TORONTO — Rob Ford, a man simultaneously adored by his fans and abhorred by his foes as his scandal-packed term as mayor of Canada's largest city propelled him to international infamy, has died.
Ford, 46, succumbed to cancer Tuesday, 18 months after doctors discovered a softball-sized malignant tumour in his abdomen, his family announced in a statement.
"A dedicated man of the people, Councillor Ford spent his life serving the citizens of Toronto," said a statement from his family.
The diagnosis in September 2014 came less than a year after Ford confessed to smoking crack while in one of his "drunken stupors" and forced the mayor to withdraw from his bid for re-election in favour of running for councillor in his west-end ward.
He won in a landslide despite three years of headline-generating notoriety that included slurs against minorities and lewd, public innuendo about his marital sex life on top of his admission — after months of denials — of serious crack cocaine and alcohol abuse.
Those who knew Ford describe a man whose loyalty to family and friends was as unshakeable as the support he received from the "Ford Nation" segment of voters inspired by his rough-around-the-edges, ordinary-guy persona.
"He's very loyal to his friends. He has a big heart," is the way former Liberal MP John Nunziata, a Ford family friend, put it. "He doesn't throw his friends under the bus."
The loyalty was reciprocated. His family stood steadfastly by him through his scandals and, then, through the dark days of his illness.
A significant segment of the public also continued to breathe life into the "Ford Nation."
Ford's brother, Doug Ford, who picked up the mayoral candidacy torch after the cancer bombshell, placed a respectable second in the October 2014 municipal vote — a sign many said of his brother's enduring popularity.
Liberal Prime Minister Justin Trudeau, asked recently about the popularity of U.S. presidential hopeful Donald Trump, invoked the populist approach taken by Ford, whose anti-elitist rhetoric resonated with many people even as he staggered under the weight of the crack-cocaine scandal and derision from those opposed to his public vulgarity.
Rob Ford fought cancer with courage and determination. My condolences and best wishes to the Ford family today.
— Justin Trudeau (@JustinTrudeau) March 22, 2016
"There were a lot of people who didn't get it," Trudeau said of Ford. "But he tapped into a very real and legitimate sense that people had around who politicians were."
Ford, who kept a photograph of his late father taped to his mayor's office computer, revelled in his everyman persona. The self-described "ordinary guy" drove his own car to work every day — albeit a luxury SUV — and railed against "downtown elites" and a "gravy train" he said needed derailing at city hall.
He was, grudging admirers said, the consummate retail politician who had an uncanny knack of making people feel that he really cared about their plights.
Yet whatever his political accomplishments, his time in office became known for its sordid explosion into an unprecedented political circus that quickly became an international story.
Fuelling the circus were drugs and alcohol, followed by denials, confessions and apologies.
Secretly taken cellphone videos were leaked, resulting in blaring headlines not just in Canada but beyond. The first apparently showed him using crack and uttering slurs against minorities. Ford claimed to have no idea what it was about.
Other videos and audio recordings followed. He spewed profanities, made offensive comments about women. The high school football team — one he had proudly coached for years — dropped him. Top aides deserted him or were fired.
An extensive police investigation turned up links between Ford, known drug dealers and gang members. His friend and part-time driver, Alexander (Sandro) Lisi, was charged with extortion, apparently as he tried to retrieve the "crack" video. That case is ongoing.
Ford narrowly survived a legal attempt to have him booted from office for conflict of interest — on a technicality. However, council stripped him of almost all his power. Yet Ford, backed up or egged on by his councillor brother and with the undying support of the Ford faithful, blustered his way through it all.
People lined up almost half-way around City Hall at one point to buy a Ford bobblehead. He was mobbed like a rock star wherever he went. He revelled in the attention. Even a two-month stint in rehab became, in his words, "awesome."
First elected as a councillor in 2000, Ford sparked controversy almost from the get-go.
"Oriental people work like dogs....They're slowly taking over," he told one council meeting. He consistently voted against AIDS funding or other social and arts grants. He ranted about a "war on cars," and spoke out against cyclists.
Increasingly, however, his come-from-behind election as mayor in 2010 began unravelling. Ex-staffers described a man by turns ill-tempered and weepy, one who could not resist the bottle, even while behind the wheel of a car.
