Two years ago, cancer paid elementary school teacher Loren Lucas an unwelcome visit.
Just before school let out for the winter break in 2007, she decided to have a doctor examine lumps she found in her breast and under her arm. When he immediately scheduled a mammogram for the next day, Lucas knew she might be in trouble even though there was no history of breast cancer in her family.
After an ultrasound and mammogram, Lucas and her husband went to Mexico on their honeymoon, which they delayed earlier because her father was dying of lung cancer. They strongly suspected Lucas had cancer, but didn't get the formal diagnosis until they returned to the United States.
"While we were in Mexico it was great because it took our mind off of what was coming, and we got to just pretend," she says. "When we got back, the next day we went in and we got my results that it was cancer. "
At age 23, Lucas was diagnosed with Stage IV breast cancer.
"They told me that you were considered young to be diagnosed with cancer if you were 40 or if you were 35," she says. "And so being 23, there was no one like me" in treatment.
"It's strange to be this age and face things like this, but I don't think it's really any different for any person no matter what age they are," she says. "It's still a surprise and it's still unexpected for how you thought your life is going to be.
Over the last two years, Lucas underwent chemotherapy, radiation and surgery. The cancer in her breast and lymph nodes responded to the treatment, but still spread to her lungs and brain. The tumors in her brain -- technically breast cancer in her brain, not brain cancer -- began to cause her to have seizures, including one incident in which she collapsed in a school restroom.
Earlier this year, neurosurgeon Kit Fox at the NeuroTexas Institute at St. David's HealthCare, removed three tumors from Lucas' brain during a surgery in which she was awake. The procedure is called an awake craniotomy.
"One of her tumors was very very close to the tumors that were controlling the left side of the body. So in that case we have to have her awake for the procedure so we can make sure we are not damaging that area of the brain," Dr. Fox says.
He says it is unusual to see someone so young have the kinds of health problems Lucas has faced.
"Usually we see these in older patients, in their 40s or 50s," he says. "It is pretty uncommon to see someone this young show up in our practice with lesions in the brain from breast cancer."
Lucas was fully awake during most of the surgery, and even called her husband as the operation was on-going. She not only survived the surgery, but was out on a boat at Lake Travis days later.
She now is back teaching in the classroom, and rarely bothers to wear a wig to cover her bald head. She says the baldness is almost a badge of honor.
"I get so many people coming up to me to say, 'I think it's so amazing you come out and you're proud to be bald, and I wish that my aunt could do that,' or, 'I wish that my friend had enough confidence to do that.'
"Or I'll be at the gym working out and someone will come up and say, 'I'll never complain about being too tired to go to the gym again.'
Her prognosis now is guarded but good, and she has two lessons she's learned the hard way to pass along: Don't put off seeing a doctor if you suspect you might have a problem, and don't take for granted the life that you have. Things can change in an instant.
She says she believes her determination is helping her heal.
"That's what people say all the time -- 'Oh you have such a positive attitude and great outlook on it.' But I don't see you have another choice. Do you just roll over and give up? I guess that's some people's option, but it wasn't for me.''
