Carol Ann Cole was photographed in Thunder Bay speaking at a breast-cancer awareness luncheon in October 2007. She raised her arm in the air as she told the audience she was close to be being a 16-year cancer survivor – but soon thereafter was diagnosed with breast cancer for a second time.

Carol Ann Cole calls it “one of the darkest days of my life.”
It was the day she lost a breast to cancer. More than a year later, she says it’s “one thing I still find depressing.”
It wasn’t Cole’s first encounter with the Big C. In fact, her first battle with it, in 1992, was the impetus for her Comfort Heart campaign – selling pewter hearts with a distinctive thumbprint in the centre, intended for rubbing to relieve stress or anxiety, to raise money for cancer research. The project has raised more than $1-million so far and won her the Order of Canada.
That time, a lumpectomy to remove the tumour, followed by a preventive course of radiation, left her cancer-free. But more than a decade and a half later, just days shy of her 16th cancer-free anniversary, she faced the diagnosis again. And, this time was more difficult.
“For 16 years I had been cancer-free. When I had the lumpectomy, they called it a ‘simple lumpectomy.’ At the time I thought that was an oxymoron – there’s nothing ‘simple’ about it. But, this time, I realized how simple that earlier surgery really had been. I didn’t even have an indentation where the scar had been.”
This time the scar went from the centre of her chest to the underarm, “a scar,” she says, “where a breast is supposed to be, where a breast once was.”
Cole, 63, has chronicled her second breast-cancer experience, along with stories of other women, in her third book –  If I Knew Then What I Know Now – The Clarity that Comes with Cancer and Age – hitting store shelves this month. In the chapter titled “The Fitting,” she describes in detail the difficult process of being fitted for a prosthesis. And in a later chapter, “Sarah, Amoena and Me,” the story of a friend also battling a recurrence of the cancer, she describes the delight of rediscovering “sexy lingerie,” and finally feeling truly feminine once again.
While Cole opted for a prosthesis, there are various options for women post-mastectomy, including reconstructive surgery.
In her book, Cole talks about dealing with the depression that came with her most recent cancer experience. But writing has been a way for her to deal with those emotions and she hopes inspirational for others, going through it.
“Journalling the struggle of my recurrence from the beginning has been therapeutic and I am hopeful it will help others,” she says in the introduction to the book. “Those who have been challenged by any life-threatening disease and those who simply see a bit of themselves
in my story will relate to life’s ups and downs.”
Cole is doing more than writing about the cancer experience. This fall, she is a spokesperson for a new campaign by the Willow Breast Cancer Support Canada, a national not-for-profit organization that offers support services, to establish an awareness day for metastatic breast cancer. The phrases refers to cancer that has spread to other areas of  the body.
This is a group of women with unique needs and an area that has been under-served in the public domain and even in the medical community, says Danielle Keystone-Adler, director of communications with Willow. “These women are not looking for a cure, but for a better quality of life for as long as possible.”
The goal is to have Oct. 13 designated as Metastatic Breast Cancer Awareness Day. It’s a date already in use in other places, including the state of Maine and U.S. cities of New York, Chicago and Philadelphia, Keystone-Adler says. This year’s campaign is designed to create awareness and set the stage for the first designated day in 2010.