Late-night TV comics lapped it up. The mayor became a household name in Canada and a recognizable name in far-flung parts of the globe. Asked in October 2014 how his mayoralty would be remembered, Ford laughed.
"It'll definitely be remembered," he said with rare understatement. "No one's going to forget it."
Ultimately, it was the rare, aggressive large tumour in Ford's abdomen that caused the circus tent to come crashing down. Surgery and a repeated regimen of chemotherapy took its toll. He lost his hair. He soldiered on, at times unable even to climb a set of stairs; he battled pneumonia; he became a fixture at city hall in his red track suit — all evidence of his mantra that a Ford "never quits."
On election night in 2014, he praised his brother before vowing to return to fight for the city's top job in the next election. Few doubted he would make good on the promise given half a chance.
Funeral arrangements have not been made but a large turnout is likely, as is a period of "lying in repose" at City Hall. Jack Layton's flag-draped coffin sat at City Hall following his death in 2011 — and Ford, then mayor, paid his respects.
"To him, funerals are mandatory when it comes to friends," Nunziata said.
The former mayor is survived by his wife, two children, his mother, and three siblings.
FLOOD OF TRIBUTES FROM POLITICIANS, PUBLIC FOLLOWS NEWS OF ROB FORD'S DEATH
TORONTO — The death of Toronto's controversial former mayor Rob Ford sent shock waves throughout the city and beyond Tuesday, with supporters and detractors alike voicing their grief and sympathy at the loss of one of Canada's most colourful and notorious public figures.
Politicians of all stripes praised the passion and fierce determination that made Ford a political powerhouse for years and endeared him to throngs of devoted followers despite the cloud of scandal that hung over him.
Ford's successor, Mayor John Tory, said he was sad the man he described as "a profoundly human guy" would not return to city hall, adding Ford's presence "will be missed."
"The city is reeling with this news, and my thoughts are with his wife Renata and their two children, as well as Rob's brothers Doug and Randy, his sister Kathy, his mother, Diane, and the rest of their tight-knit family," Tory said in a statement.
He praised Ford as a man who "spoke his mind and who ran for office because of the deeply felt convictions that he had."
All flags on official poles at Toronto civic centres, including city hall, will be flown at half-mast in tribute to Ford, the mayor said. A book of condolences will also be set up at city hall.
Ontario Premier Kathleen Wynne stopped in the middle of question period to extend condolences, with gasps coming from members of the provincial legislatures at the news.
Shortly afterward, the legislature observed a moment of silence in Ford's honour.
"It was with deep sadness that I learned that former Toronto mayor Rob Ford has passed away," Wynne said in a statement.
The former mayor "earned widespread respect for his unwavering persistence in the face of serious health concerns," she said.
The leader of Ontario's Opposition, Patrick Brown, said Ford "redefined how municipal campaigns were run in the City of Toronto."
Brown, who first met Ford when he was 22, said the former mayor was "passionate about people and public service."
"I always appreciated that he was unscripted and sincere," he said.
Rona Ambrose, the interim leader of the federal Conservatives, said Ford would be remembered as a "tireless fighter for the taxpayer and a true advocate for the people he represented."
Ford's death also captured international attention, with news outlets around the world publishing profiles of the politician who made headlines when he admitted to using crack cocaine.
Ford, 46, died in hospital with his family by his side after a long battle with a rare and aggressive type of cancer.
LIST OF MEMORABLE QUOTES FROM FORMER TORONTO MAYOR ROB FORD
TORONTO — A selection of some memorable quotes from former Toronto mayor Rob Ford, who died Tuesday of cancer. He was 46.
"I do not use crack cocaine, nor am I an addict of crack cocaine. As for a video, I cannot comment on a video that I have never seen or does not exist." Ford on May 24, 2013, on allegations that surfaced a week earlier that he's seen on a video smoking crack cocaine.
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"I think everybody's seen the allegations against me today. I wish I could come out and defend myself. Unfortunately I can't because it's before the courts and that's all I can say right now. I have no reason to resign. I'm going to go back and return my phone calls. I'm going to be out doing what the people elected me to do and that's save taxpayers money and run a great government." Ford on May 24, 2013.
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"I drove myself down there, I was not drinking. I went out, had a few beers and I did not drive home. My people met me after that." Ford on Aug. 11, 2013, on allegations he was drunk at the Taste of the Danforth street festival.
