More About the Pink

Breast Cancer awareness month continues with Wild Rose Press author Caroline Clemmons.

Lilly- Welcome Caroline. It's always a pleasure to have you on my blog.

I know you've never had breast cancer but you had thyroid cancer and your daughter has been fighting a battle with a very rare and little known form of breast cancer: Padget's disease of the breast.

Why don't you tell us a bit about your personal battle with cancer.

Caroline-
Lilly, first let me thank you for hosting me on your lovely blog. My daughter's and my cancer battles emphasizes the advice to everyone: You know your body and must be responsible for your own health! I remember a time when I assumed every doctor knew his or her business. Never take that knowledge and ability for granted! Just as there are good policemen and bad, there are careful doctors and slapdash ones. My primary care physician is an extraordinarily good doctor who seems to actually care about his patients. He had sent me to a radiologist because I felt there was something pressing in my throat on the right side and his examination concurred. The radiologist had me drink water while being scanned, but declared nothing was wrong. Later, I had an MRI of my chest for another problem, but nodules on my right thyroid showed up. My doctor sent me to an endocrinologist with a good reputation. She biopsied the largest of four nodules. Readers, this is wrong! Anytime you have nodules on your thyroid, EACH nodule should be biopsied. The results of the one came back as simply fibrous tissue, and she said there was no point in having surgery unless they bothered me or obstructed my airway. Well, they did, but I decided to wait a few months until it was more convenient. Dumb! My primary called and told me that he didn't feel comfortable with her diagnosis (not exactly what he said, but what he meant) and sent me for a CT scan and to see a throat surgeon. The surgeon didn't say the endocrinologist was lax, but did say he always biopsied each nodule. After my surgery, the biopsy of two nodules came back follicular cancer. Since they can't scrape away each cell of thyroid tissue due to involvement with important things like carotid arteries, larynx, etc., I had radioactive iodine therapy. Here I was fortunate. A friend in my book club (whose son and daughter are both physicians) had been diagnosed with thyroid cancer a couple of months before my surgery. She told me about her endocrinologist, Dr. Darren Lacken in Fort Worth, who has been chosen as one of the 100 top endocrinologists in the U.S. He administered the large dose of radioactive iodine which required home quarantine from my husband and our pets for a short time. Now that wasn't hard--I stayed in the bedroom with laptop and books, while my husband brought food and drink to the door. It was annoying because he had to sleep in the guest room and I couldn't leave our bedroom. Six months later, I received a much smaller dose which just required no one get closer than two feet from me and that I avoid pregnant women. In November, I get another of the small doses and another PET scan. We believe the cancer cells have been killed, but want to be positive. If one has to have cancer, thyroid cancer is the least threatening, especially if caught early. There are precautions, of course--one is no massage above the hips. The minute the endocrinologist said that, I longed for a full body massage. LOL Isn't that our nature? 


Lilly-
You're a real fighter. I'm surprised you had a swallowing study instead of a thyroid ultrasound from the beginning. From what I remember from x-ray school, that's usually done as soon as the lab work or physical exam show a problem. What an ordeal! It's a good thing both you and your doctor were vigilant. But I imagine watching your daughter's struggle with cancer was even more of a challenge. Can you share a bit of her story?

Caroline-
You are so right, Lilly. I was devastated when I learned my oldest daughter had breast cancer! Anyone with children knows that having bad things happen to our children is a hundred times worse than having it happen to us. My daughter called me to say she had this sore on her nipple that wouldn't heal. She thought she must have scratched herself during her sleep and that her bra irritated it and kept it from healing. I told her to see her doctor and we agreed you can't take chances. Her primary care in the small town in which she lives pooh poohed it. She insisted on a mammogram, which revealed a small cloud on the end of her breast. Her doctor suggested waiting six months and repeating the mammogram to see if there had been a change. About that time she heard the father of a friend had died. Even though she'd lost touch with this friend, she attended the funeral. At the funeral, she was shocked to see her bereaved friend wearing a turban. When they talked, the friend explained she had breast cancer that wasn't caught in time and was undergoing chemo. As the friend explained the symptoms, they were exactly the same as those of my daughter. The friend told her to forget about her primary care and go immediately to her breast surgeon, Dr. Sally Knox at Baylor Hospital in Dallas. Dr. Knox immediately scheduled a biopsy. It was positive for Paget's breast cancer (apparently Paget was a busy guy and there are other Paget cancers). This is an exceptionally aggressive cancer which spreads rapidly. My daughter's was caught early enough that she had a lumpectomy. The oncology radiologist told us that if my daughter had waited six months as her primary doctor requested, the cancer would have been into her chest cavity/lungs.


Lilly-
Paget's disease of the bone is a chronic condition that results in pain and deformity and fractures of the bones. It is rarely diagnosed in patients under forty and should not be confused with Paget's disease of the breast which is a rare form of breast cancer that begins in the milk ducts of the nipple.

Paget's disease of the breast presents with fairly benign symptoms as you describe your daughter having. A red itchy nipple that is often mistaken for irritation, inflammation or an infection. But it doesn't heal. And there can be a bloody nipple discharge, crusting and oozing associated with the irritation. That's never a symptom you should ignore. 

Women can have nipple discharge for a variety of reasons, some related to elevated prolactin levels or even a pituitary tumor, but never NEVER ignore a bloody nipple discharge.  And if the skin of your breast looks and feels like an orange peel, see a doctor immediately. Peau-de-orange is a classic sign of Paget's breast disease.

Unfortunately Paget's Disease of the breast does not always show up on a mammogram. Sometimes it doesn't show anything but thickened breast tissue or an increase in density, such as the "cloud-like" appearance Caroline described.

