A 21-year-old is making the ‘breast’ of a bad situation
Kelli Yam vs. breast cancer
“You are looking at an anomaly,” joked Kelli Yam, 21, as she flipped her hair back with her hand. “You are looking at a rarity.”
Yam was recently diagnosed with Stage 1-B triple-positive breast cancer. She said that her family history of breast cancer made her extra cautious. She said she has constantly checked herself for lumps since she turned 18. If it weren’t for her self-examination and her boss’s generosity, she might not have caught it in time.
Yam was born and raised in Lexington and said she went to college at Virginia Tech for engineering but did not finish because it wasn’t for her.
“I basically support myself, my family is 40 minutes away,” she said. “My grandmother and my aunt—my grandmother on my mother’s side and aunt from my dad’s side—they both had breast cancer, and they both beat it.”
“When I was 19, I actually had my first lumps appear,” she continued. “So, I went to the doctor, but they told me I didn’t have anything to worry about since dense breast tissue is common.”
Then, about three months ago, Yam said she felt a lump in her left breast that had been getting bigger and bigger.
“Again, I didn’t have health care, so I couldn’t go to the doctor. I just recently got it in October,” she said. “Finally, I talked with my boss; she is super amazing and supportive. She is all about women’s empowerment. I told her, and she said she was friends with this OB-GYN and that, ‘You have an appointment Monday, and you are going. It doesn’t matter what is happening at work, just go.’”
So Yam went, and for a moment, she was feeling hopeful. She was only 21 years old, after all. According to the Center for Disease Control and Prevention, “The main factors that influence your risk [for breast cancer] include being a woman and getting older. Most breast cancers are found in women who are 50 years old or older.”
“I am 21, I feel fine—I feel healthy, and I am just living my best life, or trying to at least,” Yam said of what was going through her mind during her visit to the doctor. The next day, she said the doctor called with bad news.
“It didn’t feel real,” Yam said. “It didn’t really register, honestly. Following up to that point, I was really anxious about it. I was thinking the worst. But the day I went there, and the night before, I was like, ‘Yeah, there is no way.’ So in my head, I thought it wouldn’t happen, but it did.”
She said she cried all day and went back to Lexington to tell her parents.
“It was emotional,” she said. “I told my dad first, and he just broke down in tears, because, of course, his sister went through it and his mother-in-law. My mom was upset, too, but she was at the point where she was like, ‘Kelli, we need to get this handled. You need to do everything the doctors tell you to do if you want to get better.’ And I did want to get better.”
Yam explained that she had to have several biopsies in her left breast.
“They numbed the area,” she explained. “They take like a hollow needle—or a suction tube needle—and they get the cells around [the lump] to test. Those aren’t fun and MRIs are awful. I hated it.”
For three weeks after her diagnosis, Yam said she just went to one appointment after another.
“Initially, it was 1-A when they did the stages test, so it was 1-A triple-positive, and then they did an MRI. They put contrast in my body to really see what lumps there were and how big they were. My lump was 2.6 centimeters, so that changed and was classified to Stage 1-B. In the MRI, they also found more lumps.”
The National Cancer Institute defines triple-positive breast cancer as “breast cancer cells that have estrogen receptors, progesterone receptors, and larger than the normal number of HER2 receptors on their surface. Knowing if breast cancer is triple-positive may help plan the best treatment, which may include hormone therapy and drugs that target the HER2 receptor.”
She said initially, her treatment was supposed to be two months of Taxol (which is a type of chemotherapy) and
(a type of hormone therapy).
“The cancer feeds on estrogen, progestogen and HER2 [Human Epidermal Growth factor Receptor 2],” she explained. “HER2 means that it is a more aggressive cancer. Aggressive sounds scary; it sounds bad, but aggressive is actually good in this case because the doctors can see clearly what is going on.”
She said she spoke with her oncologist, who said he was worried about her breasts because “there were so many abnormalities.” They changed her treatment to something more intense. The chemotherapy regiment they put her on is called, TCHP (Taxotere plus Carboplatin plus Herceptin plus Perjeta).
