and a couple days later, Sinco said her mother looked like she was seven months pregnant. Doctors tested the fluid, determined it was full of ovarian cancer cells, and started Martins on chemotherapy.

“It was kind of this whirlwind. … It’s like boom, boom, boom—I mean, things just happen so fast,” Sinco said. “In my family, everyone was stepping all over each other to help.”

She rotated days with her siblings to take Martins to her chemotherapy appointments and stay with her during the week. Her sister, Paula Sousa, said things went too quickly.

“It becomes a family event,” she explained. “You’re there, and you’re going through it with them.” It just becomes a part of your daily lives, she added, and all of a sudden the children are taking care of the parent. Sousa said Martins lived her whole life taking care of and nurturing other people. “It felt really strange to be on the other side of that,” Sousa said. “I really appreciated my mom’s strength the whole time. … You know, she lived her whole life for her kids.”

Sinco said her mother fought the cancer off and went into remission for about three months before it came back. A month before Martins passed away, Sinco got married. It was in December 2011, about a year earlier than she’d planned. “Everything you want to do with your mother, you should do it,” Sinco said her mother’s physician told her. “We just sped things up. We just kind of scrambled things, and it was perfect.” She remembers that her mother wore a black sequined beret, a floor length skirt, and a dark red and gold floral-print shirt.

“It was probably the longest day of her life. … There was such a fog,” Sinco said of her wedding. “You’re happy because you’re getting married, and you’re sad because your mom is dying. … She was a trooper. She was her sassy self right up until the last hours of her life.”

Martins spent those last hours in her bedroom with her family. She was lying in a hospital bed at her Santa Maria home, surrounded by flowers, gifts, cards, and books. She had been her lucid self until the day before, but refused to go without being able to set eyes on all of her children. Martins took her last breath after she was certain her daughters and her son were in the room to say goodbye. She was 72.

“She looked around the room at every one of us; her eyes looked on my brother, and she passed,” Sinco said. “I feel so grateful to have been a part of her last few breaths,” Sousa said. “It helped me maybe not to be so angry.” Doctors had given Martins three to five years to live when she was first diagnosed, and Sousa said it had been barely two years. It happened fast, and it changed the lives of her children. Sousa said she’s extremely supportive of the awareness work her sister does, and thinks it’s important for women just to become aware of what ovarian cancer symptoms are, even if all it sparks is a prolonged conversation with their doctor.

“If we can save one life, it’s worth it. “If we can do that for one woman,” Sousa said.