Community Blog

October 23, 2007

Way to young for Cancer

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Posted on Mon, Oct. 22, 2007
Way too young for cancer
Sarah Arnquist
Weeks after graduating from San Luis Obispo High School in May 2006 and celebrating her 18th birthday, Cassie Bustos learned she had breast cancer.

She didn’t believe it. Breast cancer, she thought, only happens to older women, not teenagers.

Over the next year, while trying to be a “normal” Cal Poly freshman living in the dorms, she underwent four surgeries to remove and reconstruct her right breast.

“I feel like I grew up so fast and missed a huge part of my life,” she said last week.

Cassie has long hair with blond highlights and a small diamond piercing in her nose. After her mastectomy, she tattooed a four-inch pink ribbon and rose on the underside of her left wrist.

Her cancer was never life-threatening, but it permanently changed her, she said. The tattoo reminds her of what she lost and gained.

She lost her right breast, four lymph nodes and all feeling in the upper right quadrant of her chest. She lost confidence in her body and the carefree experience of being a college freshman, living on her own for the first time.

She gained maturity, deeper

compassion and appreciation for life.

“It gave me a kick to get out of my bubble and realize there are bigger things in the world,” she said.

Few doctors have treated breast cancer in anyone as young as Cassie, which is probably why her breast discomfort was originally diagnosed as a bacterial infection.

“(The doctor) said it couldn’t be cancer, because no one in my family has ever had it,” she said.

Arroyo Grande oncologist David Palchak, who never saw Cassie, said he has never seen breast cancer in someone her age. Only half of 1 percent of invasive breast cancers occur in women younger than 30, he said.

Cassie’s type of non-invasive tumor — ductal carcinoma in situ — is even rarer in young women. Only 0.2 percent of in-situ tumors occur in women younger than 30, Palchak said.

After a biopsy confirmed she had cancer cells, local doctors referred Cassie for treatment at City of Hope Cancer Center near Los Angeles.

Diligence without worry

Dr. Marisa Weiss, a Philadelphia- based oncologist who founded the Web site www.breastcancer.org, said treating a teenager with breast cancer raises many dilemmas. A mastectomy was Cassie’s best treatment option, because of the tumor’s size. But removing a teenager’s breast is never a decision made lightly, said Weiss, who also didn’t treat Cassie.

“For someone like her, it’s hard to know what the right thing to do is,” Weiss said.

Anyone with an unusual diagnosis, though, should get a second opinion, have a pathologist who specializes in breast tissue review the tests and see a genetic counselor, she said.

Teenage girls should not worry they might develop breast cancer, Weiss said, but they should pay attention to their bodies and learn what is normal development.

She runs a breast education program to teach teenagers about normal breast development and life-long strategies to reduce their risk of cancer, emphasizing regular exercise, maintaining a normal body weight, and, when possible, eating organic foods.

Cassie has now been cancer-free for a year. Genetic testing showed she has a rare genetic mutation, and her risk of getting cancer again is higher than the average person’s. She tries not to worry but said it’s difficult.

“I think she’ll always have the thought of cancer in the back of her mind,” said Cassie’s mother, Jana Bustos.

The past year was hard on Cassie and her family, her mother said. Cassie has an older sister and two younger brothers. Her father, Jaime Bustos, works at Cal Poly.

No one understands what it’s like to be 18 with breast cancer or have a teenage daughter with breast cancer, Jana Bustos said.

“It’s completely different when you’re 18 and you’re dating,” she said. “You’re not married and you don’t have kids yet.”

At first, Cassie was embarrassed by the cancer and reluctant to talk about it. Slowly, she has opened up. Her tattoo often raises questions that she now wants to answer.

Cassie said she is regaining the sense of control she lost for 18 months. She’s planning a trip this year to Australia, where she studied abroad during high school.

“I lost my life somewhere,” she said, “and now I’m trying to find it.”