♪ Welcome to This Week in South Carolina.

I'm Gavin Jackson, the month of October is not only recognized as Breast Cancer Awareness Month, but also Domestic Violence Awareness.

Both are serious issues facing South Carolinians.

And we'll talk with Associated Press reporter, Meg Kinnard about her fight against breast cancer, but first, Sara Barber.

She's the executive director for the South Carolina Coalition Against Domestic Violence and Sexual Assault.

Sara, thanks for joining us.

>> Thank you for having me.

>> So, new data was just released this month that found in 2019, South Carolina ranked sixth in the nation for women murdered at the hands of men.

This is based on analysis by the Violence Policy Center.

That was about 57 homicides, or a rate of 2.15 per 100,000.

Sara, what do you make of this data when we look at where South Carolina ranks at the hands of women dying by men?

>> I think unfortunately, it continues a pattern that we've pretty much seen over more than two decades now that the Violence Policy Center has collected that information.

Last year, we were ranked 11th, which was the first time that we've ever ranked out of the top 10.

And I think people may have been a little too quick to jump and say, "Look, we're getting better."

- whenever you look at statistical data, you have to look at what the pattern is, rather than what the outlier was.

And last year, unfortunately, seems like it was an outlier.

>> You're talking about that 2018 data versus the 2019 data.

And when we look at, I guess, 2020, I mean, that data is still being processed.

- maybe anecdotally, what can you look at over the past 18 months, especially with the impact of the pandemic, how that may have changed things, impacted, you know, reporting or any data that you've already seen anecdotally, in terms of what the pandemic did to domestic violence rates.

>> So, I think what we do know is that reporting rates, especially at the beginning of the pandemic went down.

- I think people were... they were dealing with everything that the rest of us were dealing with, - trying to figure out what's going on with our kids, trying to figure out toilet paper, trying to figure out grocery... so, at that point, domestic violence may not have been like the biggest thing that they were dealing with.

As the pandemic went on, - you're dealing with an individual crisis within a community health crisis.

And so we did see people reaching out for help, and costs to our member program started to increase.

- we saw a small rise in the number of incidents reported to law enforcement, even though we know that's sort of an undercount of the whole picture.

As far as homicide data at this point, we don't know, ...we know there's been a homicide spike in general, but we don't know specifically for South Carolina yet what that data is going to look like in terms of domestic violence homicides.

>> So, an under reporting, perhaps is what you're saying right now, in terms of the past year, especially, because of the pandemic, what do you want women to know - maybe, those who are in these situations to know what they can do, to reach out to do something if they feel trapped, especially when - everyone was so isolated during that pandemic, too during that time, when we were locked down, we were shut away from people who might notice things or pick up on different cues?

>> What we want people to know is that our member programs who provide wraparound services in every community across the state are open, and they are always going to be willing to help you.

Those hotlines are still open.

Some of the services may look a little different.

- you might not be taken into a shelter, but we will find safe accommodation for you.

Counseling, may be via Skype or another platform or via the telephone rather than in person.

But those programs are ready and waiting to help you.

And so we would encourage anyone who's experiencing this to reach out and ask for that help.

>> Sara, when we look at, you know, these situations, - it's always different depending on the situation, of course, but there's a lot of sometimes themes with these domestic violence situations, women sometimes become dependent on these men, husbands or significant others and...financially in some ways are dependent.

And most recently, we've seen such an uptick of women leaving the workforce because of the pandemic.

Do you fear that, that might create even more of a...situation here where women are stuck in these ...situations where there's this cycle of abuse?

>> I think that's certainly a concern.

We know that domestic violence correlates with levels of unemployment and hardship around financial situations.

So that is definitely, a concern.

But it also adds to the complexity of what domestic violence is.

Every situation is different.

- there are so many things involved, whether it be you don't want to leave because of your children.

You don't want to leave because you're scared that things will get worse if you do leave, which is true for many, for many women, or you may not want to leave because the violence isn't continuous.

There are good times within that relationship and this is someone you love.

It's such a complex issue.

- always, you know, now we're dealing with additional complexities on top of what we usually see.

<Gavin> I think I've heard you say before, that even if you do have a good financial situation, it is still difficult to leave, because there are so many things that go into that decision.

