Caroline Hanes, 56, has devoted her career to mentoring students.
She’s been a school counselor for nearly 30 years and currently works at Yadkin Valley Regional Career Academy, a Lexington, North Carolina, cooperative innovative high school where students can graduate with an Associate of Applied Science degree. She also teaches at Davidson-Davie Community College helping adults earn their high school equivalency diplomas. Her husband, Norian Fordham, retired in July as a high school band director.
“We went into education because we loved it,” she said. “We didn’t expect it to make us rich.”
The couple have three children and, as Hanes said, “bills coming in.” The family lives comfortably, but they’re not equipped to pay for expensive medical tests – especially ones needed annually.
That was never an issue until 2023. Hanes has both anemia and lymphedema, a chronic condition that causes swelling in the body due to a buildup of lymph fluid. Since 2015, she’s been under the care of Dr. Tim Collins, a medical oncologist/hematologist with Novant Health Cancer Institute - Forsyth for as-needed iron infusions – a separate and unrelated condition to the cancer she would develop.
If the questionnaire indicates a patient could be high-risk, she’s offered a free consultation with a navigator to review what “high risk” means and steps she can take to mitigate those risks. If the patient is interested in further conversation about managing her breast cancer risk, she’s offered an appointment with the Novant Health Risk Counseling Clinic to meet with an advanced practice provider who will review the patient’s health history and family cancer history in depth.
Established in 2015, the Risk
Counseling Clinic is designed for women identified as high risk for developing
breast cancer. The clinic, staffed by specialists including advanced practice
providers and certified genetic counselors, provides personalized care for
genetic testing, high-risk breast imaging, clinical breast exams and options to
lower risk including lifestyle modifications, medications and surgery.
Hanes did have elevated risk,
due to her family history; her mom was diagnosed at age 83 – and four
other family members have also had the disease. When she met with Leanne
Shoffner, a nurse practitioner at the Risk Counseling Clinic, she learned she needed
more than mammograms. She needed breast MRIs every year. Hanes paid for the
first one out of pocket at $4,000 because it wasn’t covered by her medical
insurance.
“Insurance companies generally pay for
a portion of breast MRIs for women at high risk,” Chrysson said. “Some women
owe very little after insurance, however, some may owe $1,500 to $2,000, which is
still expensive. It’s not sustainable year after year.”
Breast cancer care to support your every need.
Just ask
Paying thousands a year for a diagnostic test was daunting. “I thought, there’s no way I’ll qualify for financial aid,” she said. “But I asked anyway. I asked even though it was humbling. I was shocked to find out we did qualify. It was such a blessing to not worry about the cost and just focus on my health.”
Support came from philanthropy partners (team members and community donors) at Novant Health Foundation, as well as the Women’s Council. The foundation provided 44 breast MRIs for low- and moderate-income patients seen in the Risk Counseling Clinic who qualified for assistance in 2023 and has provided 23 so far this year. Of those, one – Hanes’ – resulted in a cancer diagnosis.
“We are incredibly grateful for our donors whose generosity empowers us to provide essential preventive screenings and access to care,” said Sharon Harrington, vice president, administration for Novant Health Foundation. “Together, we’re building a healthier community for all.”
Hanes “didn’t even know these resources existed,” she said. “To ask the question and then find out that I just needed to provide our income to see if we qualified was such a gift. If I hadn’t done this MRI, where would I be a year from now? What size would the tumor have been by then? What stage would I be looking at?”
She doubts she’d have had the MRI – or she would’ve put it off – if she hadn’t found financial support. “There was nothing wrong with me – or so I thought,” she said. “But my doctors kept encouraging me to be proactive.”
When the MRI revealed something suspicious in her right breast, Hanes was scheduled for a biopsy. The suspicious spot turned out to be cancer – specifically ductal carcinoma in situ, stage 1.
“The fact it was found early increases the cure rate and can simplify treatment,” Chrysson said.
A sweet legacy
Cancer had been part of Hanes’ life for a while. She cared for her mother, Evva – whom she calls “the strongest person I’ve ever known” – during her battle with cancer.
After a lifetime of good health, Evva was diagnosed with HER2 positive breast cancer – an especially aggressive cancer – at age 83. Treatment gave her several more good years, but the cancer eventually spread to her brain.
Evva’s cancer was a wake-up call for her daughter. Taking care of herself took on renewed importance. “I've carried extra weight around for years, and I knew I needed to change,” she said. “I have three young children. I had my first at 40 and then my twins at 42, and I want to remain healthy for them.”
When Evva of Mrs. Hanes' Moravian Cookies died of breast cancer at age 90 in June 2023, the New York Times paid tribute to her in an obituary, describing her as “a North Carolina farm woman who took a centuries-old Moravian cookie tradition … and turned it into a family business.”
