Cassie Perrins 47, was diagnosed with breast cancer in 2020 and it progressed to metastatic in 2022. Throughout it all she has been supported by McGrath Breast Care Nurse Sally Haley. Cassie says Sally’s care has gone above and beyond; it has given her the strength to pay it forward and help other cancer patients who are struggling, and it kept her out of palliative care. Cassie believes Sally is her personal superhero.
The diagnosis
Cassie didn’t need anyone to tell her that chemo wasn’t working and her cancer had progressed. “I could still feel the lump and it was getting bigger. Everyone just kept saying no, it’s the cancer cells dying off and scar tissue forming,” she says. But she was right. A year after being diagnosed with primary breast cancer, she was told it had spread.
McGrath Breast Care Nurse Sally Haley has supported Cassie from the start and is helping her live well with incurable cancer. Like all McGrath Breast Care Nurses, Sally truly cares for her patients. Sally explains medical terminology, talks Cassie through procedures and provides emotional support. But Cassie believes that Sally has gone above and beyond, from the initial diagnosis to now.
“It would have been very scary without her there, especially at the start. I literally found out on the Monday, Sally rang me on the Wednesday and I met with her the week after,” Cassie says.
Sally helped Cassie talk to her daughters, who were 9 and 11 at the time, about her initial diagnosis. She also has two older stepchildren, aged 28 and 31, plus five grandchildren. “The girls have forged a really good relationship with Sally, they know they can always talk to her,” Cassie says.
Sally made such an impression that Cassie’s daughter, Jessinta, chose her as the subject of a school presentation. “It needed to be on something that was close to them and Jess chose Sally because she wanted to help other kids who were going through the same thing,” Cassie says.
Sally the superhero
One day, while waiting to go into chemo Cassie saw Sally talking to a woman who looked like she was newly diagnosed. To help allay her fears, she told the woman not to worry because Sally was a superhero. Then she backed it up by sewing Sally a superhero cape.
“Her superpower is that she’s able to make you laugh – which is important when you’re going through chemo,” Cassie says.
“She understands that you can have both sides, you can be scared with her but you can also have a joke together.”
Sally agrees. Laughter is important. “Cancer can be very overwhelming and it can consume you – you don’t want to have that clinical conversation all the time. Being silly helps bring a little bit of normality to a situation that’s not normal,” Sally says. “In my eyes, Cassie is the hero in all of this. I will be forever humbled by her kindness, love and inspirational personality. Unfortunately, her time will be limited. She knows that and her children know that, so it is important Cassie lives well and enjoys every moment she has with her family and friends.”
“I’m the one that’s in the wings, pulling up the lights on the stage show but Cassie is the star of the show – it’s her life. I’m in the background to make sure that everything ticks along as best as it can so she can have a good life.”
The strength to pay it forward
Sally’s support provides Cassie with stability, which allows her to support the next lot of women entering the chemo room. Who will then do the same when it’s their turn, thereby paying it forward. It’s why she started sewing chemo bags for other patients.
“Some of these ladies don’t have anyone to sit with them during chemo. You see how scared they are and it’s really disheartening. Mum and I were sewing and we just wanted to do something to brighten everybody’s day, so they knew that someone cares and understands,” Cassie says. “Sally’s support propels me to do more. I want some of the strength I’ve gained off Sally to go to them, it gives them hope that you don’t have to give up. You can keep going.”
Specialised knowledge
When Cassie’s cancer progressed to metastatic, her treatment had to change. When Cassie was going downhill there were discussions of putting her in palliative care, because it was believed there were no further options. Sally, with her specialised care and experience went into action. “Sally liaised with my medical oncologist and the team immediately to discuss what the best plan was moving forward, and that palliative care was not appropriate at this time”. Cassie says. “It gave me the tools to keep fighting. I know that Sal is fighting for me constantly and will take my corner every time. I would never ever give up unless Sally sat me down and said, ‘I’m really sorry, Cass, this is the end of it. There’s nothing more we can do’”.
“She got behind me and my family to keep going. Having somebody in your corner, believing in you does make you want to fight harder.”
Sally’s role is even more important because she is based regionally. Gladstone has visiting medical oncologists, so Sally is the local expert on the ground when it comes to breast cancer. Her experience dealing with metastatic cancer means she can provide expert care when a patient’s disease progresses, this includes the various treatment pathways, best evidence-based care and can liaise directly with Cassie’s medical oncologist and her cancer care team that has supported Cassie over the years.
“I know about treatment options for metastatic breast cancer and am able to provide an extra level of care,” Sally says. “We are a patient’s advocate because we have that knowledge and knowledge is power.” Keeping Cassie out of palliative care with symptom treatment has bought her more time. “She’s had 18 more months with her children that she may not have had. To me, that is magic,” Sally says.
One of the other things she did was ensure Cassie had access to Sacituzumab Govitecan. Previously, it wasn’t available for regional patients as it had a short shelf life, so you had to travel to access it. But Cassie couldn’t drive the six hours to Brisbane so Sally set to work. “Her medical oncologist and I really pushed. She was the first regional person in central Queensland to get it,” she says.
Metastatic cancer care
Sally’s care has had to evolve over the years. Early breast cancer is curable while metastatic is treatable but not curable, it’s about ensuring the disease is kept at bay to enable the patient to live well with cancer. “It helped that I had that rapport and that relationship with her already. She knew I had her back,” she says. “It takes a long time to build that rapport and to have those very honest, frank conversations.”
The continuity of care that Sally provides means Cassie doesn’t have to explain her situation over and over again, which can be exhausting. “It is heaven that you don’t have to constantly go over everything all the time. It really helps having that constant person in your life,” she says.
For Sally, the power of care is about empowering patients. “The power of my care is enabling Cassie to live her most normal, powerful and positive life that she can with her family,” she says.
