NEW YORK -- The waiting room of the St. Vincents Comprehensive
Cancer Center overflowed with patients. With its soft, warm
lighting and sunny yellow and gray decor, it could have easily been
mistaken for the reception area of any office building. But the
hushed, reverent atmosphere of the room had already revealed the
somber mood of the patients as they waited for their examinations.
Most were women with breast cancer. The youngest, Asha
Clayton-Neiderman, was just 24.
Every year breast cancer is diagnosed in 180,000 women,
according to the American Cancer Society. Cases of breast cancer in
women in their 20s are still uncommon; of the 180,000 women, only
1,400, or .8 percent, fall between the ages of 20 and 30 and the
breast cancer rate for women between the ages of 20 and 24 is only
one case in 100,000. But the numbers have been increasing.
A 1999 Breast Cancer Facts and Figures report recently released
by the American Cancer Society said that the number of women under
the age of 40 with breast cancer had been on the rise in the late
1980s and early 1990s.
Dr. Paula Klein, Clayton-Neiderman's oncologist at the St.
Vincents Comprehensive Cancer Center, said she has seen a definite
increase in the number of cases of breast cancer in younger women
in the last few years. ``We're not sure why it's happening,'' she
said, ``but we have definitely seen a rise in the number of young
breast cancer patients we're picking up.''
Dr. Klein also said that the lack of awareness among young women
was a dangerous problem that could lead to late diagnosis.
``It is very dramatic for someone Asha's age to have breast
cancer,'' Dr. Klein said of Clayton-Neiderman. ``But many young
women aren't as tuned in to this as they should be. No one ever
includes women in their 20s when discussing breast cancer victims
so they never hear about it.''
In general, women in their 20s are not at a high risk for
developing breast cancer unless they have certain risk factors in
their medical history. For patients such as Clayton-Neiderman, a
family history of cancer was probably a key factor. Her paternal
grandmother's cancer was diagnosed at the age of 81; her paternal
aunt's diagnosis came at the age of 30. Tests will be conducted to
determine whether Clayton-Neiderman carries the gene for breast
cancer. If so, she faces the risk of developing ovarian cancer as
well.
``Since ovarian cancer is harder to detect than breast cancer,
if I have the gene,'' Clayton-Neiderman said, the doctors ``will
want to remove my ovaries just to be safe. I always imagined a life
for myself with lots of children but now I kind of can't plan
anymore. Things I want have changed.''
Clayton-Neiderman first discovered a lump in her left breast
when conducting a routine self-examination in May 1999. Ever the
optimist, she refused to believe that anything was wrong. Assuming
that the abnormality was a routine cyst, Clayton-Neiderman put off
her visit to the doctor despite her family history of breast
cancer. After repeated urging by her mother, Clayton-Neiderman went
in for a mammogram only to be told that the breast tissue was too
dense and nothing could be seen. Doctors recommended an ultrasound
of her left breast. In November, she underwent the test with little
concern only to discover that the results were not good.
``They came in and said, `Asha, it's cancerous,''' she recalled.
``It didn't register at all. I grabbed my head and just started
crying. I did that for about 10 seconds before I collected myself.
And then I realized that there was nothing I could do about it so
crying wasn't going to help.''
Instead of tears, Clayton-Neiderman threw a hair-cutting party.
``I knew I was going to lose my hair and be self-conscious,'' she
said. ``I was losing control so the party was a way to get it back.
I wanted my friends to be involved in the process.''
Friends gathered at her Manhattan apartment in early January,
armed with pink ribbons and shears to crop Clayton-Neiderman's
long, black hair. The pink ribbons, symbolic of breast cancer
awareness, were tied to locks of her hair before they were cut off
by each of her friends. The guests were given a lock after the
party as a reminder of how Clayton-Neiderman looked before the
chemotherapy had a chance to ravage her body, as well as a symbol
of awareness.
``Everyone Asha talks to, she leaves an impact on,'' said Dr.
Klein. ``More and more young women are hearing about this through
family and friends that have gone through or are going through the
experience. Awareness is the key.''
After the diagnosis, Clayton-Neiderman became determined to get
the word out on breast cancer. And the word is spreading. Recently
a high school friend of Clayton-Neiderman's, Tony Texeira,
organized a fund-raiser in her hometown, Boston. Four hundred
guests donated money in Clayton-Neiderman's name to the American
Cancer Society. An estimated $10,000 was raised at the event, an
amount that went beyond Clayton-Neiderman's expectations and
bolstered her spirits.
Her present and future are now scheduled around her medical
treatments. She will undergo four treatments of chemotherapy, once
every three weeks, followed by radiation therapy every day for two
months. For the next five years, she will have to take the
prescription drug Tamoxofin every day. Even with the treatment,
there is a high chance of the cancerous tumor returning.
``Tumors tend to be more aggressive in younger patients and
they've got a long time in which it can come back,'' Dr. Klein
explained. ``In Asha's case, she has a very aggressive looking
tumor.''
Still, Clayton-Neiderman has maintained a sense of humor.
``So many people were calling me to see how I was that my friend
Liz and I came up with a new answering machine message,'' she
recalled, laughing. ``If you want to know what happened to Asha,
press 1; if you want to know her treatment plan, press 2; if you
want to know how Asha's feeling, press 3.''
Clayton-Neiderman may be able to find the humor in her situation
but there is no mistaking how seriously she takes her experience
with breast cancer. ``People always feel bad for me but I think
things happen for a reason and they make you stronger. The cancer
is part of my life and while I wouldn't choose it, I certainly
wouldn't trade it.''
