It's those milestones mothers look forward to in their children from birth to age - 12 months - the day their baby grasps objects, crawls, walks and talks.  While 40-year-old Shantell Cox-Hutchinson's life may not be as simplistic, she too looks forward to hitting a number of milestones in her life as she survives cancer.

Diagnosed with stage four breast cancer at age 34, Cox-Hutchinson has already made it through her first milestone.  She has survived more than five years without a relapse.  Now she is looking forward to hitting the rest of her markers and continuing to thrive cancer-free.  The one thing she does not want to do is forget.

"For a lot of women, once we've battled breast cancer, and it goes into remission, we forget.  We go into this mode and think we've fought it, we've won, I don't have to think about it again," says Cox-Hutchinson.  She does not want to be one of those women.  She also does not want other survivors to forget, especially as most people that battle breast cancer see it return within the first five years. So far she has surpassed her first marker with flying colors.  She describes herself as one of the lucky ones because when she was diagnosed, the cancer had spread to her bones.

"The survival rate for a stage four breast cancer diagnosis is like 10 percent in 10 years, so five years is one hump that I had to get through.  Now I have to wait for the next five years.  When I've hit the tenth year I can say oh yeah I've survived this, but it's a constant thing that I'm living with."

Knowing what her odds are makes her vigilant about her health.  While most people can ignore a pain for a couple of weeks, as a breast cancer survivor, Cox-Hutchinson knows she can't afford to do that.  For her and all other cancer survivors, that pain could mean the cancer returned.  To keep on top of her health, Cox-Hutchinson does mammograms once per year and has her blood checked every six months.  She does her PET/CT (positron emission tomography and computerized tomography) every other year, and always does a bone scan because the cancer was in her bones.

"Just as many people make healthy lifestyle choices and decide to eat vegetables, many survivors consciously decide not to dwell on having had cancer once they've gotten the initial all clear.  And that's not good, because they should all be aware that there will be things they need to be aware of in the future." Not every survivor is as vigilant as Cox-Hutchinson is.  Over the years she has met a number of survivors who, once they've been told their cancer is in remission, do not follow up with their checks.

"I met one woman for the first time who said to me 'I don't think about cancer.  I don't even want to think about cancer, that part of my life is over, done with and finished'.  Unfortunately for that young woman, the cancer came back.  And when it came back, it came back with a vengeance."

Since her diagnosis, Cox-Hutchinson has joined the Surgical Suite Sister Sister Breast Cancer Support Group, launched in September 2000 as a non-profit charitable group for women diagnosed with breast cancer.  She encourages other young women to join the fight, especially younger women, as more and more females in their early 20s and 30s are being diagnosed with the disease that can be deadly if not caught in time.

"It's the very rare woman that you come across who is willing to join the fight and say to the world, 'yes, I had breast cancer, yes, I have one breast or I have half a breast and I want to fight this fight.  I find that women -- and especially Bahamian women - we're still secretive.  Yes we've fought breast cancer, but we don't want anything to do with it anymore, or we think if we indulge in a conversation on breast cancer it will come back.  But it's going to come back regardless," says Cox-Hutchinson.

While she says they don't have to dwell on the topic every day, she says the one thing they should never do is forget.  They should always do follow-up blood checks, and have an annual mammogram as well as PET/CT, that allows physicians to pinpoint the location of cancer within the body.

"The young lady to whom it came back, if she'd talked about it... and I'm not saying if she talked about it, it wouldn't have come back, but you never know, by talking, she might have discovered it a little earlier.  I'm not saying she needed to stand on the mountaintop and scream 'I have breast cancer', but it's about learning, support and sharing."

Cox-Hutchinson says if people talk about breast cancer then they could probably help someone who may be experiencing the same pain that they are.
During her initial diagnosis and treatment she admitted she was not vocal.  As she hit milestones over the years, she developed a passion for being vocal on the issue because she saw too many young women die.  She also realized that most of the people speaking out were older survivors and not the younger generation.  She decided to take up the mantle.

"I realized if somebody didn't take up the mantle, nobody would.  I became vocal, because at age 34, no woman -- I don't care who she is, what economic background she comes from, what educational background she's had -- I don't care who she is, should not be faced with having to make a decision of keeping her breast or her life.  That is ridiculous.  I don't think any woman should be faced with that.  This year alone I've buried two friends, one at age 42, the other 38, both of whom were diagnosed at stage two.   The year before, I lost three friends.  My next friend I'm hoping she will not go through that because she's only 30, but her cancer has spread through her entire body.  Being vocal isn't easy, but someone has to carry on this fight."

