The day after Christmas 2022, Shannon Dickson, then 35 and a mother of three, was toweling off after a shower and felt something unusual in her left breast. She called to her mom, who was visiting for the holidays, and asked, “Will you feel this? This feels weird, right?” Her mom agreed.
At the time, Dickson was still nursing her youngest child and assumed it was a clogged milk duct.
But when she called her internist, Dr. Kavita Shanker-Patel of , the next day, they got her in right away and recommended a mammogram.
“They squeezed me in the next day,” Dickson said. “It turned into four mammograms, three ultrasounds, three biopsies and an X-ray, all in one day.”
The next day, she got the results: invasive ductal carcinoma. The tumor was 6.2 centimeters or 2.5 inches – a significant size. And it was Stage 3, meaning it had spread to her lymph nodes.
Empathetic care from dedicated cancer specialists.
Learn more
Dr. Peter Turk, Dickson’s surgical oncologist at Novant Health Cancer Institute – Elizabeth in Charlotte, would later call it “a devastating diagnosis.”
Dickson had HER2-amplified breast cancer, which refers to a cell protein that helps cancer spread. “Twenty years ago, there wasn’t an effective treatment,” said Turk. “Herceptin, a drug that targets HER2, changed that. It’s highly effective; 70% of patients on it have a complete response at time of surgery. But completing treatment requires a full year of targeted therapy.”
The diagnosis came as a shock. Dickson has no family history of breast cancer, and she’s young, active and healthy. She has a master’s in exercise science and has eaten a plant-based diet for more than 11 years.
“I’m very mindful of what I put in my body,” she said. “My friends call me ‘The Crunchy One.’”
Because she’s guided by faith, she felt equipped to face this challenge. “I thought: I’m glad it’s me,” she said. “I couldn’t handle it if my husband or one of my kids had this. But I know my body and I know my God, and we were going to get through this.”
Dickson’s first appointment was with her nurse navigator, Vicki Davidson – “an angel on earth,” Dickson said. For the duration of Dickson’s yearlong treatment, Davidson was there at every step. “She set up appointments, made connections, answered questions,” she said. “She even showed up at some appointments just to give me a hug.”
Turk said, “Our nurse navigators are a great benefit to patients. Vicki has been here longer than any navigator, and she really goes above and beyond.”
‘You can do hard things’
When she got the news, Dickson’s first thought was of her children. “They were so young,” she said. (4, 3 and 15 months.) “We were on this weird rollercoaster of: What do we tell them? What don’t we tell them? What will they understand?”
But then she and her husband, Michael, realized their kids didn’t know “cancer” is a scary word.
So, they told them, Dickson said, “as calmly as possible. We said, ‘There’s something in Mommy’s body called cancer that isn’t supposed to be there. God and her doctors are going to get it out.’ And then we stepped outside and bawled our eyes out.”
The children seemed relieved to know. They could sense something wrong. Family and friends were coming over often all of the sudden, and “everyone would start crying when they walked in. I’ve always told my kids: ‘You can do hard things.’ I thought: This is my chance to walk that talk. And they handled it like champs.”
‘Our ultimate goal is to cure’
Dickson was part of a clinical trial (see more details on this at the end of the story) and started chemo Jan. 19, 2023. Her regimen was 12 weeks of once-weekly Taxol infusions. A standard regimen – if she hadn’t been part of the trial – would’ve lasted 18 weeks.
After chemo came surgery. Surgery indicates to doctors how well chemo worked. “It’s like spraying Roundup and then checking a few days later to see if your weeds are gone,” Turk said. “Shannon had a complete pathologic response at time of surgery, meaning the cancer was gone under the microscope.”
As part of the trial, Dickson had targeted therapy, using a drug called Phesgo, every three weeks for a whole year. Phesgo is a combination of two breast cancer treatments – Herceptin and Perjeta – that’s administered via injection. The injection took only 10 minutes, while an infusion would’ve taken 90 minutes or more.
At every turn, her team worked to minimize the time she spent in treatment.
For instance, she got “supercharged” radiation every weekday for three weeks. A typical radiation regimen would have lasted six weeks. Instead, doctors doubled the dose of radiation, but shortened the course by half. Her oncologist, Dr. Lance Lassiter of Novant Health Cancer Institute - Ballantyne, said, “The total dose is the same. It’s just that the per-day dose is higher.”
She didn’t suffer the painful side effects – like radiation burns – some do. But the cumulative effects of 12 weeks of chemo caused nausea, vertigo, fatigue. Nausea medicine helped.
She wore a “cold cap” while getting chemo and never lost her hair, although she had prepared her children for that possibility. “We wanted them to know about side effects they might notice,” she said. “We told them if there were any noticeable effects, it wasn’t from cancer. It was the treatment. We said that if I lost my hair, it was a sign that treatment was working.”
After finishing chemo April 11, 2023, she was ready for the next hurdle: surgery.
The least invasive surgery
When she first met Turk, it was one more in a dizzying schedule of doctor’s appointments, tests and scans. “I felt like I was drowning and gasping for air and grasping for hope,” she said. But the two clicked immediately. “When I walked out, I thought: I can exhale,” she said. “He has a great bedside manner and cracks jokes at the right time to put you at ease.”
