The power of pink

survivors-hall014It’s easy to get caught up in the over saturation of pink that soaks the month of October, running through all 31 days like a Pepto-tinted flood.

In every NFL game, players sprint up the gridiron in specially designed pink Nikes and catch deep passes in pink gloves. Every publication (including, guilty as charged, Monthly) goes “pink” in the name of awareness. And across the country, breast cancer awareness events give people an excuse to carry around oversized novelty plush boobs.

ome might say all of this levity detracts from the seriousness of the message. That an evil as powerful as breast cancer should be fought with stoicism and a stiff upper lip. But here’s the thing; maybe we dress Breast Cancer Awareness Month up in pink parades and bumper stickers with the word “TaTas” on them because the thing itself, the actual demon we’re trying to defeat, is just too terrifying. Maybe the fear of what this disease can do is just too deep, the sting of those lost still so fresh, that we can’t look it in the eye. So we just paint everything pink and try not to look too closely.

Because underneath all the pink is breast cancer. And breast cancer is a horrific, remorseless murderer of mothers, daughters, wives and friends.

We grieve for those we’ve lost. We stand strong with those still fighting. And we do so in pink, hoping to at least raise some awareness of the brutality of this cancer. It’s all we can do; we leave the bravery to those women in the fight, and those advancing the technology that can save lives.

And in that technology, we see another way that looking closer changes the picture. Except in this case, it’s for the better.

After all, how many times have you heard about the latest advancement in treatment of this cancer, or a new center opened up to help early detection of that cancer? Probably a lot. Especially in an area like the Lowcountry, where healthcare is such a vital industry

But do you think twice about these advancements? Probably not. But you should. Because if you look closer you’ll see another stark truth: every one of these advancements has saved someone’s life.

Every new machine, new breast health center, every accreditation that blurs past you in the business section, has given some child back his mother. Some husband back his wife. Some parents back their daughter. Every one of them.

This month, even as we slather ourselves in pink in the name of awareness, we take an opportunity to not only look the horrors of breast cancer in the eye, but also introduce three women who stood tall, found local experts to help them out, and lived to tell about it.

That’s the power of pink.

Despite the portrait painted by statistics, anyone out there would be forgiven for brushing off cancer with the dismissive “couldn’t happen to me.”

After all, to walk around each day knowing it could happen to you at any moment would be too much to bear. We’re almost forced by human nature to tell ourselves it’s someone else’s disease.

And to be frank, some people could actually say “not me” and have statistics back them up. Say, those without any kind of family history. And those too young to be considered prime candidates for breast cancer.

Kim Hall knows better.

With no family history, and at age 38, Hall was shocked when a self-exam yielded a terrifying lump.

“One of my best girlfriends was diagnosed at 37,” said Hall. “She was on Caring Bridge, and every time she posted, she’d remind us to do our self-checks.”

And so, in late August of 2011, Hall found a lump. She made an appointment with Dr. Virginia Herrmann right away, and was in by Sept. 6.

“She looked at it and just said, ‘OK,’ but she had that look on her face that you just knew it wasn’t a good thing. Then she asked, ‘Did you feel this other one?’”
Hall was in radiology directly, getting a mammogram and an ultrasound. They found more.

All told, Hall would find out the next day, she had three masses in her left breast and four affected lymph nodes. It was stage 3 breast cancer.

And what’s more, doctors estimate she’d had it for a year. In the best physical health of her life, with a regimen that included tennis and running, Hall hadn’t so much as had the sniffles in that year.

“It was terrifying,” she recalled. “But I think I had a different response to the news than most people do.”

The response, in her own words, was “Oh my God, I need a drink.”

Her sister was over directly with a bottle of wine. She would be the first link in a web of support that would carry Hall through this.

Well, that, and a fighting spirit that refused to back down.

“I have two children, Spencer who’s 8 and Abigail who is 10, and a stepson in Wisconsin. I never thought ‘I’m going to die, this is terrible.’ There was none of that. My first thought was ‘OK, I gotta fix this.’

“I was told to fight like a girl; I decided to fight like Muhammed Ali,” she said. “There were no other options. I have too many great things in my life to sit and wallow in self-pity.”

Within 36 hours, Hall was on her way to MUSC. With the cancer in the lymph nodes, time was of the essence. She underwent a double mastectomy on Sept. 27, and started chemo the next month after her recovery was complete.