Hanes still works in the cookie shop on Saturdays – something she’s done since middle school. Her husband and daughter also work part-time for the business Evva started in the basement of the family home – the same home where Hanes and Fordham are now raising their family. When Hanes was growing up, her mom had a dining room table that could seat 22. “Once a week, we’d fill it for dinner,” she said. “Mom made dinner for anyone and everyone – family, friends, people from church. She had the gift of hospitality.”
Hanes does, too. She loves entertaining. “I learned that from my mom,” she said. “It’s impossible for me to cook for a small crowd. I don’t know how to.”
When she’d been home from the hospital just a few days, she and her husband had “friends who are like family” over to play cards. “There’s always room for more to join,” she said. “We’ll bring in extra tables if we need to. We want our home to be filled with laughter, life and love. This positive energy helps still my mind and is part of my healing process.”
Decisive action
When Hanes first met with Dr. David Carr of Novant Health Breast Surgery - Ardmore, he said, “Tell me what you’re thinking, and then I’ll tell you what I’m thinking.”
She told him that, given her family history, she wanted to treat cancer aggressively – with a bilateral mastectomy to take care of the breast where the tumor was found, as well as the other breast as sort of an insurance policy. Removing both breasts means that Hanes no longer needs the breast MRIs she was supposed to have yearly.
That’s exactly what Carr recommended. “He listened and affirmed me,” she said.
Carr, who performed Hanes’ double mastectomy on Sept. 24, is a big proponent for early detection – as is Hanes now. “By age 40, all women should be getting regular mammograms,” he said. “And those recommendations change depending on how much risk there is.”
To hear Hanes tell it, you’d think she had surgery at a luxury spa. In reality, she was at Novant Health Medical Park Hospital, which she calls “the Shangri-La of hospitals, thanks to their phenomenal service.”
“That hospital is exceptional,” she said. “My surgical team was great, and I received the best care during and after the procedure. Everyone made me feel special.” She even raved about the food.
Top scores for safety in NC
Novant Health received the most ‘As’ for patient safety in North Carolina from The Leapfrog Group. With a focus on safety, quality and patient experience, the national, industry-leading nonprofit, evaluates and assigns letter grades ranging from A to F to hospitals across the country. Novant Health’s hospitals with “A” grades outperform 70% of hospitals nationwide for safety and quality.
Hanes’ positive attitude comes, in part, from her faith. “I’ve had a sense of peace since receiving my diagnosis, and it’s remained consistent as I’ve face surgeries and uncertainty about what might be coming,” she said. “I know God has a plan for my life. God is in control.”
She knows her children are watching to see how she’s handling her illness and recovery. “My mom handled adversity beautifully,” she said. “She’s my role model. And I want to be a role model for my kids. I want them to know it’s OK to cry; it’s OK to feel sad.”
That sadness was temporary. She recently learned her surgery was successful. She’s cancer-free and won’t need chemotherapy, radiation or additional medication.
She also learned that tissue from her left breast showed signs of ductal carcinoma in situ, which confirmed that she made the right decision. “I’m grateful I took the aggressive approach,” she said. “I thought I’d mourn my breasts. But I’m kind of indifferent. I’ve spent a lifetime trying to become comfortable in my own skin. Once I decided to focus on being healthy versus my physical size, I was able to embrace my curves. Cancer was a complete game changer for my outlook.”
Dr. Hampton Howell of Salem Plastic Surgery will do Hanes’ reconstruction surgery. “I’d probably be OK without reconstruction, but I’m choosing it to help restore confidence in myself,” she said. Her sense of humor fully intact, she quipped, “In time, my cup will runneth over. OK, maybe not runneth over. That’s still to be determined.”
‘You don’t have to live with fear’
Throughout this journey, Hanes hasn’t been afraid. She attributes that to her faith and the financial support she received.
“Having the foundation’s support took such a weight off my shoulders,” she said. “I felt instant relief – like things were going to be OK.”
She had been her mom’s primary advocate while she was battling cancer. And she knew the importance of advocating for herself. That’s a big reason why she had the courage to ask about financial support.
She wants others to feel similarly empowered.
“I want to share my story,” she said. “If I can encourage even one person to get a yearly mammogram and to live life fully even when uncertainty exists, then it is well worth it. I want people to advocate for themselves. You don't have to live with fear. There are people and organizations to support you throughout the whole process.”
Through philanthropy, Novant Health Foundation provides greater access to lifesaving care for more patients by supporting patient transportation, medication assistance, mammograms, breast MRIs and funding for patient navigators. A special thank-you to all our team members and community philanthropy partners who help accelerate, expand and enhance care for those who live in the communities we serve.
If you do not have insurance and cannot afford a mammogram, click here to visit our mammogram website and scroll down to "Do you qualify for a mammogram grant?" to see if you qualify for payment assistance.
If you’d like to learn more about supporting breast health and access to preventive screenings, visit https://supportnovanthealth.org/cancer-care/