And it's not just, you just up and leave automatically there.

- there's a lot of decisions that have to go in place.

Can you elaborate on that for people who maybe say to others who may know someone in a situation like this, that, Oh, just leave, just get up and go?

I mean, what should people be doing when they hear that a friend or, you know, maybe a family member is in a situation like this, and what kind of advice they should give, instead of just saying, just leave, since that's such a easier said than done?

It seems like?

>> It's much easier said than done, I think for any of us to suddenly think about uprooting our lives.

- especially in the context of fear.

We have no idea.

We have no idea what we would do, because we're not in that situation.

It's easy to sort of call that when you're not facing it.

What we advise people to do is to listen, to listen without judgment, to offer to find resources, and most of all to believe what your friend or family member tells you.

They may not be ready to leave yet.

But if you have the resources ready, then you can help them maybe make that decision in the future.

<Gavin> I want to talk to you a little bit about a big report that just came out from The State newspaper.

They did an in depth report on police and domestic violence looking at over the past 10 years from 2010 to 2020.

At least 96 people tied to law enforcement agencies were accused of violence against current or former spouses.

Three officers were charged more than once in the decade for a total of 99 cases.

Have you seen that reporting?

And if so, what do you think needs to be done to mitigate these situations that are happening within those who are sworn to serve and protect us?

>> I have seen that reporting.

And I've also seen similar reporting coming out of other states and other countries.

It is an issue, you know, the police, we talk about how domestic violence crosses all sectors of our community.

And that is true for police forces too.

What - and it is especially terrifying for a victim who if we think of the police as being our first responders around domestic violence, who do you then turn to when you're calling on somebody who's an active officer.

What we would encourage law enforcement to do is to take these complaints seriously, and to do training with their, with their offices, and to take action, if they find that this is in fact happening in a relationship that one of their officers is currently in.

<Gavin> Training and take action.

So, it does seem like there has been some improvement with at least weeding out potential law enforcement personnel, when they go through training.

They do some surveys to kind of figure out who may be a potential offender.

It sounds like about 100 people have been weeded out over the past two years of that policy's been in place, but it still seems like more need to be done on a statewide level when it comes to law enforcement being involved in a personal level when it comes to domestic violence.

Are you guys going to be advocating for anything at the statewide level, this upcoming legislative session when it comes to maybe getting some policies in place for law enforcement?

>> I don't know if this is really a sort of legislative issue.

I think it's a policy implementation issue for all of our law enforcement agencies to come together and figure out something that's going to work and a way to hold people accountable, so that they are making sure that the families of their officers are safe.

>> - when we look at guns in these situations, obviously, it's the number one weapon used to kill women in these domestic violence situations.

I'm wondering when you look at some cases that have played out across the state and even that State newspaper article, it sounds like a lot of people are originally charged with domestic violence, but then they plead to a lesser assault and battery charge, which I don't know if that means that they won't have their firearms taken away.

Are prosecutors being tough enough when it comes to making sure people are, you know, facing the full extent of the law and having these weapons removed from the homes where they could be used to kill a person in the future?

>> I never think enough is being done around the issue of firearms and domestic violence.

We have a homicide rate that far exceeds comparable industrialized countries.

And that is solely due to the number of guns we have in this country.

Prosecuting cases is complicated, ...for the same reason that people don't always leave, people may not want to go through with the prosecution.

And so sometimes prosecutors are working on doing the best they can within that situation and trying to get help for that family, either through a plea or through a diversion program.

We also have an issue where even though we say that you can't have firearms, if you have a misdemeanor conviction for domestic violence, nobody is going to get those weapons.

Nobody's doing any checkups.

And so really, we have a law that doesn't have any teeth.

And those weapons remain in the home and sadly, sometimes are then used in a homicide situation.

>> Wow!

Definitely something to follow up there too.

We have less than a minute... Sara and I want to ask you just what are the warning signs people should be looking for and maybe even when it comes to teen dating violence, which is also a problem in the state?

>> I think it's also difficult there everything about this is complicated because oftentimes, the early part of a relationship when everything's fun and romantic sort of mimics the warning signs for domestic violence but if somebody's trying to control who you see, trying to keep you from your family, checking upon who you're texting or with on social media, I think those are definite warning signs that you should start to take notice of.