She continued, "When I became a member of Sister Sister, the older women were the more vocal ones, and I couldn't honestly relate to a lot of them.  They were there for wonderful mother support, but I couldn't come to them and say the chemo is doing this, that or the next, because I couldn't relate.  I looked at them as mommy or grammy.  They were not the girl friend.   And chemo's reaction on a 30-year-old is totally different than on a 50-year-old, because the medication is different.  How do you go to grammy and say something ain't working here?  That was my plight.  And the younger women weren't talking like that, so one of the reasons I really became vocal was because I don't think any young woman should have to walk this journey.  But because we do, we need to be a little more open."
As the world celebrates Breast Cancer Awareness Month during October, the color pink is everywhere, which Cox-Hutchinson says she loves and appreciates.  But she hates when the thirty-first day rolls around, as everything pink is usually relegated to the closet and people forget.

"We forget the young woman who has been battling cancer.  We forget we have young women as young as age 27 having to decide if they should have a double mastectomy.  We forget the 34-year-old mother who has to make a choice between taking a certain medication, or whether she'd be able to take care of her children.  I love October because it's Breast Cancer Awareness Month, and everyone is wearing pink, everyone has on the band -- everyone is gung-ho.  Everyone wants to have the ribbons and stuff, but after October, the pinks go in the closet until the following October, and we forget."

Cox-Hutchinson doesn't want survivors and their supporters to forget.  She says everyone knows somebody who has had breast cancer, whether it was a family member or a friend.  And the number of women diagnosed with breast cancer in The Bahamas is high.  The members of Sister Sister have noticed the rise because of the 60 porthacaths (a medical appliance that connects a to a vein, through which drugs can be injected and blood samples drawn many times) the group has given out so far this year.

Sister Sister received $25,000 from the Susan G. Komen Race for the Cure and Marathon Bahamas, which was used to purchase 50 porthacaths at $500 a pop at the beginning of the year.  As of today, Cox-Hutchinson says Sister Sister has no more porthacaths, having given out an average of seven ports a month, keeping in mind that the porthacaths the organization purchased this year were supplemented with porthacaths that were left over from the previous year.

"Between January and today, we have given out about 60 porthacaths to women who can't afford to buy a port - and that's who we are know of.  That just goes to speak to the amount of women that are being diagnosed between stages one through four, and speaks to the five families per month that have been affected by breast cancer.  That is way too much.  And that's just the women that we encounter at Sister Sister.  That's not the women that see private doctors, or the ones that go away to the United States and have treatment and diagnosis done."

While Cox-Hutchinson encourages survivors not to forget, she wants men to realize that breast cancer is not just a female disease, and that men are also at risk for breast cancer. During her years as a member of Sister Sister, she says the group has known about one male diagnosed with breast cancer about three years ago.  At the time, he was in the last stages of the disease.  They haven't come across any men since, but she says even if men are diagnosed with breast cancer, they probably won't come out and say it.

"It's going to be awhile before we have men come out and say they have battled breast cancer, because women are not doing it and are still hiding," she says. If the fight for the cure is to be a success, Cox-Hutchinson says it has to start with education, as early detection is key.

"We need to educate our young girls starting from age 15, to do breast self-examination.  If they start examining their breasts at age 15, if something goes wrong, they would know their breasts so well, that the minute something goes wrong, when the smallest minute change takes place, they would recognize it and go to the doctor.  But if you don't, you won't know."

Cox-Hutchinson says at Sister Sister they know of an 11-year-old girl who presented with lumps in her breast.  The lumps were not cancerous.  "And we need to stop thinking of breast cancer as an October disease.  It's a year round, 24-7, seven days a week, 365 days a year disease," she says. As education is key, Cox-Hutchinson says the women of Sister Sister are always open to corporate Bahamas, inviting them to speak to their employees -- women and men -- because to fight breast cancer in The Bahamas early detection is needed.

A recent breast cancer study involving Bahamian women found that 25 percent of their relatives who participated in genetic testing had been found to have a genetic mutations.  The study results means that the women are at a high risk of developing breast cancer according to Dr. Judith Hurley, a breast cancer specialist at the University of Miami School of Medicine.

Health statistics show that 34 percent of Bahamian women diagnosed with breast cancer are 44 years old or younger, compared to 12 percent of American women under age 44. The average age of women with breast cancer in The Bahamas is 42 while the average age in the United States is 62.

Bahamian health officials currently use the American Cancer Society's screening recommendations, which call for screening at age 40.  Dr. Hurley told The Nassau Guardian that 28 percent of the women who have breast cancer are under the age of 40.  She says the screening guidelines currently in place are inadequate and new ones tailored specifically to the population of The Bahamas are needed. Breast cancer is the sixth leading cause of death of Bahamian women, according to health officials.

Click here to read more at The Nassau Guardian