“The first treatment was pretty lax; I wouldn’t lose hair or feel nausea,” she said. “But with this one being more intensive, and since I have gone to my first treatment, I knew what to expect. It is definitely a lot worse.”
She said she receives treatment through a port-a-cath, which the National Cancer Institute describes as “A device used to draw blood and give treatments, including intravenous fluids, drugs, or blood transfusions. The port is placed under the skin, usually in the chest. It is attached to a catheter (a thin, flexible tube) that is guided (threaded) into a large vein above the right side of the heart called the superior vena cava. A port-a-cath may stay in place for many weeks or months. A needle is inserted through the skin into the port to draw blood or give fluids.”
Yam showed me her port while we sat at a Greensboro Starbucks for our interview. I could see it protruding from the upper right part of her chest, and she let me feel it. It did not feel like it would be comfortable in any way.
“Chemo destroys your veins,” she said. “They do it through here instead, so I don’t have an I.V. in my arm.”
She said she is doing her treatment at Cone Health Wesley Long Hospital, and she said it isn’t like what you see on T.V. She said the treatment area is more private with secluded booths in a large common area. The treatment regiment is composed of the four medications (TCHP) via an I.V. drip, with doctors monitoring her reaction to the medicines throughout the session.
“So, they will do one medicine, wait a long time, do another, wait a long time,” she explained. “They put all the medicine in slowly. My first session was nine and a half hours long.”
She said she has six treatments taking place every three weeks, and she just recently finished her first round. She only has five more to go until she gets to ring the bell. Her next one takes place on Friday, Dec. 20.
“I am pretty much immobilized for a week after chemo, then two weeks I work,” she said. “The day after, I felt fine, and that was expected because they give you pills to stop nausea and whatnot. The second day, I started to feel it. I had neuropathy [pain from nerve damage]. I felt it in my feet as I was standing in the kitchen; it was just like pins and needles in my feet with cramping as well. The third day was the worst day for me; they give you a shot to increase your white blood cells because chemo destroys the good cells, too.”
Since chemotherapy is radiation, Yam said there are so many health risks involved. One of the things she said she has done to lower those risks is staying completely hydrated. She said she has to literally flush the radiation out of her system. She said the radiation gives her “chemo brain,” which results in thinking problems, memory loss and other cognitive dysfunction. Radiation, she said, also impairs the immune system.
“The white blood cell shot gives you flu-like symptoms as well, so that doesn’t help,” she said. “I didn’t really experience nausea because they gave me medication, so I am staying really consistent with that.”
Among a dozen others associated with chemo and cancer treatment in general, one in particular risk factor she is concerned about is her fertility.
“You know, I’m 21 I don’t know if I want kids, I am not ready to make that decision,” Yam said. “[Freezing] eggs is expensive, and insurance doesn’t cover that at all. It is like $300 just for a consultation, just to talk about it. As I said, I support myself fully, and $300 may not be much to a lot of people. But this is going to be me having treatment for the whole year, and obviously, that is scary, and the actual surgery and procedure is $5,000—but that doesn’t take into account storage [of the eggs], and medications after.”
She said the other option to protect her fertility is by taking a shot of Zoladex, which she describes as a shot to the abdomen that essentially shuts down the reproductive system temporarily. But the scary part, she said, is not even getting a needle in the abdomen.
“It is 86 perfect effective,” she said. “So like, with breast cancer, cases under 40 is only like 5%. If I am already a part of that 5%, I could also be part of the 14% that are infertile. But I can’t do anything about it because I can’t afford to [freeze] my eggs.”
But what is the absolute worst thing about chemo for Yam? She said it’s not being able to taste.
“I am big foodie, I love food,” Yam said. “But chemo changes your taste buds. Everything just loses its taste. Food is in your mouth, but it feels like it shouldn’t be there. After my first treatment, I lost 10 pounds. The first meal that I had in days was yesterday morning [Dec. 11].”