<Gavin> - just where can people find these resources website, in person on the phone.

>> Go to our website, SCCADVASA.org.

And on there, you'll see a map and you can click the county on and where you live, and it will bring up the contact information for the 24 hour hotline for both the domestic violence and sexual assault programs that serve your community.

>> Right.

Thank you, Sara Barber.

She's the South Carolina Coalition Against Domestic Violence and Sexual Assault Executive Director.

Thank you.

>> Thank you, Gavin.

>> Meg Kinnard is a politics reporter for the Associated Press.

She's based in Columbia, and she just beat breast cancer.

Meg, thanks for spending time with us to share your story and your journey, something that one in eight American women will face in their lifetime.

>> It is so good to be with you, Gavin.

Thanks for having me.

<Gavin> Meg, let's talk about your journey.

Talk about...the diagnosis, how it came to be, and how you got that treatment to save your life.

>> Back in February of this year, I was initially diagnosed with stage three invasive ductal carcinoma, that is known as the most common type of breast cancer.

- that's the original diagnosis I got after having several years of mammograms and monitoring that just didn't seem quite right.

But...I started chemotherapy at that point here in Columbia, and began my initial phases of treatment, but also decided at that point that since there had been several years of monitoring and knowing that something was going on, I also decided to seek a second opinion to make sure that, that diagnosis was precisely what was going on.

>> Meg, how did you determine this?

...was it self exam?

Was it something that you noticed over time, or, you know, you said you got mammograms, but nothing really kind of showed up, stood out?

How do people?

What should they be looking for?

What did you notice originally, I guess, >> Back in 2017, when I was 37 years old, so a bit younger than the recommended age of 40.

At that point, which is when women were supposed to begin mammograms.

I was doing a self exam and I noticed something that to me felt like a small pebble in my left breast.

I told my doctor about it and was referred for a mammogram at that point was told that this was something we could just monitor.

It was a very small area.

It could be hormonal, It could be a calcium deposit, something that just happens in our bodies and dissipates on its own.

My doctors continued to monitor that area for the next several years.

Things did grow and change, become painful at times, but I was still told that this was nothing that I really needed to worry about.

Given that, that had been the circumstance, by the time I finally did get to a biopsy in February and received my initial diagnosis, given that, that had been the circumstance, my husband Jeffrey and I decided that it really was important for us to seek a second opinion.

We were hoping that asking a different set of doctors to review my information would yield the same thing.

That this would be a very common type of cancer, you know, very treatable, curable, all those good words that we want to hear when we receive bad medical information.

But we just basically would confirm what we had already heard.

We decided to go to MD Anderson Cancer Center in Houston, Texas at the University of Texas Medical Center, which is the leading cancer center in the United States to seek that second opinion.

So in March, actually, I got a corrected diagnosis of inflammatory breast cancer, which is not the most common type.

It's actually one of the most rare types of breast cancer affecting under 3%, I believe of breast cancer cases.

So it wasn't until that next month that I really figured out that I had something different.

So, we had to come up with a different plan of attack.

>> And like we said, you just...tackled this cancer.

You fought it for the past several months.

Do you feel like things would have been different, if you got a second opinion earlier on in this whole process?

Talking about back when you were 37?

Maybe if you're 38, 39?

How things maybe could have changed?

I know you don't want to live in the past.

You live in the now.

But what do you think when you look back at those days?

>> Absolutely.

It is imperative particularly with inflammatory breast cancer, but with any breast cancer overall, or any cancer for that matter, to attack things as early as possible.

So, the earlier the better in terms of knowing exactly the enemy that you're going up against.

Had I known several years earlier that there was a possibility that I was dealing with inflammatory breast cancer, then it is likely that, that cancer would not have spread as much throughout my skin.

That's the way that inflammatory breast cancer works.

It's not necessarily or even ever, sometimes a tumor like we think of a round object that's within our breast that can be surgically removed.

Inflammatory breast cancer affects the skin so it involves much more of an area that needs to be taken out, and that's part of the reason why sometimes it isn't detectable as readily on imaging, such as mammograms or ultrasounds.

So, if I'd gotten that information earlier, it is likely that there would have been the possibility of formulating a plan.

The good thing for me though, is when I was diagnosed initially, and then my corrected diagnosis, the first recommended course of treatment was the same.