"That was pure stupidity. I shouldn't have got hammered down at the Danforth. If you're going to have a couple drinks you stay home, and that's it. You don't make a public spectacle of yourself." Ford on Nov. 3, 2013.
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"Whatever this video shows, folks, Toronto residents deserve to see and people need to judge for themselves what they see on this video." Ford on Nov. 3, 2013, of the infamous "crack video."
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"You didn't ask the correct questions. No, I'm not an addict and no I do not do drugs .... I want to be crystal clear to every single person: these mistakes will never, ever, ever happen again.'' Ford on Nov. 5, 2013, admitting he smoked crack cocaine, likely while in one of his "drunken stupors'' and denying he lied about it.
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"Robbie is not a drug addict. I know because I'm a former addict... It depends what you want to consider an alcoholic. Robbie does not drink every night, and he does not drink one. When Robbie drinks I think he just goes full tilt.'' Kathy Ford, the mayor's sister, tells TV station CP24 on Nov. 7, 2013.
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"If he was really, really in dire straits, he needed help, I'd be the first one, I'd put him in my car and I would be taking him, as would all of us, you know. No. He isn't there.'' Rob Ford's mother, Diane Ford, said in the same interview, adding that her son's biggest problem is his weight.
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"I put myself in the shoes of the taxpayers, if they were to look at the few incidents that we've had, I can understand they would say, 'He may have a problem.' I can assure you I am not an alcoholic, I am not a drug addict.'' Ford at a city council meeting on Nov. 13, 2013.
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"I've never said that in my life to her, I would never do that. I'm happily married, I've got more than enough to eat at home." Ford on Nov. 14, 2013, on allegations he made lewd comments to a female aide about performing oral sex on her.
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"I might've, I might've, I don't recall, I might've had some drinks and driven, which is absolutely wrong, but outside of that, I've said what I had to say... Again, I'm not perfect." Ford reacts to allegations in court documents that he had driven drunk on Nov. 14, 2013
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"The revelations yesterday of cocaine, escorts, prostitution has pushed me over the line and I used unforgivable language and again I apologize. These allegations are 100 per cent lies." Ford on Nov. 14, 2013.
"This... reminds me of when I was watching with my brother when Saddam (Hussein) attacked Kuwait and (U.S.) President Bush said 'I warn you, I warn you, I warn you, do not.' Well folks, if you think American-style politics is nasty, you guys have just attacked Kuwait." Rob Ford before the vote on Nov. 18, 2013 to strip him of his powers.
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"I'm not going to run around and be phoney and lie. I'm not going to have someone try to blackmail me and say they got videos of this.... I've just had enough, I was sick and tired of all these allegations and all the bulls--t, excuse my words, and that's all it is." Rob Ford, in an interview broadcast on CNN on Nov. 18, explaining why he admitted to using crack cocaine.
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"Monday was unfortunate.... I had a minor setback. We all experience these difficult bumps in life.'' Ford on Jan. 21, 2014, after a new video emerges on YouTube of him in a rambling, profane rant using Jamaican patois.
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"I have a problem with alcohol, and the choices I have made while under the influence. I have tried to deal with these issues by myself over the past year. I know that I need professional help and I am now 100 per cent committed to getting myself right.'' Ford said in a statement on April 30, 2014, after three Toronto newspapers publish a slew of new Ford reports, including about another video showing him allegedly smoking crack cocaine, an audio recording of the mayor drunk, spewing profanities and making lewd comments, and witness accounts of him snorting cocaine at a city nightclub.
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"Rob was very emotional when he told me the hardest thing about this is he knows he let people down, he let his family down.... I love my brother. I'll continue to stand by my brother and his family throughout this difficult journey.'' Ford's older brother, Coun. Doug Ford.
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"You name it, I pretty well covered it. I was in denial. I convinced myself I didn't have a problem." Ford in a series of one-on-one media interviews in July 2014.
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"It's not just an addiction. Some people can drink, some people can casually use drugs. I have a disease. I have a chronic disease. I was born with blond hair and I'm going to die with blond hair. I was born with this disease. I'm going to die with this disease." Ford in July 2014.