Yam said she would have to get a lumpectomy, which according to the Susan G. Komen Foundation website, is “a surgery to remove cancer from the breast. Unlike a mastectomy, a lumpectomy removes only the tumor and a small rim of normal tissue around it. It leaves most of the breast skin and tissue in place.” She said they would do a lumpectomy because despite her grandmother and aunt having breast cancer, she did genetic testing, and it came back negative. She said that means she is not at-risk genetically for breast cancer. Her diagnosis was “purely bad luck.”
“Throughout your life, you see these bad things happening to people—these unfortunate things—and you are always like ‘that will never happen to me,’” she said. “You never know, and it just hits you out of the blue. Luckily, and not in a conceited way, I am a very resilient person. When something happens to me, I accept it for what it is. I haven’t really been sad about cancer. I just need to do what I need to do. Being depressed about it makes the situation worse. When you have a positive mindset, your body reacts positively as well.”
Remaining resilient and looking on the bright side, Yam said she is lucky she caught it early and was able to get a headstart on treatment.
“Younger people who are diagnosed with cancers are normally, not to sound morbid, their results are a little bit grim,” she said. “When you are younger, your cells are multiplying faster, and so the cancer spreads faster.”
Yam said she does not attend support groups because she has social anxiety, but she acknowledges she wants to attend and that it would be good for her to attend. She said she is a bit antisocial, but ever since her diagnosis, she has been actively reaching out for support more.
“It has helped me a lot, and I understand that human interaction is good,” Yam said.
Yam said her biggest concern with her diagnosis isn’t necessarily the risks involved with treatment, the inevitable hair loss (“because fuck gender norms! I can rock it bald. You can be feminine without hair”), or surgical scars. It is the financial burden of treatment that is, understandably, stressing her out. Recently, Yam created a GoFundMe account to help raise money for her medical expenses.
The GoFundMe fundraiser is called “The ‘breast’ of a bad situation.”
“*Scratch disc* *freeze frame* I bet you’re all wondering how I got here,” states Yam’s GoFundMe page, which was created on Nov. 11. “It all started about 2 months ago when I found a lump in my right breast. Hi! My name is Kelli Yam. I grew up in a pretty quiet town, Lexington, NC, but I currently stay in Greensboro, NC. I’ve lived a pretty normal life honestly, as normal as a 21-year-old can get, but I knew I wanted to be different. With that in mind, being a rare statistic wasn’t really what I was thinking. On November 1st, I got a phone call, and they told me something I didn’t even think was a possibility. The lady (wonderful Nurse Lin) on the phone told me I had breast cancer. The word ‘shocked’ doesn’t even come close to how I felt. We cried on the phone together for a bit because words wouldn’t come out, but there were so many thoughts running through my head. ‘How can I ever afford treatment?’ ‘How do I tell my friends and family?’ ‘What did I do to deserve this?’ ‘What will my future be like?’ ‘Is this just a really bad prank?’ It wasn’t a prank. It was the terrifying truth. It’s still hard for me to fathom that this is really happening to me. I know life is full of hardships, but I wasn’t prepared for this one. I like to think I’m pretty tough, but honestly, I’m a little scared. Before I even thought about my health, my main concern was entirely fiscal, but I knew if I wanted to live, I would have to make it work. After further testing, it was established that I was at Stage 1-B triple-positive. Even though it sucked being diagnosed in general, I was lucky enough to have caught it during a highly treatable stage. Traditionally, we hear about the numbered stages; the letters help to categorize it a bit more specifically. With Stage 1-B cancer, it hasn’t yet metastasized to my lymph nodes, but it has grown to be about/at least 2 centimeters. What triple-positive means is that during my biopsy, estrogen receptors, progesterone receptors, and HER2 were all found in my tumor. This being said, my options for treatment are a little more viable. The chances for a 21-year-old to get breast cancer are ‘astronomically rare,’ as my doctor told me, and she’s right. I did some research on my own. Apparently, cases of breast cancer for women under 40 only run about 5% of all cases. What I’d really to emphasize is the urgency that any woman at any age monitors their health and wellness, especially when it comes to our breasts. I first had lumps appear three years ago when I was 19. My doctor told me, ‘They’re just caffeine deposits,’ and I’ve come to find out that it doesn’t even exist. I am a firm believer that one of the reasons about 30% of women under the age of 40 loses their battle to breast cancer is due to unawareness. A lot of young people are looked past due to their age because it isn’t ‘likely.’ Mammograms aren’t recommended until at least the age of 35 due to the physical state of our breast tissue, and it’s also one of the reasons breast cancer is caught at later stages for younger women. Technology is being worked on to target them as well now that breast cancer is a growing concern. ‘That would never happen to me.’ It can. It happened to me. Please, everyone, love your bodies and treat it kindly!!! I honestly don’t know what to do because, due to chemo, I won’t be able to work, which will take a toll on me mentally, physically, and financially. At this point in time, I fully support myself. With that being said, I don’t make enough to pay for my living expenses and treatment at the same time. I recently got health insurance through my job, but haven’t reached my high deductible. I’ve been advised to apply for grants and seek any monetary assistance. I don’t want this to be a sad story. As I’ve been saying, ‘It is what it is,’ and the best thing to do is keep looking forward. I look forward to smiling with everyone once I beat it! Please help me to afford my treatment as well as my living expenses. Any dollar, share, or comment of positivity will help! Thank you guys for any love and support!”
She said her current treatment plan (which she needs to update on her GoFundMe page) would last a year. First, it is six rounds of chemo for four and a half months, followed by a month of rest. Then, the lumpectomy with a month of rest. After the surgery, she will still need four to six weeks of radiation. For the rest of the year, she will have to go every three weeks for an infusion of Herceptin and Perjeta.
She said it took a lot of courage to set up her GoFundMe account.
“I am deathly afraid of asking for help,” she admitted. “I have always depended a lot on myself, and I have been self-conscious of my performance and how I do and how I appear to other people. I don’t want people to feel bad for me; I don’t want them to feel like I am using them. I’m gonna be honest before I even thought about my health and life when I first got the call that I had cancer, I thought, ‘It doesn’t matter, I can’t afford it,’” she continued. “Everyone says, ‘People are here to help, you are going to find the finances to get through it.’ And I have had a lot of people tell me, ‘You are going to have a lot of bills, you just can’t help it.’ But why is that? I didn’t choose this. Obviously, it is not something I could have stopped or prevented, per se. And yet, I have to be stuck with all these bills. And I am only 21, and it is like, that is going to be on me for a long time.”
Yam said she wants to be open about her experience, and she remains positive that she will beat cancer.
“I think the scariest thought is that it is going to come back,” she said.
Yam said she is very treatable, and luckily, the cancer hasn’t metastasized to her lymph nodes yet. She’s had to think about the worst-case scenario, and she has made peace with it because “It is what it is.” But Yam said she’s a fighter and she isn’t going to lose hope.
“If I can get through this, I can get through anything,” Yam said. “That is the way I wanted to look at it. I’ve had a lot of mental issues—like depression, extreme anxiety— and I have had to control that and learn not to let that stop me. Because of overcoming and being able to control that, it has helped me come to terms with my diagnosis.”
“Feel yourself, you know your body best,” said Yam of the advice she would give others, especially young women. “If I hadn’t done it, I wouldn’t have caught it. If things go unchecked, things can progress to worse stages. I understand that it is scary, but sometimes you have to put yourself first before your fear. You can’t just let fear control you, if I let it control me, I would be in a far worse situation than I am in now. Of course, I also want to stress how difficult it is for everyone, but health care is not really on your side when you are young. You are never prepared for a situation because you are still a kid trying to build yourself.”
As of Dec. 17, Yam has raised $5,315 of her $25,000 goal. To learn more and to make a donation, visit her GoFundMe page.
Katie Murawski is the editor of YES! Weekly. She is from Mooresville, North Carolina and graduated with a bachelor’s degree in journalism with a minor in film studies from Appalachian State University in 2017.