So the type of chemotherapy that I was already on by the time I got to Houston was exactly what my doctors at MD Anderson recommended, I stay on and would have recommended in the first place.

So that was at least good news for me that I hadn't lost any time in between that first diagnosis and the second one, <Gavin> And you were just 40 years old, when you got this diagnosis, too.

How did your life change when you first got it to maybe how things are right now?

>> I'm certainly taking fewer things for granted these days.

You know, life moves very quickly in all of our lives are full of a variety of different things.

- it's easy, sometimes just for the simple things to kind of get lost in the shuffle.

But certainly, I think I have an appreciation not only just for the people around me, my children, my three children, my husband, Jeffery, my mother, my close friends, all of those things, and all of those people are imperative to me, and I'm appreciating them more and more.

But I'm also in this space, where I'm taking stock of the medical opportunities that I've had available to myself, I'm very fortunate that I was able not only to receive very good health care initially, but also to seek a second opinion to travel somewhere outside of my home area to go to a different hospital to seek advice from some of the top oncologists in the entire country and in the world.

That's not an opportunity that everybody has.

And so to have seen up close what is possible at a leading cancer center, like MD Anderson, I am now very, very well aware that very few people on the planet have that chance.

And so, for me, having had that experience having gone through what I've gone through, I'm now determined as much as I can to pay my opportunities forward and to try to find ways to make that a possibility for more people out there.

I know at this point, if I had not been able to harness that amazing opportunity to have that healthcare available, I wouldn't be here very likely or wouldn't have had such a good prognosis as I now have given the chemotherapy, the surgery, the radiation and the continuing treatments that I'm now having under the direction of MD Anderson.

Seeing all of those things play out in my life in real time, gives me an appreciation for what I have and also it gives me determination to try to make that possible for more people.

>> And Meg, I definitely want to talk about your experience with healthcare in America, specifically battling cancer.

But, let's talk about your prognosis and really the steps that had to be taken to get to where you are right now.

And you mentioned chemotherapy over the summer, and then kind of traces through, the remainder of your past few months and your battle with this cancer and what you had to do to get where you are right now.

>> At the end of those 16 rounds of chemotherapy, which was disbursed over 20 weeks, I was given the greenlight for surgery.

So in early August, my family and I went out to Texas.

So I could have a double mastectomy, as well as the removal of 64 lymph nodes and something called lymphovenous bypass which is essentially rerouting your lymphatic system into your venous system to hopefully avoid the kind of arm swelling that can accompany surgery, removing lymph nodes.

All of those things were possible to remove the tumorous cancer from my body.

It was a 12 hour surgery.

It was from what I've learned about as long as those typically go I didn't really know at the time it was going to be that lengthy, but it was successful and my surgeons were able to achieve clear margins, which is the technical term for removing all the cancer that they could possibly see and test in the skin surrounding the tumor area.

Following that, I had about four weeks of recuperation.

I also had a hematoma evacuation which is a technical term for a large mass of blood that accumulates under the skin.

Just one more surgery to add on to things that does happen sometimes.

But following that I had 44 rounds of radiation.

So, that was twice a day for 22 treatment days.

That's a protocol recommended by MD Anderson specific to inflammatory breast cancer cases.

It was very rigorous.

It targeted not only the area that was involved in surgery, but also my supraclavicular area on the left hand side where there were still tumorous lymph nodes that were too risky to remove during surgery.

So, they were treated with curative radiation.

And that was a very arduous process going in twice a day, feeling, feeling pretty crispy, still am.

The effects from that go for about two weeks after the last treatment.

So, I have about a week to go before my skin really begins to heal.

But that was the end of my active treatment at MD Anderson.

And the day after I got my final treatment, I came on home.

I didn't come home, though, before being admitted into a clinical trial for immunotherapy, which is a new class of drugs that is used to treat some types of cancer already, but it's not FDA approved for inflammatory breast cancer cases such as mine.

So, for the next few years, I will continue to go to Houston every three weeks to receive IV transfusion of a medicine that hopefully will train my immune system to stave off any future recurrence of cancer.

In any cancer, that's a possibility.

But for inflammatory breast cancer, the chances are high, particularly in the first two years post treatment.