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"This is what I love to do. This is not causing the disease. I've had this disease before I even entered this office." Ford on whether the stresses of the job contributed to his drug and alcohol abuse in July 2014.
"I offended a lot of people and all I can do is apologize and say sorry. I cannot change the past." Ford in July 2014
A LOOK AT SIGNIFICANT DATES IN THE LIFE OF FORMER TORONTO MAYOR ROB FORD
TORONTO — A look at some significant dates in the life of former Toronto mayor Rob Ford, who died Tuesday of cancer. He was 46.
May 28, 1969: Robert Bruce Ford is born in Toronto. He is the fourth and youngest child of Deco Labels co-founder Doug Ford and his wife, Diane.
1983: Ford begins high school at Scarlett Heights Collegiate in the west-end neighbourhood of Etobicoke, beginning his freshman year while his elder brother Doug was in his final one. Rob Ford went on to play high school football, a lifelong passion.
1989: Ford begins studying political science at Ottawa's Carleton University.
June 8, 1995: Ford's father, Doug Sr., is elected to the Ontario legislature as a Conservative. He serves as a backbencher in the government of premier Mike Harris, but earns a reputation as a loyal and outspoken party member.
Nov. 10, 1997: Rob Ford makes a run for Toronto city council, but comes in fourth place.
Feb. 15, 1999: Ford is charged with drunk driving and possession of marijuana in Miami. Though the drug possession charge was later dropped, both would surface more than a decade later as controversies during his eventual mayoral campaign.
Aug. 12, 2000: Ford marries high school classmate, Renata Brejniak.
Nov. 13: Ford is elected to his first term on Toronto city council.
March 6, 2002: Fellow city councillor Giorgio Mammoliti accuses Ford of calling him a "Gino boy." Some councillors claim to have overheard the exchange, but Ford denies saying it.
2002: Ford begins coaching high school football at Don Bosco Catholic Secondary School.
Nov. 10 2003: Ford is re-elected to Toronto city council with 79 per cent of the vote.
2005: Ford's first child, a daughter named Stephanie, is born.
April 15, 2006: An intoxicated Ford sparks complaints from a couple at a Toronto Maple Leafs hockey game who said their night out was ruined by a man shouting and swearing. Ford initially denied being at the game, but then later retracted the denial. The Toronto Star reported Ford said he had too much to drink before going to the game, and that he originally denied he was there because he was embarrassed and humiliated by the situation.
June 28, 2006: During a council debate, Ford claims that people won't get AIDS, "probably," if they're "not doing needles" and "not gay." The remarks were recorded in a National Post transcript and were later raised by Ford's 2010 mayoral rivals as evidence of his character. In May 2010, the Toronto Star reported that Ford — in reference to the comment from years earlier — told an HIV-positive gay man: "I apologize if I offended you or your husband in any way."
Sept. 22, 2006: Doug Ford Sr. dies of cancer.
Nov. 13, 2006: Ford is re-elected to Toronto city council, this time with 66 per cent of the vote.
March 5, 2008: Ford raises eyebrows during a council debate on whether to allow stores to open on holidays when he praised the work ethic of "Oriental people" who "work like dogs."
March 26, 2008: Ford is charged with uttering death threats against his wife. The charge is later dropped.
2008: Rob and Renata Ford welcome their second child, a son named Douglas.
July 2009: Ford has his appendix removed due to appendicitis; the resulting inflammation required a piece of the nearby colon to be removed. This information was revealed by the head of Ford's treatment team in 2014 when he was diagnosed with cancer.
March 25, 2010: Ford announces his candidacy for mayor and is widely dismissed as a long shot.
Oct. 25, 2010: Ford is elected as mayor with just over 47 per cent of the vote, riding a wave of populist support built on his promise to end the "gravy train" and cut government waste. His elder brother Doug succeeds him as a city councillor and becomes his frequent defender and champion both in and out of city hall.
Dec. 1, 2010: Ford says he has scrapped "Transit City," a proposal to bolster Toronto's aging public transit system, a key accomplishment of the previous mayoral administration. Ford proposes to build subways instead of the light rail projects favoured in the original plan.
Dec. 16, 2010: In Ford's first council meeting, he succeeds in delivering on two of his major campaign promises when council votes to scrap a vehicle registration tax and reduce office budgets for all city councillors to $30,000 from $51,300. The vehicle tax, which saw car-owners pay an annual fee of $60 per passenger vehicle, was said to bring in an estimated $64 million in revenue per year, but Ford had campaigned on a promise to abolish the unpopular levy.
