For Peggy Martin, living for 13 years as a survivor of advanced colorectal cancer that spread to her liver – years after she was first told she might have weeks to live – has meant many decision points: Which treatment strategies to pursue. Whether to enroll in a clinical trial. How to live life. How to face the future.
Through it all, Martin says, those decisions have been informed by the collaborative relationship she has developed with her care team at the University of Colorado Anschutz Cancer Center – a relationship built on trust and candid communication.
“Whether I was going to live or whether I was going to die, I knew I was going to be taken care of,” she says. “Either way, I trust them implicitly.”
Leading that care team is oncologist Wells Messersmith, MD, who was recently named director of the cancer center after more than a decade as head of the CU Anschutz Department of Medicine’s Division of Medical Oncology.
With help from Messersmith and a multidisciplinary team of specialists, Martin has navigated years that swerved from hope to disappointment to renewed hope. Now, 13 years after her initial diagnosis, she has completed her treatment.
“At this point, we hope she’s cured,” Messersmith says. “We’ll continue to follow her, but that’s our hope.”
He says the “main take-home message for a case like hers is that it helps to go for treatment to a specialized place like ours that has clinical trials, with access to drugs years and years before they're eventually approved. Had we not had a clinical trial available for her, and had we not had insider knowledge of developments in the field long before they were published, I'm not sure she would be here.”
Messersmith says Martin’s journey also points out the importance of collaboration between patients and providers.
“She's very smart,” he says. “She’s been able to grasp the complexities around the oncologic decisions we've made together. As an oncologist, that's always reassuring. Some patients just throw up their hands and say, ‘Oh, you decide.’ Of course, there usually isn't a black-and-white answer to treatment. So it's nice when you can reason through decisions together and it's a shared process.”
Martin says her experience highlights the importance of screening for colon cancer. She says she had not been screened before her diagnosis. “I’ve never been good about getting screened for things. I definitely encourage people to do it.”
→ More on colorectal cancer screening
Photo at top: Peggy Martin at home with her grandchildren. Photo provided by UCHealth.
Peggy Martin skiing with her husband, Max. Photos provided by Peggy Martin.
Martin, 70, is a retired counselor for a Colorado school district. She has always led an active life: travel, skiing, hiking, golf, and horseback riding.
The Pittsburgh native and her husband, Max, whom she married in 1979, have three grown children and seven grandchildren who call her “Nan,” all born in a six-year span. She and Max live in Denver, not far from the CU Anschutz campus, and regularly host Sunday family dinners. She has four siblings.
In 2013, after returning from a vacation, Martin says she felt sick – she couldn’t keep any water or food down – and went to a local hospital. Tests showed a tumor, later identified as cancerous, was blocking her bowel, and she had surgery to remove the tumor and several nearby lymph nodes where the cancer had spread.
Then Martin was told she had stage 4 colon cancer that had spread to her liver. She was also told it was inoperable, and that she probably had six weeks to six months to live.
Devastated, Martin and her husband sought out a second opinion.
“We called friends who had doctor friends at places like University of California San Francisco and MD Anderson, and they said, ‘You have this great cancer center, and this guy, Wells Messersmith, is there.’”
→ Colorectal Cancer Becomes the Top Cause of Cancer-Related Death in People Younger Than 50
Martin recalls her first encounter with a CU Anschutz Cancer Center patient advocate. “I came up the stairs, and there was this cute little woman who was all bubbly. She said, ‘Hi, are you a survivor?’ I said, ‘I don't know.’ She said, ‘Well, when were you diagnosed?’ I said, ‘About a week ago.’ And she said, ‘Oh, honey, you're a survivor the minute you're diagnosed.’ That really was their attitude.”
Once Martin was under Messersmith’s care, and after many cancer center specialists had discussed her case in a multidisciplinary clinic, she learned she had more treatment options.
In early 2014, after rounds of chemotherapy and radiation to shrink the cancer in Martin’s liver, she had surgery to remove a portion of her liver where tumors had spread. Then came more chemo to combat new lesions in her liver.
By 2015, it became clear that Martin needed something more, Messersmith says. “At this point, her cancer wasn’t curable with surgery,” he says.
It turned out that Martin’s cancer cells had a rare genetic abnormality that made her a good candidate for immunotherapy – a treatment that bolsters the body’s natural defenses to fight disease.
The abnormality is known as microsatellite instability, in which errors occur when DNA is copied in a cell. It’s found most often in colorectal cancer and certain other types. Cancers with high microsatellite instability are far more likely to respond to immunotherapy.