So, for those next two years, I'm fortunate enough to be able to avail myself of that possibility.

And then depending on the results of the study, it could become approved for more patients throughout the country in the world.

So, that's pretty exciting for me, too.

<Gavin> Yeah.

That's wonderful news to hear, especially when you're talking about that recurrence rate, which we obviously don't want to think about.

But that's always a reality when it comes to cancer.

Meg, we have about two minutes left, I want to ask you just what you've learned over these past few months with dealing with health care, with dealing with the medical field and having to deal with cancer and diagnosis and traveling across the country to get treatment.

What have you learned?

This is something that we didn't expect you'd to be dealing with a year ago and then here you are going through the ringer of it.

What's your takeaway?

>> My big takeaway, in addition to what I mentioned earlier about how a lot of these opportunities just aren't possible for all people.

And that's something that I feel, as a society should be looking to really change.

A big takeaway for me personally, is that anything is possible for an amount of time.

It was very difficult to be away from my family, my children, in particular, for almost three months to be outside my comfort zone, to be away from the people, mostly that are so dear to me.

But, knowing why I was there that I was in Texas to literally be fighting for my life and to be receiving top notch care.

My only job while I was there.

I did do some recording, it's true, the Associated Press has been wonderful to give me that flexibility.

But my primary job was just to take care of myself and to do what I needed to do for my treatment.

And so knowing that, knowing why I was there that I was there temporarily so I could come home to my family more permanently and for a longer time.

That helped me mentally get through it.

It was difficult.

But we are all able to get through things, keeping perspective at the forefront of exactly why we've been given these challenges.

And so that's really what helped me get through it.

>> Some good advice there, too.

Do you have any more advice maybe for women who are thinking maybe I should get examined or what they should do if they just got initial diagnosis of breast cancer at this point.

Any advice that you'd like to give or miss you'd like to dispel ever since this journey you've been on?

>> The biggest thing is to continue to advocate for yourself.

Nobody knows your body better than you do.

If you take a bit of information to your doctor and feel that you've been dismissed, go talk to another doctor that is very possible.

Don't be afraid of stepping on anyone's toes or making them feel uncomfortable or saying oh, I should just trust whatever my doctors have told me.

I have utmost respect for the medical profession.

I'm the child of two doctors myself, and there are many other physicians in my family.

So I'm not saying to distrust everybody, but nobody knows you better than you.

So, absolutely advocate for yourself.

Push for answers.

If you get one, it doesn't sound right, push for a different one.

And honestly, nobody can keep along this path more directly than you yourself can.

So, don't stop until you really feel that you have the actual problem in front of you.

And that you can then come up with a plan to fight it.

>> Meg, really quickly, we were both down in Charleston this week to see the First Lady of the United States, - Excuse me, who was touring the Hollings Cancer Center there at MUSC.

What were some big takeaways that you heard from her during that visit?

>> One of the big things that the First Lady talked about is clearly something that we've seen playing out is that cancer affects every American family.

It has clearly affected her family in the form of the death of her son, Beau, as well as she mentioned several close friends of hers through the years, all of whom ended up with breast cancer, particularly.

So, this is something that we may think happens only to other people, but it doesn't.

It's right here in front of us.

And in her visit, the First Lady said that she was determined to continue to use her platform and her profile to call for further cancer research, pushing toward a cure, trying to figure out ways to eradicate this from our society and to find better ways to treat people and showing her determination at the Cancer Center here in the United States at MUSC was part of how she's doing that and drawing attention, particularly during October, which as we all know is Breast Cancer Awareness Month.

So, it sounds that she's going to be continuing to beat that drum, perhaps as we see her visit other locations, like MUSC, across the country.

<Gavin> Gotcha.

We'll leave it there.

That's Meg Kinnard.

She's an AP reporter political reporter for the Associated Press here in Columbia and she's a breast cancer survivor.

Meg, congratulations again and thank you for sharing your story with us.

>> Thank you, Gavin.

It's always good to be with you.

>> Stay up to date with the latest news throughout the week.

Check out the South Carolina Lede.

It's a podcast that I host, twice a week and you can find on South Carolina public radio.org or wherever you find podcasts.

For South Carolina ETV, I'm Gavin Jackson, Be well, South Carolina.

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