February 2011: Ford returns to hospital with a kidney stone.
June 2011: Ford angers the city's gay community by declining to attend either the city's gay pride parade or the flag-raising ceremony to kick off Pride week. Ford says he would be at the family cottage during the parade. His decision breaks with tradition that saw the city's three previous mayors march in the parade.
Oct. 25, 2011: Ford makes numerous calls to 911 after being confronted by a crew from the CBC comedy show "This Hour Has 22 Minutes." Ford says he felt threatened by the presence of the crew and alleges they scared his daughter.
Jan. 17, 2012: City council begins the first in a series of votes against Ford's agenda by defeating a major package of substantial budget cuts.
Feb. 5, 2012: Tentative deal reached between City of Toronto and one of its major unions, averting a strike by about 6,000 city workers,
Feb. 9, 2012: In a rebellion led by Ford's appointed transit chair, council votes to return to a light-rail-based transit plan and abandon Ford's subway proposals. Ford later dismisses the council defeat as "irrelevant."
March 12, 2012: Toronto resident Paul Magder launches a lawsuit alleging Ford had a conflict of interest when he voted on a council matter involving his football charity.
March 17, 2012: According to internal security reports and multiple accounts published in local media, Ford begins partying at city hall before moving onto a local bar. Police documents contain interviews with witnesses who claim Ford became violent towards staff members, made lewd remarks and proceeded to drive while intoxicated.
May 2, 2012: Ford calls police after a confrontation with Toronto Star reporter Daniel Dale. Ford alleges Dale was spying on him at his home, while Dale contends he was on public property doing research for a story. Dale alleges he was physically threatened by the mayor, a claim Ford denies.
August 2012: Ford is hospitalized with throat and stomach problems.
Nov. 26, 2012: A judge rules on the Magder lawsuit by concluding that Ford violated the Municipal Code of Conduct and must be removed from office. Ford announces he will appeal the verdict.
Jan. 25, 2013: Ford wins his appeal and is allowed to remain as mayor.
March 8, 2013: Ford vehemently denies allegations from former mayoral rival Sarah Thomson that he touched her inappropriately ("he grabbed my ass") at a political event.
March 26, 2013: Ford denies a published report that he was asked to leave an event the previous month celebrating the Canadian Forces because organizers were concerned he was impaired. Ford describes the Toronto Star story as an "outright lie."
May 16, 2013: Reports surface in both the Toronto Star and U.S.-based news site Gawker that Ford was seen on video smoking what appeared to be crack cocaine. The Toronto Star also reports that Ford can be heard using a homophobic slur in reference to Liberal leader Justin Trudeau. The video cannot be independently verified. In the aftermath of the reports, Ford's lawyer says it is impossible to tell what a person is smoking by watching the video. Ford says later that month: "I do not use crack cocaine."
May. 22, 2013: Ford is dropped as volunteer coach of the Don Bosco Eagles football team, with the Toronto District Catholic School Board saying only that it decided to pursue a "different direction" with a new volunteer.
Oct. 1, 2013: Ford's friend and occasional driver, Alexander Lisi, is arrested and charged with four drug-related offences, including trafficking marijuana. Ford defends Lisi the next day, calling him a friend and a "good guy."
Oct. 31, 2013: Chief Bill Blair announces Toronto police had recovered a copy of a video file that contains images of Ford "consistent with those previously reported in the press." Blair refused to give details but said there was nothing in the video that would support the laying of a criminal charge. He said that as a result of discovering the video, Lisi was facing an additional charge of extortion.
Nov. 3, 2013: Ford apologizes on his weekly radio show on Newstalk 1010 for making mistakes, including appearing in public while "hammered" and texting while driving. But he tells AM640 the next day: "I'm not an alcoholic, I'm not a drug addict."
Nov. 5, 2013: Ford admits he smoked crack cocaine about a year earlier while in one of his "drunken stupors." He denies he is an addict. He adds he does not recall there being any video and wasn't lying when he suggested the video didn't exist because reporters had not asked the right question.
