Back in the ring

The smile rarely leaves Moyia Matthews' face, even as she talks about being diagnosed with breast cancer last year when she was just 24 years old.

She smiles even as she talks about the cancer returning in April, despite a double mastectomy, and then a third spot appearing in September. She smiles even as she talks about treatments that made her so ill she got sick the night before just thinking about them.

"I still smile," said the now-26-year-old mother of two young children. "It's OK because I'm still here. That's the main thing."

Breast cancer rarely strikes women younger than 35. Only 1.9 percent of breast cancers diagnosed between 2001-05 were in women aged 20 to 34. according to the National Cancer Institute. The median age at diagnosis was 61 years old, more than double Ms. Matthews' age. Surgical oncologist Ron Stallings says he sees one or two cases of breast cancer a year in women in their 20s.

"That tells you it's not very common," he said.

MS. MATTHEWS first found a small lump in her breast in November 2006 but didn't think much of it. By January 2007, however, it had gotten bigger.

"It was only like maybe two months and it had doubled in size," she said. She went to see her gynecologist, Dr. Calvin Hobbs, who was concerned enough to send her for a mammogram. That's when Ms. Matthews started to worry.

"I then began to consider that something could be wrong. But still, not thinking cancer," she said. "I'm a positive person, so I didn't think anything negative. I wasn't going to think anything negative until they said something."

She was referred to Dr. Stallings for a consultation and ultrasound, and at first it appeared to be a benign fibrous tumor.

"The first thing we told her is it's not often that you see breast cancer in a young woman like that unless they have predisposing factors," Dr. Stallings said. "And because that tumor had enlarged in size and it was palpable, the best thing would be to biopsy it."

Ms. Matthews smiles as she thinks back to her chief concern at the time.

"My biggest thing, I remember from talking to him the first time, was I didn't want a big scar on my chest," she said. "I don't have any stretch marks from my kids and I don't want any big scar."

That changed with the biopsy.

"And I get the news, that it's cancer," she said, her strong voice now trailing to a whisper, her smile fading. "I went into complete shock. I heard him say cancer, and I don't think I heard anything else after that. I was just blown away."

Dr. Stallings laid out her options and suggested a bilateral mastectomy because of her age and the high likelihood the cancer would return, an option she initially rejected.

"My first reaction was, 'No, I'm not going to do that,' " Ms. Matthews said. "Then my godmother talked to me some more. She's like, 'You know, you can't really worry about that. You have kids to raise.' My kids were a factor in my decision."

Tiara Cabrera was 6 years old then, and her brother, Isiah, was only 4.

"I just knew I had to do it," Ms. Matthews said. "It's not that I wanted to, and it's not that I was happy about it. I wasn't thinking about myself."

The worst for her wasn't the surgery but the chemotherapy that followed. The first weekend after treatment, she was so dehydrated from nausea she had to get IV fluids. Later she would become so anxious that the nausea would begin the night before the treatment.

"It was mental," Ms. Matthews said.

That kind of sickness isn't typical anymore, Dr. Stallings said.

"And there are a lot of folks who don't get sick from it," he said. "And there are a lot of folks that continue working while they're taking chemotherapy and don't miss but the day that they go for that chemo."

Often wiped out by the chemo, she and the children moved back in with her mother, Juanita Harvey, who often had to see the children to and from school, cook and even help Ms. Matthews do simple tasks.

"I literally couldn't take care of myself," she said. "She had to run my bathwater. She had to feed me, had to help me get dressed because I had no energy."

She never actually told her children she had cancer, choosing instead one day to take off her hat and show them her bald head.

"And I was like, 'What do you think?' " Ms. Matthews said. "And they said I was cute and they asked me why. And I said because of the medications I take; it makes my hair come out."

They knew she was sick and would sometimes sit by the bed and watch over her.

"That was my strength to get better, because of them," Ms. Matthews said.

After the last treatment in September 2007, "I was excited," she said. "I was like, I'm done with it. I had my (breast reconstruction) surgery. And I was ready to go.

"And I was on my way."

She went to work as an administrative assistant at her church, Abundant Life Worship Center. And in March she enrolled at Augusta Technical College to get a medical assistant degree, the first step toward one day becoming a nurse in a neonatal intensive care unit.

A MONTH LATER, she found a lump on the left side of her chest.

"I thought it couldn't possibly be a recurrence because I don't have any breasts," Ms. Matthews said. "How could it come back?"

It is a common misconception about mastectomies that all of the breast tissue is gone, Dr. Stallings said.

"There's a certain percentage of breast tissue that is still going to be left even though you do the mastectomy," he said. "That tissue is still at odds for a recurrence. I don't think you can humanly possibly remove 100 percent of the breast tissue, in my experience."

The cancer had returned, and she started chemo again and radiation. In September, Dr. Stallings removed a tiny tumor from the same area of the recurrence.

Though she is still in the midst of treatment, Ms. Matthews refers to herself as a breast cancer survivor.

"When I was first diagnosed, I considered myself a survivor," she said. "Death is not an option."

Ms. Harvey, her mother, beams when she talks about her daughter's determination.

"We're attacking this like a bulldog," she said, turning to look at her daughter in the kitchen. "That's a walking miracle right there."

That spirit is what led Dr. Stallings to hire Ms. Matthews to work in his office.

"You knock her down, she gets up, keeps going. She's a remarkable person," he said. "We're happy to have her because her attitude is so good. And she's a hard worker. There's a strong faith."

And that, Ms. Matthews said, is the secret behind her ever-present smile.

"My faith has been the foundation of why I am going through this smiling," she said.

Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.