Cancer Takes its Toll on St. Pauls Woman, but Can’t Steal Her Joy for Life
Eleanor Scott Bell, 79, was born and raised in Lumberton, the capital of Robeson County in North Carolina.
One of her earliest memories is of picking tobacco to supplement the family income. They were a family of nine with a large extended family — part of the Lumbee Tribe of NC, "People of the Dark Water."
“My daddy was in construction. He did brickwork, but he let us work with the local farmers. I started when I was probably 9 years old standing up on a cinder block handing tobacco to my momma,” she said.
Her first full-time job, once she turned 18, was at a local linen supply company. She began working for Temptation Hosiery Mills in Lumberton — maker of L’eggs pantyhose and other Hanes products — after it opened in 1974. Her sister Carolyn worked at the large Converse factory in Lumberton, which had opened in a former B.F. Goodrich tire manufacturing facility in 1972 to make Chuck Taylor All-Star shoes and other sneaker styles.
In 1970, Eleanor Scott married Travis Bell, also a member of the Lumbee community. In 1977, the couple moved out of their single trailer in a Lumberton mobile home park and bought land and a double-wide further north in St. Pauls — a “Small Town with a Big Heart” located closer to the Fort Bragg U.S. Army base where Travis worked as a barber.
St. Pauls and Lumberton were part of the late 19th/early 20th-century textile boom that created mill communities across the Piedmont region of the state. The communities’ prosperity really took off in the 1940s when a big textile corporation purchased several area cotton mills. By 1953, North Carolina was a manufacturing powerhouse, leading the nation in hosiery production.
Textiles (including hosiery, clothing, and footwear) were woven into the fabric of many lives in the region. But beginning in the mid-1980s and through the 1990s production shifted to Latin America, China, and Southeast Asia — leaving thousands of workers, including in the Lumberton area, jobless. As noted in the Our State magazine article “Heart & Soles,” “if you grew up in the Piedmont in the half-century prior to the mid-’90s, chances are good that someone in your family — your grandfather or grandmother, your mom or dad, your aunts or uncles, your siblings or cousins — worked in a hosiery mill. These days it’s common to find mentions of Temptation Hosiery (bought by the Sara Lee Corporation, then closed in 1994), Kaiser Roth Mills, Converse (which closed their Lumberton plant in 2001), and other prominent factories of that era in The Robesonian newspaper obituary pages.
In 1980, at the age of 37, Eleanor Bell was forced to resign from Temptation for medical reasons. She had developed rheumatoid arthritis in her legs at around age 35 and stayed active — working and attending church on a regular basis — for as long as she could. But after undergoing surgery on her legs, her ankles then hips started “giving out.” She began using a walker, and one day fell and broke her knees. In 1999, she started using a wheelchair off and on to get around and in 2007, at age 64, became a full-time wheelchair user. Her church procured her a bed with a remote control that helps lift her up and out of the bed into her electric wheelchair each morning, which has allowed her to stay active.
In July 2021, she was faced with another life-changing challenge. A routine blood test at her annual physical revealed a dangerously low level of hemoglobin, prompting an urgent call from her doctor directing her to get to the hospital. Low hemoglobin means the body isn't getting enough oxygen and can indicate different kinds of anemia and/or cancer among other conditions. Hers was so low she was at risk of heart failure. After she received fluids, she was diagnosed with high blood pressure. Further testing at the hospital also revealed a tumor in her colon. Up to that point, Bell didn’t have any symptoms and was already past the recommended age for a screening colonoscopy (45 to 65). It was unexpected.
Once the doctors got her vital signs back on track, Bell was able to leave the hospital and get a referral to Gibson Cancer Center in Lumberton, a hematology and oncology clinic located within UNC Health Southeastern that, uniquely, is staffed by both Duke and UNC oncology providers. Duke Cancer Institute Hematology-Oncology Fellow Hannah Dzimitrowicz McManus, MD, diagnosed her with stage 4 colon cancer that had already begun spreading to her liver. McManus prescribed CapOx, a combination of capecitabine + oxaliplatin chemotherapies administered via both pills and monthly infusions, and took Bell off the blood pressure pills because it turned out her blood pressure was too low.
“My blood pressure said, ‘You don't have to think of me anymore.’ My husband takes my blood pressure and it’s always normal now. I don’t feel dizzy at all,” shared Bell in an interview last September. “I don't know what's going on in my body because I’m not having side effects from cancer that I hear other people talking about. What amazes me is how come I'm still able to eat and drink and I’m not nauseated or vomiting or nothing.” She continued, “A while ago I had some pork rinds, if you ever heard of that, and I can drink anything now with the (cancer) pills. I drink milkshakes, whatever I want. I don’t drink liquor or wine or none of that, I never have, but I love water. I drink a lot of water and I eat collards and my favorite is mashed potatoes. I can eat regular fish, like a good flounder. And we buy a seafood platter about every other week from the IGA (grocery store).”