Nov. 7, 2013: A video is posted online by the Toronto Star and Toronto Sun that shows Ford using obscenities and threatening words, including "kill" and "murder." The mayor tells reporters moments after the video is posted that he was "extremely" drunk and is "extremely" embarrassed.
Nov. 8, 2013: NewsTalk 1010 announces Mayor Rob Ford and his brother will no longer be appearing on their regular weekly radio show.
Nov. 13, 2013: Newly released segments of a court document show former mayoralty staffers told police Ford was intoxicated at work, drank while driving and associated with suspected prostitutes. The release came shortly after city council voted overwhelmingly in favour of a motion urging Ford to take a leave of absence and just hours after he admitted buying illegal drugs while in office.
Nov. 14, 2013: Ford spouts an obscenity on live TV while denying allegations in the court document that he told a female aide he was going to have oral sex with her ("I've got more than enough to eat at home.") He later apologized and said he was getting professional help. City councillors called for him to resign. Ford refused to do so, and the province's premier said she would step in only if council said it could no longer function.
Nov. 15, 2013: Toronto city council overwhelmingly passes two motions that would reduce Ford's powers. He says the motions set a dangerous precedent and that council left him with no choice but to begin costly legal action to try to overturn the decisions.
Nov. 18, 2013: City council votes by a wide margin to slash Ford's mayoral budget and hand many of his duties to the deputy mayor. Ford called it a "coup d'etat" and vowed it would be war in the October 2014 municipal election.
Jan. 21, 2014: After recently saying he had given up alcohol, Ford admits he had been drinking the previous night after a video emerged on YouTube of him in a rambling, profane rant using Jamaican patois. Ford says he had been on personal time at a west-end Toronto restaurant and did not think the language he used was offensive.
March 3, 2014: Ford makes a highly anticipated appearance on "Jimmy Kimmel Live," with the host introducing him by saying: "Our first guest tonight has tripped, bumped, danced, argued and smoked his way into our national consciousness." Ford told Kimmel he wasn't elected to be perfect but to clean up the financial mess at city hall.
April 30, 2014: Ford's lawyer announces the Toronto mayor will take a leave of absence to seek help for substance abuse at a rehab clinic. The announcement comes just hours after the Globe and Mail reported that a drug dealer had shown two of its reporters a new video of Ford allegedly smoking what a self-professed drug dealer described as crack cocaine. The Globe said it could not confirm the substance inside the pipe.
June 30, 2014: Ford returns from rehab to resume his limited duties as mayor, saying that seeking treatment for substance abuse was a life-saving decision. He also promises his commitment to "living clean is unwavering."
Sept. 10, 2014: Ford is admitted to hospital after complaining for months of abdominal pain. Doctors discover a tumour, and a biopsy is performed the next day, after he's transferred to the downtown Toronto Mount Sinai Hospital.
Sept. 12, 2014: Citing his health, Ford withdraws from the mayoral race just ahead of an official deadline to do so. Instead he files papers to run again for council in his former suburban Toronto ward.
Sept. 17, 2014: Dr. Zane Cohen of Mount Sinai Hospital tells a news conference that Ford has been diagnosed with malignant liposarcoma, which arises in soft tissue structures and makes up about one per cent of cancers. He says Ford will undergo two rounds of chemotherapy treatment over the next 40 days. The mayor's brother, Doug Ford, says the diagnosis has been "devastating" but that Rob Ford "remains upbeat and determined to fight this."
Oct. 27, 2014: John Tory is elected mayor of Toronto. Ford says his family is not ready to abandon their mayoral ambitions. "I guarantee, in four more years, you're going to see another example of the Ford family never, ever, ever giving up," a wan-looking Ford tells cheering supporters.
March 24, 2015: A hearing into drug charges against Alexander Lisi begins.
March 25, 2015: Ford, now a city councillor, says he's tentatively scheduled to have surgery to remove his cancerous tumour in May since the growth had shrunk enough to allow the procedure.
March 31, 2015: Ford apologizes for using racial slurs while he was mayor during a city council meeting. The apology came a week after the city's integrity commissioner released a report saying Ford violated council's code of conduct and called on him to apologize in front of his fellow councillors.
May 8, 2015: Lisi is found not guilty on drug-related charges. Lisi still faces separate charges of extortion related to trying to retrieve the infamous Ford "crack video."