“I got the ‘Who’s your Daddy’ of chemo,” she said. “Some call it the red devil. The nurses have to inject it while wearing a special suit.”

Four treatments led to a weekly treatment, which led to an eventual all-clear signal from doctors, but not before Hall’s friends proved to be a formidable support system.

“My cancer became a community event,” she said. Whether taking her out for dinner once a month or administering shots (one of her friends is a nurse), her support system came out strong.

“I couldn’t have done it without my friends.”

These days, Hall can look back on her experience and smile. After all, it’s the best medicine.

“I’m a firm believer in positive mental attitude,” she said. “I think that if you go in with good mindset, you can get through anything.”

survivors-ingles02

“The treatment of breast cancer has really changed in the last decade or so,” said Dr. Virginia Herrmann of the Hilton Head Hospital Breast Center. “Instead of treating all breast cancers and all women the same, we’re focusing on targeting therapy. We’re asking, ‘What’s best for this woman?’ and the outcome is much better.”

Dr. Herrmann is a key member of the Breast Center, a nationally accredited (by National Accreditation Program for Breast Centers) multi-disciplinary approach to breast health. The multi-disciplinary approach brings together experts from all facets of breast health under one roof and lets them work together to provide treatment.

“The data shows that treatment is better when it’s managed by an interdisciplinary team,” said Herrmann. She lists several who work at the Breast Center, in fields like surgical oncology, medical oncology, radiation oncology, genetic counseling, nurse breast care, breast pathology, and a dedicated breast imaging or radiologist.

In fact, the breast imaging at the Breast Center recently earned Hilton Head Hospital the coveted Breast Imaging Center of Excellence designation by the American College of Radiology. It makes the hospital the only one in Beaufort or Jasper counties with this designation.

The Breast Center also benefits tremendously from an affiliation with MUSC Hollings Cancer Center, which has been given the National Cancer Institute designation.

“The guidelines that were involved in the ACI designation, and in our affiliation with MUSC, the standards that you have to meet are so high,” said Herrmann. “The reason the accreditation is important is that these standards are evidence-based. You follow very rigid guidelines about the care being given.”

And while experts in every conceivable field can heal the body, they haven’t forgotten the soul. The hospital offers “Hope and Healing,” a breast cancer patient and survivor support group, on the first Tuesday of every month.

“We felt the need to provide real cutting edge science and medical care combined with passion and the ideal team here in the Lowcountry,” said Dr. Herrmann. “I think that’s what makes our program unique.”

It’s the sentence every husband dreads: “I don’t know if she’s going to make it through the night.”

When delivered by your wife’s doctor, after sixteen hours of surgeries, it can make even the strongest husband lose hope. And that’s just what Jim Ingles was told right before his wife Nancy started the fight of her life.

Even now, seated in the breakfast nook of her Sun City home and with the entire ordeal behind her, Nancy still lets her smiling demeanor slip for just a moment as she recalls that dark time. But it’s only a moment, and then the sunny grandmother of three and breast cancer survivor is back to her positive self.

But it’s hard for her not to be positive, when she’s being asked to talk about some of her favorite people in the world (besides her grandkids): the staff at Beaufort Memorial.

“I am just so passionate about the care that I had there,” she said. “The people who were there to help me, the breast care coordinator, Dr. Burrus, the nurses, even the people in the cafeteria. I am such a proponent of that hospital.”

Nancy’s experience began with her annual mammogram. She’d just had a breast exam that morning, so she had little to suspect. And then the phone call came.

“The next morning they called and asked me to come up to Beaufort to the women’s imaging center,” she said. She went, and right away, Nancy was introduced to one of the most important members of the team: Jackie Brown, her breast care coordinator.

“Jackie Brown ended up being like I’d known her for years. She was my best friend, she was a sister, everything to me in a period of four hours. It was just amazing.”

Due to the all-under-one-roof nature of BMH’s breast health center (and thanks to some hard work from Brown), Nancy was able to get biopsied that day. That’s where the good news ended.

“They said ‘Mrs. Ingles, you have cancer,’ and I said ‘OK, what are you going to do about it?’” Nancy said with one of her ever-present smiles.

The next step was to pick out a surgeon. A friend recommended Dr. Perry Burrus.

“From then on, it was a match made in heaven,” Nancy said. “He’s the kindest, most passionate person you’d want to meet in this situation. And he told me something very important: You are the boss here. You have some major decisions to make and I will guide you through this decision, but it is very important to me and to you that you make the decision. And I like that, because I like being in charge.”