“When patients have a mutation in the DNA editing genes, they end up having a more immune-responsive disease, because there are more mutations for the immune system to react to,” Messersmith says.
Messersmith knew of a clinical trial of an experimental immunotherapy drug that he thought could help Martin. “Because folks like me go to a lot of scientific meetings, we were having conversations nationally with colleagues, and we knew she would have a good chance of responding to this study drug.”
At the time, he says, the drug “didn’t even have a name – it was called simply a series of numbers and letters, MPDL3280A.”
Martin joined the trial, and the drug produced what Messersmith calls “an incredible, lifesaving response.” The drug – today known as atezolizumab – would not be approved by the U.S. Food and Drug Administration for another 2⅟₂ years; Martin was among the first to be treated with it, thanks to the trial.
But Martin faced another obstacle: A scan had found she had a brain aneurysm, a bulge in a blood vessel in the brain that, if it ruptured, could cause life-threatening bleeding.
To tackle the aneurysm, Martin enrolled in another clinical trial – this one involving a mesh device implanted in the aneurysm to keep it from rupturing.
Martin says her trust in Messersmith and her CU Anschutz Cancer Center care team deepened through that experience. “Wells and I, along with my husband, were able to discuss frankly the pros and cons of treating the aneurysm right away or waiting. I knew I was a part of the discussion and was heard.”
→ Everything You Wanted to Know About Colonoscopy Prep (But Were Afraid to Ask)
Peggy Martin hiking with her husband, Max. Photo provided by Peggy Martin.
Martin stayed on immunotherapy until early 2021. But the bad news was not over. In 2023, Martin needed lung surgery to remove potential lesions. Fortunately, they turned out to be noncancerous. And when doctors found cancer cells in additional lymph nodes, she went on another immunotherapy drug, pembrolizumab, until late 2024.
Today, Martin’s cancer scans have gone from every three months to every six months. “I feel really great. I’m in a good place,” she says. She has returned to skiing again after a 10-year pause.
Through it all, she says she never considered giving up. “I don't think I've had a big-enough setback to throw me into that. But I do still get worried about scans.” She says her husband, siblings, and kids have all been a huge help during her cancer journey.
“She and I have the same attitude about any cancer therapy, which is, do as much as necessary but as little as possible,” Messersmith says. “So it's been very natural to make treatment decisions with her because we're very aligned. Sometimes I'll have patients who want to keep going with therapy no matter what, even if we’re not sure why we’re giving it anymore. We both want her to have as much therapy as needed, but we also think we should stop when there’s really no reason for it.”
“My dad was still alive when I got sick,” Martin says. “He always used to ask me how my heart was,” she says. “I was always happy to answer, very truthfully, that my heart was just fine. And he was happy and I was happy.”
At one point, she says, “my brother flew out and said, ‘Can we take a walk?’ That was his way of supporting me. It’s been a big lesson to learn that people offer support in so many different ways. You’ve just got to open your arms to that.”
→ CU Anschutz Cancer Center’s ‘FIT for Life’ Colorectal Cancer Screening Program Goes Online
Martin credits the CU Anschutz Cancer Center’s BfitBwell exercise program for cancer patients with helping to sustain her through her treatment. The program is personalized for each participant, and it seeks to help them cope with the side effects of chemotherapy and other treatments.
In most cases, a cancer patient will stop seeing their oncologist five years after their last treatment. “I almost graduated out of the program” before the cancer cells in her lymph nodes were detected, Martin says. “I had a laugh with Wells, and said, ‘I didn’t want to stop seeing you, so I drummed up a little thing you have to take care of.’ The fact is, if I could stay with Wells until the day I die, I’d love that.”
Messersmith says it’s been “really fun” to get to know Martin across the 13 years he’s been caring for her. During their visits, they trade anecdotes about their kids, he says.
“It’s very gratifying to be able to follow someone for this long and to see them do well and even thrive,” he says. “You know, oncology can be hard. A lot of our patients are dealing with many symptoms and possibly facing death, and their families are struggling. It’s just a hard place to be sometimes. So with her, especially now, it's a pleasure to see her. She has a great sense of humor, she's self-deprecating, she’s curious, and she cares about people. It's really a highlight of my day.”
As for Martin, she says of Messersmith: “He’s so empathetic. On so many levels, he is just a really good human being.”
Peggy Martin at a Christmas 2024 family gathering. Photo provided by Peggy Martin.