May 11, 2015: Ford undergoes surgery to remove the cancerous tumour from his abdomen. Doctors remove the "main mass" of the growth.
Oct. 17, 2015: Former prime minister Stephen Harper, in the dying days of the federal election campaign, appears with the Ford at a campaign rally in Etobicoke. A photo of Harper, who lost to Justin Trudeau two days later, posing with the Ford family became a social media sensation and the subject of political ridicule.
Oct. 29, 2015: A tearful Ford vows to fight for his life after saying another tumour doctors discovered, this one on his bladder, is cancerous.
March 3, 2016: Ford returns to hospital to continue his cancer treatment. His brother, Doug Ford, says he was admitted to Mount Sinai Hospital at the end of February for another scheduled round of chemotherapy.
March 22, 2016: Ford dies.
LIPOSARCOMA, RARE CANCER THAT TOOK ROB FORD'S LIFE, HARD TO TREAT: ONCOLOGIST
TORONTO — The cancer that took the life of former Toronto mayor Rob Ford is among the rarest and most challenging to treat, says a doctor who specializes in a class of tumours called sarcomas.
Known as a pleomorphic liposarcoma, it belongs to a large group of malignancies called soft-tissue sarcomas, which arise in such tissues as muscle, tendons, blood vessels and fat.
"It's rare to have a highly successful outcome with a pleomorphic liposarcoma once it's spread," said Dr. Brian Van Tine, a medical oncologist at Washington University in St. Louis.
Saddened to learn that former Toronto mayor Rob Ford has passed away. My thoughts & prayers are with Rob's friends, family & colleagues.
— Kathleen Wynne (@Kathleen_Wynne) March 22, 2016
There are four or five different types of liposarcoma, all of which arise in fat cells. While they can occur in almost any part of the body, tumours most commonly develop in the arms, legs and abdominal cavity.
Pleomorphic tumours are the rarest form of liposarcoma, and can often be highly aggressive. Pleomorphic means all the cancerous cells within the tumour have varying shapes and sizes when viewed under a microscope.
Ford, 46, was diagnosed in September 2014 with two tumours — a large one in his abdomen and a much smaller one in his buttocks — and underwent a combination of surgery, radiation and chemotherapy.
The treatments shrank his original tumours, but last November it was discovered that the cancer had come back in the form of two new tumours on his bladder.
The Toronto city councillor resumed chemotherapy, but recently got involved in an innovative program in which bits of his tumour were being grown in specially bred lab mice. The goal of the experimental program is to test different drugs on the rodents to see which ones might be able to put an individual patient's cancer into remission, without exposing them to an ineffective agent.
Van Tine said there are about 100 different kinds of sarcoma, which represent about one per cent of all cancers; liposarcomas make up about 20 per cent of that one per cent, and cases of pleomorphic liposarcoma account for a fifth of those — making this kind of cancer extremely rare.
The Canadian Cancer Society doesn't have separate statistics on liposarcoma. But overall, 1,175 Canadians were diagnosed with soft-tissue sarcomas in 2010, the most recent year for which statistics are available, and about 470 died of the disease.
While the cause of liposarcomas is not known, risk factors include being exposed to certain types of chemicals and radiation or having a weakened immune system. There is no scientific evidence linking liposarcomas to the use of alcohol or tobacco, nor is obesity a known risk factor.
Liposarcomas can occur at any age, but are most common in adults over age 50. Recurrences of tumours following treatment are not uncommon. Currently, the five-year survival rate for pleomorphic liposarcoma is about 56 per cent.
"Depending on where it arises and how big a tumour is before you catch it the first time, the challenges can be immense," Van Tine said of trying to successfully treat the cancer. "I think the number one challenge is the lack of research in rare tumours and funding for research in rare tumours."
Although there has been some progress in the field — two new drugs that don't cure but can extend life for up to 14-16 months in some patients were approved for use last year — there's still "no real game-changer," he said.
Researchers and clinicians are now pinning their hopes on ongoing trials of "immunotherapy" drugs, which are aimed at revving up the body's immune system to destroy cancer cells.
Van Tine said immunotherapy drugs used for melanoma skin cancer and lung cancer are now being tested in sarcoma patients.
"In the liposarcoma field, it will be interesting to see if immunotherapy is active."