Her decision, made in the span of a long conversation with her husband, was a lumpectomy. So shortly after, with the support of Jackie Brown, and the guidance of Dr. Burrus, Nancy went under the knife.

It was Thursday of the following week when Nancy found herself recovering from surgery and feeling all in all fairly health when a sneaking suspicion formed.

“When I was in my room, I knew they’d found something,” she said. “(Dr. Burrus) was right there. He was there when they brought me up from recovery.”

They had checked her lymph nodes, and found that the cancer had spread. And it was at that point that the fighter in Nancy came out.

“I told him, ‘I have too much to live for. I have three grandchildren, and I’ll fight this thing to the end.’”

“And he told me, ‘Keep that attitude.’”

But the fight was just starting. Results from testing done during the first surgery indicated that Nancy’s cancer was far worse than they’d thought. Dr. Burrus was recommending a total mastectomy.

Nancy and Jim spent the night weighing their options, and in the end they decided it had to be done.

“I’m such an upbeat, positive person,” Nancy said. “But I knew if I didn’t have this done, I was going to dwell on it.”

When she called BMH to share her decision, Dr. Burrus called her right back, even though he was a country away at a training session in California.

The operation was scheduled for when he got back and Nancy went under the knife once again. The operation lasted eight hours.

“When I came out, I was fine,” she said. “Then early the next morning, my hand was swollen where they had placed the IV.”

Moving the IV created more swelling. Moving it again didn’t help. Within an hour, Nancy’s temperature had skyrocketed and once again, Dr. Burrus was by her side immediately.

“I could hear (Dr. Burrus and Jim) talking, but I didn’t know what they were saying,” Nancy said.

She was rushed back into surgery. They found massive infection in her chest cavity.

“I was in surgery for another eight hours,” she said. “They sent a nurse down four times to Jim.”

It was after this surgery that Jim and Dr. Burrus had their discussion about Nancy’s chances, and when Nancy’s fight began.

Dr. Burrus pulled out all the stops, calling in infectious diseases specialists and seeing Nancy through what should have been a four-hour surgery that turned into another eight-hour ordeal.

“Dr. Burrus came in (after the surgery) and said, ‘If she can make it through this night, I think she’s seen the other side.”

And she did.

And now, staring through the lens of the intervening months, perched on a chair in her Sun City home, surrounded by photos of her loved ones, she can still smile.

“All the people that took care of me there, and all I went through, look where I am now,” she said. “And it’s because of the dedication of those people.”

“We’ve developed an expectation among ourselves and the women we serve to provide an outstanding level of breast care, right here in our community,” says Dr. Perry Burrus, who leads a very special group of doctors at Beaufort Memorial Hospital dedicated to women’s breast care.

As the hospital’s Breast Program Leader, Dr. Burrus assembled a team of specialists from a variety of fields – oncology, radiology and social services, to name a few – to evaluate and create services that address the fullest scope of a woman’s breast health needs. The team is working with Duke University to develop the program, and is following the National Comprehensive Cancer Network guidelines to ensure that each woman receives the most current and widely accepted screening and treatment recommendations.

This team allows Beaufort Memorial to provide coordinated, comprehensive care customized to meet the individual needs and desires of the patient.

It starts with the image. The hospital recently opened a new Women’s Imaging Center, a 4,100-square-foot facility devoted solely to women’s imaging needs. Services include digital diagnostic and screening mammograms equipped with MammoPads for a softer, more comfortable experience, ultrasounds, bone density scans and stereotactic breast biopsy. The facility’s spa-like setting was designed with the healing arts in mind.

BMH offers same-day mammogram results available at both the Women’s Imaging Center in Beaufort and at Bluffton Medical Services. An onsite radiologist reviews every mammogram just moments after the screening, providing patients with their findings before they leave.

“When a woman finds a lump in her breast, it changes her whole world,” said Burrus. “In the past it would take weeks to find out what it was. It’s very very stressful. What we’re offering now is a definitive diagnosis in a day or two.”

From there, the breast care coordinator takes over. The breast care coordinator will partner with the patient the moment an abnormality is identified. She will provide the patient with educational information and help her schedule appointments, coordinate treatment and communicate with doctors. The breast care coordinator will serve as the patient’s advocate throughout the treatment.

