More young women than ever are diagnosed with cancer – at 22, I was one of them ...Middle East

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“I don’t think I’m meant to be here.”

That was the thought running through Anisa Ali’s mind when, aged 22, she found herself at a breast cancer screening centre. Having felt a lump in her right breast while showering, looking around the waiting room that day crystallised the thought she had been avoiding: “What if I do have cancer? That was the first time I really questioned, why me?”

Ali is one of the growing number of young women being diagnosed with early-onset cancers. According to a new OECD report, between 2000-2022, reports of cancer among 15-49-year-old women jumped by 16 per cent (early-onset among men, by comparison, remained stable). Breast and thyroid cancers accounted for 80 per cent of the increase.

Though rates are clearly rising, the outlook in Britain remains bleak. Of the 40 European countries analysed by the OECD, the UK ranked 36th for deaths, with only Slovakia, Denmark, Croatia and Hungary ranking worse. NHS breast screening is offered to women aged 50-70 every three years, yet research from breast cancer charity CoppaFeel! shows that a 25-year-old woman diagnosed with stage three breast cancer has a quarter of the chance of surviving for 15 years post-surgery, compared to a 65-year-old with the same disease. Delays or dismissal within healthcare settings, more aggressive tumours, lower awareness of symptoms and lifestyle factors are among the key drivers of a disease that is leaving far too many young women at risk.

When Ali, now 27, first discovered the six centimetre lump in 2021, she put it to the back of her mind, “hoping that it would go away”. But the next day, concerned it might be something serious, she contacted her GP. She was seen that day, with the doctor telling her that, based on her age, it was most likely a fibroadenoma (benign breast lump).

She was then referred for screening – news she barely shared with her family (none of whom has any history of the disease), not wanting to cause a fuss over what she assumed would be nothing. “I remember just trying to be brave,” she says. “The quicker I’m out of here, [the quicker] I can just go back to planning my future.”

During her ultrasound, though, doctors began rushing around her, calling more senior colleagues in to assess what was on the screen; she was then told she needed a biopsy to test the tissue.

When she returned to see the consultant, her worries were completely dismissed, and they appeared to have no knowledge of her biopsy. Insistent on pushing for answers, it finally became clear that the consultant was reading from the wrong patient’s notes.

“I could have easily believed them and walked out of the hospital that day thinking the lump was benign.” Instead, she would learn that she had stage three triple negative breast cancer, a particularly aggressive form. “That was another challenge, another pill to swallow,” she reflects. “It felt like it was just getting worse and worse and worse.” They told her it was treatable with chemotherapy, but didn’t elaborate on her survival chances. “I don’t think I was even brave enough to ask that kind of question,” she says now. “In the back of my mind, I don’t think I wanted to ask: am I going to make it at the end of this? Because then I’d have to live with knowing.”

Ali had applied to study postgraduate medicine, but postponed her interview when the reality of treatment set in. “It just felt like it was a mountain piling up,” she says of the relentless bad news. She was told she needed to decide whether to freeze her eggs, which would delay chemotherapy by a further two or three weeks, or forgo fertility treatment and risk never being able to have a family. She also had to choose whether to undergo chemotherapy with cold capping – where helmets are filled with cold liquid or gel during treatment in order to minimise hair loss.

“It was just a lot of decisions to be making,” Ali says of that time. She chose to go through with both, hoping the latter would mean: “I might be able to hang on to a little bit of myself, and still recognise myself through this.”

On her way to the teenage and young adult cancer centre at University College London Hospital, she passed through the adult clinic. “It felt like I was in a movie, almost; walking through and seeing what my life could look like”; that she could one day be the age of the older patients around her, and still having treatment. That prospect, she says, “was honestly terrifying”.

Still, the first round of chemotherapy didn’t seem too bad. Ali busied herself reading articles about the curative effects of food and exercise (she took up the fruit and veg-centric alkaline diet), and didn’t lose any weight from treatment, nor her hair.

As the rounds went on, however, “it did literally hit me like a tonne of bricks”. She becomes emotional recalling how “there would be days where my siblings would have to help me get upstairs to my room. It definitely took a toll. I remember being scared of how quickly things were changing, because I went from feeling like I was ‘not your typical’ cancer patient to literally embodying everything you see in the movies.” Her family (she is one of seven siblings) suggested moving her bed downstairs, but she refused, desperate to keep some shred of life as it had been before her diagnosis.

There was no hiding how different her day-to-day was now compared to her peers, though. “I remember just looking around and sometimes feeling like a burden to my friends,” she says. Throughout her six rounds of chemotherapy, she powered through as if on autopilot. “I wasn’t really taking the time to process things because I didn’t have the time to sit there and feel sorry for myself, in a sense. It did feel like life or death.”

After chemotherapy, Ali was offered a mastectomy (where the entire breast is removed) or a lumpectomy (where the tumour is removed, alongside some surrounding tissue). “There was no doubt in my mind that I was going to do it,” she says of the more invasive surgery. Though it has radically changed her body (she also now suffers from lymphedema, a chronic swelling condition), Ali has convinced herself that it was “the price to pay for my health again. And I would pay that a hundred times over.”

Her surgery was followed by radiotherapy; she is still on the waiting list for a reconstruction. When Ali reaches the five-year all-clear mark this September, the chance of her cancer returning is equal to that of someone being diagnosed for the first time.

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Along with a much-deserved holiday to mark this anniversary, she also wants to see screening made available for younger women – something that was absent from the Government’s recent national cancer plan released on 4 February. “Over 50 per cent of women who are diagnosed in the UK are under the screening age,” she says. Lowering it “shouldn’t even be a conversation”.

Ali also believes there needs to be far more widespread implementation of breast self-checking guidance, such as during sex education lessons at school. “Breast cancer is no longer a thing that affects older women – we are all at risk. So catering to that is definitely something that I think is so, so, so, so important going forward.”

For more information on breast cancer warning signs and screening, visit coppafeel.org

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