Whenever there is a palpable lump or physical change in the breast, a mammogram should be followed immediately (or as soon as possible) with a breast ultrasound. And never wait six months to follow up on a breast complaint if you don't feel comfortable doing so. Ask for copies of your x-rays and take them to another doctor or hospital for a second opinion.

Another often misdiagnosed breast cancer is Inflammatory Breast Cancer. IBC is a rare, extremely aggressive breast cancer characterized by symptoms resembling a rash, skin infection, or "bite" that won't heal. IBC can occur in women at any age and even, much more rarely, in men.

 For more information on these aggressive type breast cancers, please visit: http://www.cancer.gov/cancertopics/factsheet/Sites-Types/IBC



But enough scary news. Breast cancer is no longer the death sentence it once was. When caught early, most breast cancers are curable. And five years is supposedly the magic number for being considered "cured" of the disease. But the fear never abates and the reality with any cancer is: It can come back. So we must be diligent with our own health care and make sure we stay informed and aware. And positive. Faith and a positive attitude make all the difference. Wouldn't you agree?

Caroline-
I certainly agree! My daughter has been cancer free since five years ago April, and as you said, this is considered the "magic" number. I think she feels it's only in remission. Because of the fact that Paget's breast cancer usually pops up in the other breast eventually, she feels as if she's waiting for the other shoe to drop. However, she is careful about her diet, takes vitamins, and is vigilant. Again, the bottom line is that we know our bodies and when there's been a change! Also a positive attitude can save your life! Neither of us feels we were doomed to painful death, for instance. We both have strong faith that God is watching over us. Now let me say that I am NOT implying that God is not watching over those who die of cancer. Not at all! My daughter and I are merely the lucky ones. I believe it was God who put my daughter back in touch with her friend. I believe it was God who arranged for my friend to send me to a top endocrinologist--one of the few who specializes in thyroid problems. My favorite Bible verse is Jeremiah 29:11-13, "For I know the plans I have for you, declares the Lord...plans to give you hope and a future." I want to emphasize that, as you said, we must be diligent with our own health care. I believe that vigilance is a part of God's plan. Blogs like yours help spread information to enable that vigilance. Good for you!

Lilly-
Oh, I agree! I do not think God gives anyone cancer. And he doesn't just save the faithful or let the unfaithful die. Cancer, like other tragedies in life just happen. But God does perform miracles. He doesn't use magic. He uses people and science. And he puts those people in our lives when we need them the most.

Life isn't always easy but it's always an adventure. And you've had some good luck recently with your writing. Haven't you Caroline? Tells us a bit about some of your recent releases and where we can find them.

Caroline-

Thanks for asking. How long do I have? (said with a cheeky grin) I'm ecstatic that THE TEXAN'S IRISH BRIDE received 5 Hearts from The Romance Studio and is a Top Pick from Night Owl reviews.  You can buy it at www.thewildrosepress.com/caroline-clemmons-m-638.html I enjoyed writing this book even though it involved a ton of research. It's set in Texas, as all my books are, either partially or totally. The time is 1885 in the central hill country, which is mainly ranching with a few apple orchards and other fruits or vegetables. My website is www.carolineclemmons.com and blog is http://carolineclemmons.blogspot.com I'm also part of a new blog for those who write books set West of the Mississippi River, http://sweetheartsofthewest.blogspot.com

 
Lilly-
How about a blurb and an excerpt?

Caroline-
Certainly!
Cenora Rose O’Neill knows her father somehow arranged the trap for Dallas McClintock, but she agrees to wed the handsome stranger. She’d do anything to protect her family, and she wants to save herself from the bully Tom Williams. A fine settled man like Dallas will rid himself of her soon enough, but at least she and her family will be safely away from Tom Williams.

Texas rancher Dallas McClintock has no plans to wed for several years. Right now, he’s trying to establish himself as a successful horse breeder. Severely wounded rescuing Cenora from kidnappers, Dallas is taken to her family’s wagon to be tended. He is trapped into marrying Cenora, but he is not a man who goes back on his word. His wife has a silly superstition for everything, but passion-filled nights with her make up for everything. Ah, but what is he to do with a wife and her wild Irish family?

Here's a G excerpt from immediately after Dallas and Cenora's wedding. Aoife is Cenora's mom:

Dallas raised his gaze where Aoife directed. Four girls danced, but only one drew his attention. Shoulders straight and feet flying, Cenora met his glance, then broke away from the other dancers to perform only a few yards from him. 

Catcalls sounded nearby. She ignored them but gave a toss of her head. Her hair had come unbound, and her act sent her fiery hair awhirl. Light from the blazing campfire cast an aura-like radiance around her. Lantern glow overhead reflected her eyes sparked with merriment, challenge, and something mysterious he couldn’t name. 

No longer the delicate china doll, her wild beauty called to him, mesmerized him. He visualized her brilliant tresses spread across a pillow, her milky skin bared only for him. His body responded, and savage desire shot through him. Surprised at the depth of his reaction, he wondered if her performance in bed would parallel the unbridled nature of her dance.

Good Lord, could this glorious woman truly be his wife? And if so, heaven help him, what on earth was he to do with her?

Lilly-
This isn't your first visit to my blog but The Texan's Irish Bride  sounds better every time I hear about it or read one of your fabulous excerpts. It's definitely on my list of books to download to my Nook!

And, you have a 4.5 star review on Night Owl Reviews. http://www.nightowlreviews.com/nor/Reviews/Terri-reviews-The-Texans-Irish-Bride-by-Caroline-Clemmons.aspx

I'm thrilled for your writing success and I wish both you and your daughter many years of good health. Thank you for sharing your stories.

Caroline-

Lilly, Thank you so much, and thank you for doing your part to promote cancer awareness. I've enjoyed our visit.

Lilly-
For more information on thyroid or breast cancer, please visit: www.cancer.org