The Dicksons discovered that the church where they first met is the church Turk attends. Toward the end of their first appointment, the couple and their doctor prayed together. “My husband and I just looked at each other like, ‘This is where we're supposed to be.’” (Turk is also medical director of surgical oncology at Novant Health in the greater Charlotte region and adjunct assistant professor of surgery at the UNC School of Medicine.)
“Having the peace of God with you when you're walking this path is indescribable,” she added. “It really is the peace that surpasses all understanding. And when that peace is connected to your doctors, who are literally saving your life, it’s remarkable.”
When she saw Turk the second time, it was to discuss surgery.
Dr. Peter Turk was recently named the inaugural appointee of the Novant Health Catherine P. Bessant Endowed Chair - Breast Health.
Bessant, a civic leader, former Bank of America executive and former Turk patient, directed a $1 million gift from Bank of America to the Novant Health Presbyterian Medical Center Foundation. Her generosity established a fund to support cancer research; the purchase of state-of-the-art, lifesaving oncological equipment; and holistic care and outreach.
“I was a wreck,” Dickson said. When she was diagnosed, she and her husband had been contemplating a fourth baby. Nursing has been a big part of motherhood for her, and she was struggling with the thought of not being able to breastfeed. She told Turk she wanted the least invasive surgery with the greatest efficacy.
“He said, ‘Let’s do a lumpectomy,’ and my jaw hit the floor and my eyes started welling up,” she said. “I’m not even sure I spoke because I was so thrilled that he took our real lives, our hearts and our desires into consideration.”
She described her May 12, 2023, lumpectomy as “not too terrible.” A week and a half after surgery, she did a modified “Murph workout” that included 100 pullups and 200 pushups.
Since she’s not at high risk for recurrence, Dickson is a candidate for reconstruction. But she’s undecided. “We’ll wait to see if we’re blessed with a fourth baby,” she said. “We’re in the detox period of making sure all the drugs are out of my body. But, we're hopeful and prayerful for another.”
A new take on life
Turk said, “Cancer is transformative – for either good or bad. Shannon turned it into a positive. When someone gets a diagnosis of Stage 3 cancer, they’re suddenly face-to-face with their own mortality.”
Despite all the uncertainty, Dickson found several silver linings. “Cancer changed our marriage, the way we parent, the way we love our community – all for the better,” she said. “We had so much help from our village. Everyone rallied around us.” Dickson’s parents live in Blythewood, South Carolina – just outside Columbia – and they’d come up and stay for a few days after their daughter’s chemo infusions.
The grandparents had a profound effect on their daughter and grandchildren.
“When we talk about the last year, my kids talk about their grandparents being here with them often,” Dickson said. “There were lots of family naps and family movie nights. They don’t understand the magnitude of what we went through, but I hope one day, they’ll look back and think their mom took on her own ‘hard thing.’ I walked up that mountain – and they were right there with me.”
Her health care team accompanied her on that trek, too. And they kept the long game in mind – as well as considering every way possible to minimize cancer-related disruptions to Dickson and her family.
“Our ultimate goal is to cure patients,” Turk said. “But we also want to limit the extent to which treatment impacts their lives. It can be difficult for patients to squeeze in all their appointments. If we can eliminate some, we will.”
Despite initial concerns, Shannon Dickson opted for a clinical trial
(She’s glad she did.)
Shannon Dickson’s husband, Michael, joined his wife for her first meeting with a member of her care team – and most subsequent ones.
“My sweet husband had a million questions for Vicki, my nurse navigator,” Dickson said. “She told us she was recommending Dr. Lance Lassiter to be my oncologist for Michael’s sake. She said he was thorough and patient and would answer all of Michael’s and my questions. And he was everything she said. He came to all our appointments with a big notebook and would say to Michael: ‘Go ahead; ask me anything.’”
Dickson worked with Lassiter, of Novant Health Cancer Institute - Ballantyne, to develop her treatment plan. Lassiter thought, because of her young age and the kind of cancer she had, she was a good candidate for a clinical trial Novant Health was part of.
The trial, which enrolled 2,156 participants nationwide, sought to confirm that patients treated with less intense chemo and radiation can still have the same outcomes as those treated with the standard regimen. The treatment would include a shortened course of chemo, followed by surgery, followed by radiation – plus the ongoing Herceptin treatment.
When Lassiter brought it up, the Dicksons’ first thought was: Absolutely not.
“Michael and I didn’t want to be part of an experiment,” Dickson said. “But when Dr. Lassiter told us more, it began to sound too good to be true. If I could have the same, or greater, success with a shorter course of treatment and fewer side effects, of course that’s what I’d want.”
But Michael had one more question for Lassiter. He asked, “Doctor, if this were your wife, how would you advise her?” Without hesitating, Lassiter said he’d want his wife to be part of the trial.
“That felt very comforting,” Dickson said. “This felt like a welcome and solid choice.”
The trial’s results haven’t been finalized, but Lassiter is optimistic about its findings. He thinks it could lead to a new standard of care that’s less burdensome for patients than the current standard.