Fortunately for Bell, she could access Duke-level cancer care 20 minutes from home. In the heat of summer, she said she would have refused to take her van (whose air conditioning was on the fritz) any further than that. Gibson, part of the Duke Cancer Network, offers comprehensive assessments/cancer diagnoses and multidisciplinary care, including infusion services, an on-site pharmacy, blood transfusions, bone marrow biopsy, radiation treatments, and access to clinical trials and support groups.
“Good people in my path”
Bell has only gratitude for her providers, family, friends, neighbors, and her God.
“I thank God for the doctors and the nurses, giving them wisdom and knowledge about how to help me, and I pray for them. I thank God they had the desire to become a doctor or nurse and to help people. And they’re kind. I know when I go down there (to Gibson), they do everything they can to help me,” she said. “And I thank God for that. He's put good people in my path to help me. I feel like I’m not worthy of all the help he sent… Overall I’m amazed at how God is taking care of me.”
Bell’s husband Travis regularly cooks her breakfast. The Fort Bragg barber with 55-plus years of celebrated service in this role now works part-time so he’s home more.
“You ain’t going to believe it. This morning I had grits, bacon, eggs, a biscuit, jelly, and coffee,” said Bell when she spoke to DCI last September (2022).
“He’s really involved, really devoted, and he’s her main caregiver,” said McManus. “Their whole lives are built around each other. So, it's been really special that they can navigate this together.”
The couple goes to church in Lumberton most Sundays and they like to grab dinner at a diner down the road after services.
He helps Bell get dressed “decent” before they go to church. Sometimes she’s asked him to assist with her pantyhose. Not so much anymore.
“He says, ‘Oh no’ when I ask. He has a time helping me get them on,” Bell laughed, explaining how she got used to wearing them every day when she worked at Temptation Hosiery and has been reluctant to give them up.
Bell is fortunate to be surrounded by a lot of love and support.
Her husband, her children, and her grandkids couldn’t be any closer and her neighbors, her church community, and her extended family are never far away.
Daughter Melody Bell Hernandez, who works at Southeastern Regional Medical Center, and her two daughters live with Bell. Bell's son Andy, a retired postal truck driver, and his wife, a nurse, live next door with their two boys. Both her daughter and daughter-in-law often cook for her.
A neighbor lady often provides tasty meals as well.
“She’ll load you down with any kind of food, whatever,” said Bell. “I really like lima beans. That’s what she brought this week, so I pigged out on them. I ate two bowls!”
Around Christmas 2022 Bell was hospitalized for a few days with bleeding from the tumor in her colon, which was quickly resolved.
In February 2023, Bell’s scans showed that metastases in her liver had grown. So, McManus switched her to a different chemotherapy regimen — FOLFIRI (5-FU + irinotecan). Both CapOx and FOLFIRI are standard first- or second-line regimens for metastatic colon cancer.
McManus had ordered next-generation molecular sequencing (NGS) tests of Bell’s tumor tissue early on to determine if her cancer cells carried any mutations that could potentially be targeted with newer, less toxic, drugs (known as targeted therapies) should the standard options stop working. (The testing was 100% covered by Medicare and private insurance.)
McManus was also able to receive clinical decision decision-making support from Duke Cancer Institute’s Molecular Tumor Board (MTB) once the test results came back.
Bell’s test results revealed that her tumor had a mutation in the KRAS G12C gene — a mutation most identified in lung cancer cells. Various treatment options were discussed by the MTB, including available drugs and current or forthcoming clinical trials. Just months before Bell’s colon cancer diagnosis in 2021, the FDA had granted accelerated approval of a drug (sotorasib) to treat locally advanced or metastatic non-small cell lung cancer driven by the KRAS G12C mutation. MTB co-leader John Strickler, MD, meanwhile, has been running clinical trials testing the efficacy of sotorasib in various KRAS G12C- mutated GI cancers, including colon cancer, both alone (as a monotherapy) and in combination with other drugs.
“I have appreciated the involvement of the Molecular Tumor Board. It’s kind of a check on whether you’re interpreting the NGS results to their fullest,” said McManus in an interview in February. At the time, she noted that Bell had been continuing to do “really well” on the latest chemo regimen.
“Eleanor really has remarkably few side effects from aggressive chemotherapy treatment and no clear symptoms from her cancer, which has been fantastic … fewer side effects or tolerance issues than a lot of young people on the same therapies, which is kind of mind-blowing,” said McManus. “She’s a very hearty person despite having the significant comorbidity of rheumatoid arthritis that went untreated and caused orthopedic deformities, having predated the availability of the newer biologic therapies.”
