
Every year, Deb Shapiro and her daughter, Daryl West, travel around the world together to go sea kayaking—British Columbia, the Bahamas, Roatán.
In 2022, they embarked on a very different mother-daughter adventure: breast cancer treatment.
“When Daryl got her diagnosis, it was quite shocking. I was like, this can’t be Daryl’s pathology report. And then 100 days later, just in a routine mammogram, I’m diagnosed,” says Shapiro, who lives in Bristol. “We had no breast cancer history in our family.”
West, of Cranston, was diagnosed with invasive ductal carcinoma and referred to Theresa Graves, MD, clinical director of the Breast Center and Multidisciplinary Clinic at the Brown University Health Cancer Institute.

Right away, West felt cared for and heard. “That first visit is a whirlwind,” she says. But with her entire care team and all of her appointments in one place, “everyone talks to each other. … You’re not having to repeat yourself.” She adds, “I felt really comfortable being there.”
Shapiro received her diagnosis of invasive lobular carcinoma at Mass General Brigham, where she was still a primary care patient after years of living in Boston. During a follow-up at Dana-Farber, she told the medical oncologist her daughter’s story. “And he said, Deb, Stephanie Graff [MD] runs a great shop in Rhode Island,” Shapiro says. Graff, the director of breast oncology for the Brown University Health Cancer Institute, was West’s oncologist. The implication was, why drive to Boston when she could get world-class care close to home?
“If Daryl wasn’t diagnosed first, I would have never known that this care existed in Rhode Island,” Shapiro says. Not long after they had both recovered, she asked herself, “How do we get that word out?”
Shapiro and West had learned that some of their physicians shared their love of kayaking, including Graff and Graves, their surgical oncologist. West says as they brainstormed fundraisers, they noted there were few paddling-related events, “so we thought, this was something that was specific to us.” They brought the idea to Graves, who replied, “I’m in. Let’s do it.”
Paddle for Progress RI, an annual two-mile paddle in Wickford Harbor, launched in 2023 and raised $35,000, and then almost $65,000 last year. Buoyed by their success, they’ve set a fundraising goal of $100,000 for this year’s event, which takes place Sept. 21. All funds raised go toward research and patient care; Shapiro and West rely on in-kind sponsors for food and swag, and pay any other expenses themselves.
“It’s important for Rhode Islanders to know that all funds that are raised are kept in Rhode Island, and 100 percent goes to the breast cancer research conducted at Brown University, which will affect patients here and globally,” says Graves, an associate professor of surgery and the director of the Center for Breast Care at Brown Surgical Associates.
Rhode Island has the highest breast cancer incidence rate in the US, and one of the highest screening rates. But Graff, an associate professor of medicine and member of the Legorreta Cancer Center’s Cancer Therapeutics Program, notes with frustration the state’s “disproportionately high mortality rate—which is one of the reasons that events like Paddle for Progress can be so powerful, is that they can help us do research locally that then has impact on not only the state, but the country.” Trying to understand Rhode Island’s “unique” cancer risk is a rich area for research, she adds.
Graff and her colleagues are leading or participating in several national clinical trials of new therapies, and others seeking to decrease side effects and toxicity. “We have a wide breadth of research across different stages and subtypes of breast cancer that’s both trying to improve the standard of care so that patients are more likely to live, or live longer, with a diagnosis of their breast cancer, and that make the treatments safer and more tolerable and more personalized for the patient,” she says.

This year, like every year, Graves, Graff, and many of their colleagues at the Multidisciplinary Clinic will be paddling with Shapiro, West, and a growing flotilla of breast cancer survivors, family members, and friends. “Theresa and I both are dressed to the nines most of the time in clinic,” Graff says, and patients are “amazed” to see them wearing kayaking gear. “Being out on the water and paddling up to patients and their families that I hadn’t seen in a while, just the general spirit … was so enthusiastic and friendly,” she adds.
Shapiro says Paddle for Progress aims not only to raise funds for and awareness about the breast cancer care and research happening locally, but also to encourage people to get regular screening. West, who was diagnosed at age 40 after a routine mammogram, says many people with no family history are told to start screening when they’re 45, “which is crazy to me. If I hadn’t gone, I wouldn’t even be 45 right now. I’d probably be dead.”
“Clearly screening mammograms annually, particularly starting at 40, will allow for an improved survival in our patients,” says Graves, who’s had many patients around West’s age. The clinic also offers genetic testing to all patients, which informs their treatment, including medication and surgical options. “The five-year survival for breast cancer patients is more than 90 percent, which is amazing and reflects early detection and advances in care,” she says.
“It’s not a death sentence anymore,” West says. “When I got diagnosed, I was thinking, I probably have a couple of years in me. And to just see the word curative, it’s kind of crazy. So I want other people [to] have hope that there’s something around the corner that can change this.”
The third annual Paddle for Progress RI will take place Sunday, Sept. 21, in Wickford Harbor, North Kingstown, RI. To register for the event or to donate, visit https://paddleforprogressri.org. The Kayak Centre is a key supporter of the event; for information on becoming a sponsor, contact info@paddleforprogressri.org.