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    'I was too young for breast cancer'

    At 21, Danielle Etzler went from focusing on her future to focusing on her recovery.

    By TERRI D. REEVES
    © St. Petersburg Times
    published February 9, 2003


    PALM HARBOR -- On Wednesday, Danielle Etzler ran her fingers through her shiny brown mane and pulled out clumps of hair. It was day 14 after her first chemotherapy treatment, and the doctors and nurses had warned her this would happen.

    "I'm really upset right now," the Palm Harbor resident said. "I'm trying not to cry."

    At 21, Danielle has breast cancer. Until recently, she was pursuing a finance degree at the University of South Florida and worked as a fulltime customer service representative with Capital One. Now she has taken a leave from both to battle this beast.

    Whilemost of Danielle's peers are facing angst about body image, sexuality, college, careers, dating and marriage, her concerns have shifted to mastectomies, scarring and breast reconstruction.

    She is dealing with menopausal symptoms and effects of chemotherapy. She wonders about her ability to have children in the future.

    Though breast cancer occurs less frequently in women Danielle's age, her doctor at the H. Lee Moffitt Cancer Center in Tampa says any woman who has begun menstruation should begin self breast exams.

    Women of "all ages should pay attention to changes in their bodies," said breast oncologist Dr. Pamela Munster.

    Waging war with breast cancer is tough at any age. But for young women, who have expectations of a long, healthy life, it can be especially traumatic.

    "It's terrifying," she said. "I worry about what could happen down the road, but I try to keep a positive attitude."

    'I never really did self-exams'

    Danielle's mother, Marlene Etzler of Tampa, said she "is a totally perfect child."

    She graduated with a 4.5 grade point average from Jefferson High School in Tampa. She was a member of the National Honor Society, the Spanish and math honor societies, and captain of the soccer and volleyball teams.

    Two years ago, her father died from a heart attack.

    "I was devastated," she said.

    She dropped out of college for six months. For a while, she turned to clubbing in Ybor City, and then realized that was not the life for her.

    Then, as things seemed to be returning to normal, a dog she was considering adopting jumped on her and injured her breast.

    As she examined it, she noticed a large lump.

    "In a way, the dog saved my life," she said. "I never really did self-exams. I thought I was too young for breast cancer."

    A mammogram revealed a tumor. A biopsy showed she had a very aggressive form of breast cancer.

    Danielle remembers the moment she woke up from the surgery to see her mother's red, tear-filled eyes.

    "She didn't have to say anything," she said. "I knew it was bad. I just didn't know what to think or expect."

    On Dec. 19, Danielle had her left breast and 11 lymph nodes removed.

    The tumor had rapidly grown to 9.5 centimeters, the size of an orange, and the cancer had spread to a lymph node.

    The day after her discharge, Danielle went Christmas shopping.

    "I was mad and angry that I had this but I wasn't going to let it ruin my life," she said. "I needed to get some shopping done."

    "She amazes me with her strength and energy," said her mother. "And she has such a positive attitude. I hope it continues."

    'He tells me how beautiful I am'

    At Moffitt, Munster is conducting a clinical trial with the drug Triptorelin. It is hoped that the women who take this hormonal drug will be able to remain fertile and bear children after chemo.

    "Sometimes women (who have had chemotherapy) have a problem staying pre-menopausal," Munster said. "This drug will stop ovulation in hopes that it will prevent damage to the eggs."

    The study began just before Christmas and could eventually include 130 patients. Danielle is one of the participants and will be followed for five years.

    "Having a family is really important to me," she said.

    The drug has plunged Etzler into a temporary menopause. She is experiencing symptoms similar to those faced by older women: mood swings, crying, hot flashes.

    On top of that, the chemotherapy has given her headaches, nausea, swelling of the mouth, mouth sores, and now she is losing her hair. She will have to undergo five more chemotherapy treatments, 21 days apart.

    "It's hard to deal with physically, but much more draining emotionally," she said.

    Her friends and family members have offered to shave their hair in an offer of support.

    "I don't want them to," she said. "I don't want to attract any more attention."

    Through it all, she tries to focus on the positive.

    She looks forward to having breast implants: "I'd love to have them. It's something I wanted anyway."

    It has given her a new career focus: "I want to go into medicine now, either as a doctor or a nurse."

    She realizes Anthony Suarez, her boyfriend of three years, will stand by her: "He is very supportive and tells me how beautiful I am everyday."

    She says she is a more caring and compassionate person: "You can't have compassion without suffering."

    It has improved her relationship with her mother and sister Olivia, 17: "It has brought us much closer together and made me realize how important family is."

    At this point, her prognosis is uncertain, her mother says. But Danielle feels that she has some special guardian angels to help her get through this ordeal.

    Her maternal grandmother and grandfather died from cancer. She feels that they and her father are watching her from heaven.

    "I know my dad and my grandparents are up there," she said. "They are looking out for me and taking good care of me."

    Breast cancer in young women

    A woman's lifetime risk for developing breast cancer is 1 in 9. For age 25 and younger it is 1 in 19,608.

    Breast cancer is the leading cause of cancer death in young women ages 15 to 40.

    When breast cancer is caught in its earliest stages, the 5-year survival rate for young women with breast cancer is 82 percent.

    Most breast cancer studies are conducted on women over the age of 45.

    -- Sources: Young Survival Coalition (www.youngsurvival.org). Susan G. Komen Breast Cancer Foundation (www.komennyc.org)

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