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A Lonely Battle

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By Nicola M. White and Lorie Jewell

Published: October 20, 2007

HOLIDAY - She lay on the couch, wiped out after another chemo treatment, sucking on a cherry Popsicle to calm her churning stomach.

Her 2-year-old son nudged her arm, asking her to read him a story.

Michelle Bradley-Carley shifted between her two worlds. In one, she muses about scoring tickets to concerts and potty-training her son, Ashton.

In the other, she wonders how he would behave at her funeral.

A year ago, Michelle, now 35, found a lump in her left breast. It was Stage 3 breast cancer, the worst kind. All of a sudden, she became a newlywed and young mother dealing with a complicated, potentially fatal disease.

She felt alone.

Michelle is one of a relatively small number of young breast cancer patients. Not only do younger women usually face a more aggressive form of the disease, they also have to confront it while raising children and building careers.

When you're a young mom, nauseous and exhausted after a round of chemotherapy, how do you tell your toddler you can't get down on the floor to play? How do you explain that one day you have breasts and that the next, the doctor will cut them off?

While Michelle recovered last month from her double mastectomy, she was forbidden from picking up anything more than 10 pounds. Ashton weighed 34.

"I can't stop being a mom because I have surgery," she said.

Last October, Michelle's life was starting to come together. She and her husband, Tom, a critical care nurse at Community Hospital in New Port Richey, had been married for five months. They were living in a ranch home on a half-moon shaped street in Holiday with two cars in the driveway. Their son was almost two years old.

Having finished a business program at Eckerd College, Michelle had realized her true passion was health care and enrolled in the accelerated nursing program at the University of South Florida's Clearwater campus.

She was headed for good things.

Everything changed after she found the lump. She had reason to worry: Her grandmother and two aunts had suffered through breast cancer, and one of her aunts had died from the disease.

Michelle dealt with the physical pain but wasn't prepared for the emotional havoc.

She was steeped in guilt. Newlyweds don't expect cancer or the financial strain of living on one income while going to school and scraping together medical co-payments. Until a student loan refund check rolled in at Christmas, Michelle wasn't sure they could afford presents.

She had trouble finding others to whom she could relate. As part of the hands-on training for her nursing program, she had worked the oncology floor at Mease Countryside Hospital in Safety Harbor. The breast cancer patients there were all older. Everyone she talked to was retired or had grandchildren.

One day this summer, she attended the funeral of a 40-year-old friend. While watching the woman's children, she wondered how Ashton and Tom would handle her death.

"They only gave me a 50 percent chance to live. If chemo doesn't work, I'm pretty much dead," she said.

One in 233 women younger than 40 is at risk of being diagnosed with breast cancer. The rate climbs to one in 38 after 50 and one in 27 after 60, according to the National Cancer Institute.

Young women usually deal with a more aggressive form of breast cancer, and their survival rate is lower, experts say. For breast cancer patients younger than 40, the five-year survival rate is 82 percent, compared with 89 percent for older women, according to the Young Survival Coalition, a support group based in New York City.

Detecting breast cancer in younger women also is tougher and often happens at a later stage.

Mammograms, typically the best way to detect cancer, are not as reliable in testing pre-menopausal women. Older women's breasts have a higher fat content that provides a sharp contrast to cancer cells when a doctor is reading a mammogram. Christine Laronga, a surgical oncologist at the H. Lee Moffitt Cancer Center in Tampa, compares looking for breast cancer in pre-menopausal women to "looking for a snowball in a front yard filled with snow."

A sonogram or MRI is more reliable, though women often have to push for such tests because some doctors think pre-menopausal women are too young for breast cancer.

Anna Cluxton was diagnosed with breast cancer at 32, six days after she got back from her honeymoon. She went to a local breast cancer support group in her hometown of Columbus, Ohio, and was the youngest woman there by far.

"They want to go play golf and talk about how can they spend more time with their grandkids and I was like, 'Oh, I don't even know if I can have kids,'" she said.

When she finished her chemotherapy treatments - Cluxton is now six years cancer-free - she discovered the Young Survival Coalition's Web site.

The organization recognizes that young breast cancer patients are a small but significant group facing different challenges from older women, such as dating, raising children and getting pregnant.

Cluxton and her husband signed up for the organization's annual conference. She went the next year and soon after became a board member.

"We really felt like, OK, this is it. This is where I can get some answers," she said.

The week before Michelle's double mastectomy, she and her mom, Marlene Bradley, went to her plastic surgeon's office in Palm Harbor to talk about what to expect during the surgery and recovery.

Michelle had other things on her mind, though: a final exam in her medical-surgical course. This was her toughest class to date, and she wanted the appointment over so she could go home and cram. Studying was harder with cancer because of what Michelle called "chemo brain."

Then a woman walked in wearing pink scrubs and a pixie haircut - much like the short spikes that had grown back on Michelle's head after chemo made her hair fall out.

After recognizing Rene McIntyre, 31, a surgical technologist, as a fellow survivor, Michelle's tough-guy demeanor disappeared. She dropped the talk about studying and told McIntyre about her heart arrhythmia and her oncologist's concerns about the cancer spreading to her bones. Between school and Ashton, Michelle said, she was just plain stressed and exhausted.

McIntyre could relate. She, too, was a mom who had had to tell a young boy about big changes in his mother's life.

"He asked me things like, 'Are you gonna die?'" McIntyre said. "We had some pretty deep conversations for a 4-year-old."

Michelle tried to keep things as normal as possible in the days leading up to her surgery. She made eggplant parmigiana and her famous greasy spaghetti for a big family dinner the night before.

She watched "Disturbia" on DVD, made out a living will and picked up 12-hour Superstay lipstick at the drugstore so she'd look good throughout the next day's surgery.

"I watched 'Why I Wore Lipstick to My Mastectomy' on Lifetime," she said the following day, strapped into a gurney at Morton Plant Hospital as she prepared for pre-op tests. Her lips were a subtle plum.>

She winced as nurses inserted needles into her nipples and tried to crack jokes about getting a new, better set of breasts after the surgery.

As the nurse wheeled Michelle off to surgery, Tom leaned in and kissed her cheek.

"Well, the party's beginning, baby," he said.

Many moons ago, when the chemotherapy threatened to bedevil her brain and sabotage her studies, Michelle posted a to-do list on her refrigerator, detailing tests, school assignments and daily chores.

Her first priority wasn't on the list, though.

No amount of chemo brain could make her forget:

Live.

Photographer Chris Urso contributed to this report. Reporter Nicola M. White can be reached at (813) 779-4613 or nwhite1@tampatrib.com. Keyword: Michelle, to watch an interview with Michelle and a narrated slideshow about her.

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