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Cancer patient finds treatment locally

The saga of a woman's treatment in McDowell

by Linda Cloherty

Published: August 24, 2009

It began like any other Sunday for Tommy and Annette Stines, but May 17 was about to become the day that life turned upside down for this Marion couple. Settling into her recliner, Annette raised both arms over her head in a long, relaxing stretch. Feeling an unfamiliar pulling sensation on the side of her left breast, she automatically reached over to the spot and was shocked to feel a golf ball-sized lump.
"My first thought was that this was it, it's all over," she remembered.
Annette told her husband Tommy, who silently hoped it wasn't cancer. He recalled the loss of two loved ones to cancer: his mother, Minnie Haupt, and brother, John Stines. To Tommy, a cancer diagnosis was a death sentence.
With no health insurance, the next dilemma was where to go first. Annette's youngest daughter, Jamie Wyatt, suggested the McDowell County Health Department. This turned out to be a critical choice. Recognizing the urgency, they gave her an appointment immediately. Annette learned that she qualified for the Breast and Cervical Cancer Program (BCCCP), a federally funded gynecological exam and cancer-screening program.
Because BCCCP was her first stop, and she hadn't been previously diagnosed elsewhere, Annette was eligible for the N.C. Breast and Cervical Cancer Medicaid, which covers subsequent treatment. The groundwork was now laid and events proceeded at a rapid pace.
Enter Tonya Waycaster, nurse navigator responsible for providing a continuum of services through a new program, the McDowell Cancer Care Partners. Her role was to help Annette, Tommy and their children, Chris Stines, Becky Dove and Jamie Wyatt, every step of the way. Tonya offered explanations and clarifications and arranged appointments. Most importantly, she made sure that the Stines' wishes were heard. For Annette, that meant getting as much of her care as possible in McDowell County.
"I never even considered going somewhere else," she said. "I want to be at home."
"At the time, I thought she should be in Asheville," Tommy said, "but now I'm so glad that she stubbornly demanded to stay here."
Just three months earlier, Annette wouldn't have found as much support locally. Responding to the community's needs for breast cancer services, The McDowell Hospital obtained funding through the Duke Endowment, and launched their Cancer Care Partners program in February.
Registered Nurse Tonya Waycaster manages the program, which provides free access to an oncology-certified nurse, to support women from diagnosis through treatment. The program's strength comes from the fact that it's a partnership. In addition to the personal one-on-one guidance for women and their families, comprehensive treatment is guaranteed through a partnership with McDowell Surgical Services, Health Plus of McDowell, 21st Century Radiation, McDowell County Health Department, The American Cancer Society and Mission Hospital Breast Center.
With support in place, Annette took the next step. The Health Department referred her to Robert Morrow, a surgeon with McDowell Surgical Services. The family had heard excellent reports about the way he treated and cared for his patients, and they weren't disappointed when they met.
"He's very likable and a very good surgeon," said Tommy.
Even though experience told him that the lump was cancer, Morrow ordered tests to confirm the diagnosis. Some were done in Asheville, but most in Marion, including a biopsy performed using state-of-the-art equipment, also acquired through the Duke Endowment. Radiologist John Ende used the new equipment to perform an ultrasound-guided, vacuum-assisted biopsy. The diagnosis was confirmed. In fact, the biopsy revealed a suspicious spot on her right breast as well and a bilateral mastectomy was scheduled.
Before the surgery, the medical team helped the Stines family prepare for the process. Medical oncologist Don Jackson and radiation oncologist Quinten Black talked to them about the treatments following the surgery and what to expect.
"A whole team of kind and compassionate people were working with us," said Wyatt. "We feel so lucky to have these people around us at a difficult time. We have never felt alone the whole time. We know we always have the support of this great team."
Annette Stines' surgery took place on June 23 at The McDowell Hospital, just one month after she first felt the lump. She experienced little pain and was discharged after only an overnight stay in the hospital.
Her first chemotherapy treatment with The McDowell Hospital's infusion nurse, Peggy Poplin, took place on July 15. Phase I of her chemotherapy consists of one treatment every three weeks for 12 weeks. Phase II intensifies with one week for another 12 weeks. Annette knows that she may experience hair loss and nausea as treatments progress, but the medical team has helped her prepare for that, too.
"I dread the nausea, but already have medications to help, and I have two wigs so I'm ready for whatever is ahead," she said. "My tumor was large and aggressive, so we'll do whatever we have to do."
The team hasn't decided yet whether radiation treatment will be part of Annette's future. In the meantime, Annette, Tommy, their three children and seven grandchildren, joined by a powerful team of caring and experienced professionals, are fighting this battle together.
"We just can't get over how wonderful everyone with Cancer Care Partners has been to our mother and family," said Jamie. "She couldn't be in a better place."
The Duke Endowment in Charlotte seeks to fulfill the legacy of James B. Duke by enriching lives and communities in the Carolinas through higher education, health care, rural churches and children's services. Since its inception in 1924, the endowment has awarded more than $2.4 billion in grants.