And all of this comes with a serious partnership. Beaufort Memorial’s affiliation with Duke University Health System in cancer services enables the hospital to participate in local clinical trials programs that will give eligible area cancer patients the opportunity to receive cutting-edge cancer therapies that otherwise might not be available to them, while helping researchers learn more about the effectiveness of new treatments. The hospital’s commitment to opening a clinical trials program is significant for the local community – and not just for those people who participate in the trials.

“The collaboration with the different specialists allows us to offer state-of-the-art care,” said Burrus. “And now patients don’t have to travel to Duke or whatever. Have treatment at home, be here with families. That’s a big plus.

survivors-cannell03It was July 1, 2010 when McCracking Middle School Teacher Andy Cannell first knew something was wrong.

She remembers that time well, not only because of the terror she felt in discovering a lump, but because of the heartbreak of saying goodbye to her brother.

He had been just diagnosed with lung cancer. Within ten days of diagnosis, he would be gone.

“As I’m sitting in hospice, telling him goodbye, I felt a lump in my armpit,” she said, voice swollen with emotion. “I had the mammogram after the funeral. It was total shock.”

Still reeling from her brother’s sudden descent, she received her own diagnosis.

Stage two breast cancer.

But Cannell’s shock and sorrow was short lived, as she soon went into what she refers to as “war mode.” And this warrior was not alone.

“I had lots of warriors: My sisters, my family, my church and longtime friends Laurie Andrews, Cynthia Wibel and Bev Jobert,” she said. “They rallied and supported me.”

Within a few weeks of diagnosis, Cannell was undergoing eight rounds of chemo every two weeks.

“The first couple of days (after chemo) I was really weak and felt like I had the flu,” she described it. “And every day I would get better and better. By the seventh or eighth day I felt more like myself. I’d have three or four days, then it was right back to it.”

But even as the treatments sapped her energy, her network of support held strong. Cannell’s friends kept her occupied with “Shave the Head” parties and pink champagne parties, looking for any way to, as Cannell said, “turn a negative into a positive.”

“My doctor laughed because every time I came in, I had so many people helping me out. I had my entourage. Instead of it being something awful, it came away as a blessing because the love and support was unbelievable.”

Friends provided meals. Off-Island Cancer Thrift helped pay for bills. A nonprofit service called Cleaning for Reason came by and helped clean her house.

“You name it, and people were there with support.”

These days, Cannell is cancer-free and loving every second of it.

“I feel great,” she said. “The cancer’s totally gone. I just had the scan and everything and I’m clear.”

So how does she celebrate? Cannell pays it forward in two ways. The first is through clinical trials, including one with Dr. Gary Thomas investigating means to keep cancer from spreading into bones. The second is through fundraisers.

You can catch Cannell at the Rockin’ the Pink Breast Cancer Awareness Walk Oct. 13 starting at Red Cedar Elementary School.

Or, better yet, you can join her and be another one of her warriors.

The fight against cancer, from a personal standpoint, is a grueling struggle. While the body weakens under treatment, the mind rails against the fear of what might come next. This past spring, cancer patients around the Lowcountry gained two huge allies in this fight. The first came in June, when a comprehensive cancer care network came online under St. Joseph’s/Candler’s Nancy N. and J.C. Lewis Cancer & Research Pavilion and helmed by long-time islander Dr. Gary Thomas.

The second came in July, when the National Cancer Institute’s Community Cancer Centers Program (NCCCP) extended its relationship with the pavilion for another two years.

“With the help of the NCCCP, the Lewis Cancer & Research Pavilion has truly become a destination for cancer care,” said Dr. Howard A. Zaren, who serves as Principal Investigator for the NCCCP. “Physicians in Savannah and around the region know they can refer their patients here for the latest treatments and the patients want to come here for all their treatment under one roof.”

The LCRP has been a member of the NCI Community Cancer Centers Program (NCCCP) since the program’s inception in 2007 and was awarded $796,000 to fund participation in the NCCCP network for the program’s next two years. This feat has only been accomplished by a handful of cancer programs nationwide.

The pavilion also recently received a three-year accreditation from the National Accreditation Program for Breast Centers.

“This tells patients that we were vigorously reviewed and proved to be providing the highest levels of breast care,” said Zaren, who is also the medical director of the Lewis Cancer & Research Pavilion. “Whatever breast problem they have, we have the answer for.”

But accreditations, partnerships, grants, these are all words.

At the end of the day, the only network that really matters is people.

People like Andy Cannell, who was diagnosed with breast cancer in 2010, and owes her life to the clinical trials she underwent under the care of Dr. Thomas.