The next-generation molecular sequencing services were fully extended to Duke cancer patients at Gibson Cancer Center, along with four other Duke Cancer Network community care sites in 2022, with more to come, as part of DCI’s mission to expand equitable access to quality care and clinical research to traditionally underserved communities. Robeson County, where Lumberton is located, has a 26.6% poverty rate compared to 11.7% for Durham County where DCI’s main medical campus is located. (2020 U.S. Census)
Through its Community Outreach, Engagement, and Equity (COEE) program, DCI, with the community outreach and engagement teams from Wake Forest Baptist Comprehensive Cancer Center and UNC Lineberger Comprehensive Cancer Center, is also engaged in several initiatives to address the cancer-related health needs of American Indian communities specifically. The mission of the Southeastern American Indian Cancer Health Equity Partnership (SAICEP) is to address the stark disparities in cancer rates experienced by American Indian communities in North Carolina, including the Lumbee. (The Lumbee Tribe is concentrated in Robeson, Hoke, and Scotland Counties).
Bell, who said she hopes that the three medical institutions will continue to do everything they can to help her people, the Lumbee, has suffered multiple losses in her long life, beginning with her mother’s death when she was only 15, and her father’s death from heart disease when she was 32. She and her brother Terry are the only two of seven siblings left. Her brother William, a postal truck driver, was killed by a drunk driver in 1999 while on his route. Most recently two of her brothers succumbed to the coronavirus; Robert in 2020 and Larry in 2021. Both of her sisters, each of whom lived with her into old age and kept her company, are also gone; Edna died in 2007 and Carolyn in 2020. About five years ago her nephew passed away from stomach cancer right before his high school graduation. Her nephew’s wife succumbed to brain cancer last spring and her niece passed away unexpectedly last summer.
“There’s been a lot of tragedy in our family, but I have to give God credit for helping me cope with it,” she said. “I don’t let sadness control me. You know, I’m not isolated. And I don't like a dark room except when I'm going to sleep. But in the daytime, my shades are up so I can look outside if I’m not outside. I'm a people person. I love people. I love to talk on the phone and have people come and visit.”
Bell spoke of an older next-door neighbor lady who used to check in on her every day. “She would say, Granny, ‘How are you doing?’ and I would say, ‘Well I’m blessed. I’m happy. And she would say, ‘I don't see how in the world you can feel like that in the condition you’re in (referring to her use of a wheelchair),” shared Bell.
Bell learned to bite her tongue and to look for the good in people.
She said her four grandchildren kept her feeling young. “I can get down the ramp and roam around in the yard with my granddaughters and their little cars,” she said. “They love for me to go out. They say, ‘Grandma, let's go outside. And I know what they’re up to, they want to race, and sometimes my wheelchair can outrun them.”
“I pray and hope; I would love to be healed. But we never know what God’s purpose or plan is for us,” Bell reflected. “I told Dr. Hannah, I said, I'm not gonna leave this world until my appointed time comes — as the Bible says in Hebrews 9: 27 ‘And as it is appointed unto men once to die but after this the judgment.’ I'm not leaving planet Earth because of cancer. I will leave it because it'll be my appointment. I don't fear death because He's in control. I don't fret over it; it’s in His hands. I’m not losing any sleep. Matter of fact, I think I sleep better now than ever.”
“We're all destined to leave here one day; I just hope we’ll be ready to meet the Lord God. I know that in the end, I’m going to a better place than this,” Bell continued, laughing. “I don't want to go nowhere where it’s hotter than this. We’ve seen some days, girl, where I can hardly stand it.”
Bell had already survived more than 18 months after a stage 4 cancer diagnosis and lived well when in March 2023, she was hospitalized for a bloodstream infection and entered rehab for a month-long stay.
McManus saw her clinic on April 13 but had to send Bell back to the hospital for a suspected infection and she was once again admitted. On April 16, she was able to return home, much to her family's relief.
Given the recent complications, McManus and Bell discussed discontinuing cancer-directed therapy. A body can take only so much. They decided, instead, to focus on supportive/palliative care.
“She will continue to see me for now; she remains in good spirits," said McManus.
On April 25, as Bell finished a hearty lunch prepared by her daughter of beef, rice, squash, and her favorite, lima beans, plus a Coca-Cola, she again praised the Lord and expressed her gratitude for the "five people taking good care of me” including her family and “Dr. Hannah.”
Hannah Dzimitrowicz McManus, MD, is in her third and final year of fellowship, which ends in July. For her second and third years of fellowship, she’s had a full-day clinic once a week at Gibson Cancer Center in Lumberton. She has her own panel of patients with different types of cancer and is supervised by Melanie Thomas, MD. McManus sees patients with prostate and urologic cancers at Duke Cancer Center (DCI's main campus in Durham) and will join the Duke University School of Medicine GU faculty when her fellowship ends.
CIRCLE PHOTO (top right): Eleanor Scott Bell, 79, and her daughter Melody Bell Hernandez, 41, in a recent selfie.