Melissa Bell is a testament to resilience and dedication. Now living in Ranfurly, Central Otago, New Zealand, she manages her job and her advocacy all while continuing to manage her health. Diagnosed with Stage 3 breast cancer just before her 41st birthday, Melissa endured a mastectomy, chemotherapy, and radiation, followed by heart complications from treatment. Her battle against cancer and its side effects has fueled her advocacy for better patient care. Melissa’s involvement in breast cancer trials and cardiotoxicity research reflects her commitment to improving outcomes for others.
Tell us a little bit about yourself:
I am Melissa Bell, 52 years old. I am married to Nigel and have two adult children – Nico who is 23 and lives in Auckland and Max who is 22 and lives in Brisbane. I have lived in Dunedin most of my life, but relocated to Ranfurly in rural Central Otago in January last year. I am the Principal of the area school there. We have students from Year 1 through to Year 13.
Tell us more about your breast cancer diagnosis.
I was diagnosed just over 10 years ago, days before my 41st birthday. I never had a lump but had a small indentation in my chest. On diagnosis, I was Stage 3 and had multiple tumours including one that was 10cm. I was triple positive – ER+, PR+ and HER2+. It was not an early-stage diagnosis.
Can you tell us about the treatment you received for your breast cancer?
I started with a mastectomy and then commenced 12 rounds of chemotherapy. Following that I had 5 weeks of radiation treatment. It was there that I first experienced clinical trials as I participated in a small trial of the use of mepitel film during radiation treatment. This got me very interested in how treatment evolves to ensure the best outcomes for patients. After radiation, I started a year of trastuzumab (Herceptin) infusions. I experienced some damage to my heart during this phase of the treatment and was diagnosed with a low ejection fraction. I was put on medication and was fortunately able to complete my Herceptin treatment,
Were you told about the side effects of breast cancer treatments?
Yes, I was. I had incredible specialists and amazing nurses. I knew every possible side effect – which honestly gets a bit overwhelming. I think I had a good run though – I skipped a lot of the bad side effects, especially during chemo. I found radiation strangely relaxing. I never had a chemo delayed because of my blood count. That’s why I think I was a bit blindsided by the heart issues during Herceptin. I thought that the long list of side effects wouldn’t apply to me,
When were you diagnosed with Inappropriate Sinus Tachycardia and tell us a little bit more about this condition?
I was diagnosed with [inappropriate sinus] tachycardia about 6 years after cancer – which is frustrating as by then, I was discharged from Oncology and Breastcare. I know now that cancer patients can experience tachycardia many years after treatment – and to be honest, it wasn’t something that was really on my radar to look out for. I got diagnosed after driving to work one day and just feeling awful. I stopped at a chemist for a blood pressure check – they noted that my heart was racing and I was sent to the doctor immediately. My resting heart rate was sitting at around 120 beats per minute. I started tracking it and realised it was hitting 180 or 190 during exercise and was never going below 100.
I was referred to a cardiologist and for now, it is being managed with beta-blockers. This may not be the final solution and I know there are options to be considered but for now, the meds seem to be managing things well.
How has your condition of low ejection fraction and tachycardia affected your daily life and long-term health?
My long-term health is a bit of an unknown really. I am great right now, but I am careful to keep an eye on my heart rate and look for changes. I try not to be complacent. In terms of my daily life, I know one of the biggest survival factors for breast cancer is exercise. That is also one of the key things for heart health so I really work hard to prioritize exercise in my life. I also personally believe stress management is a factor – and that is always a work in progress for me!
How has your experience with cancer and its treatment influenced your advocacy work?
I have a real interest in cardiotoxicity of treatment and I get excited when I see trials in this area. In 2022 I was fortunate to win a scholarship to attend the San Antonio Breast Cancer Symposium and I selected cardiotoxicity as my special interest area. The challenges I have had really motivate me in my advocacy work. I know that in America, it is now becoming more common to have a cardiologist as part of a patient’s multidisciplinary team. It would be great to see that here one day. I have always fought for better monitoring of patients after treatment. I think there are a lot of health challenges that emerge from treatment, and many of us feel a bit unsupported as we try and understand and manage these.
What challenges do you face living in a rural area with your medical history, and how do you manage them?
I don’t think I would personally choose to live in a town without a hospital – for me, it just feels like insurance! I am lucky to have a medical centre here in the small town where we are based. I am also close enough to Dunedin that I can return for specialist appointments. I had to do that last year when the lymphodema in my arm flared up. Here I have the best of both worlds.
Quality of life is really important too – I live in a beautiful place, in a town with a real sense of community. I think that too is important for survivorship. I get to walk the trails and watch the light on the mountains, there is no traffic noise, and there is a real sense of peace.
What is your involvement with Breast Cancer Trials?
I am on the Consumer Advisory Panel or CAP, as we call it. I am one of two advocates from NZ in this group. We are very fortunate to help prioritize and shape clinical trials – and to promote them to our consumer networks.
Learn more about Breast Cancer and Heart Health at Breast Cancer Trials’ next free online Q&A on Wednesday 7 August from 5-6:30 pm (AEST). Link to register here.
