ORONO, Maine — Nicole Langlois was 20 years old when she first felt the lump in her right breast.
Doctors told Langlois, then a University of Maine sophomore, the lump was just a swollen duct and sent her home. They told her it would go away. It didn’t.
Two months before her 21st birthday, Langlois sat in a doctor’s office and saw the mammogram and ultrasound results displayed. She diagnosed herself before the doctor spoke. Tests revealed Langlois had Stage IV metastatic cancer, which had spread to her lymph nodes. She soon began chemotherapy.
Three years later, the 23-year-old swimmer’s natural blonde hair is back. Langlois, a fifth-year student majoring in kinesiology, will don her cap and gown and receive her degree during University of Maine commencement ceremonies on Saturday.
Breast cancer is extremely rare among women in their early 20s. Women age 20 to 24 have the lowest incidence rate of breast cancer of any age group, accounting for 1.4 cases in every 100,000 women, according to the American Cancer Society. The median age of diagnosis is 61.
“It was kind of shocking. I wasn’t expecting it because I was so young,” the Washington, D.C., native said during an interview Wednesday next to the pool in which she spent countless hours practicing with her teammates. “I knew it was true, but I didn’t want to believe it.”
After the doctors laid out her diagnosis, questions rushed through her head.
“How is my family going to handle this? How long am I actually going to be around? Can I beat this? Can I swim? Can I go to school still? Will I have to put my whole life on hold?” she said.
She also played the “what-if” game, wondering what might have happened if the biopsy of the 7-centimeter growth had been taken months earlier when a doctor sent her home assuming it was a swollen duct, she said.
“That was the hardest part, just thinking, ‘This isn’t fair,’” Langlois said.
She didn’t cry, she said — not until after she started chemotherapy and shaved her head three weeks after her diagnosis. Then she bought a collection of wigs. Her favorite was a long, blonde wig that reminded her of a Barbie doll.
Her chemo treatments, the bulk of which took place at Johns Hopkins Hospital in Maryland, were aggressive because doctors knew she was young, athletic and strong enough to handle the side effects. Less than a week after her diagnosis, doctors put her on a chemo medicine nicknamed “The Red Devil” because of its red color and the burning sensation it causes. It also causes urine to turn red, hair loss, severe nausea and can lead to heart problems.
Langlois said she had a relatively easy time in chemo. She’d go for the all-day treatment in the hospital, sleep through the night and go back to work a 12-hour shift at a pool as a swim coach and lifeguard in the morning. She still “sucked it up” when she wasn’t feeling well and went out with friends.
Another common side effect is “chemo brain,” a mental cloudiness that results from treatment which can lead to lapses in concentration and memory. Langlois said she sometimes struggles to remember where she lives or how to get to places she has been to a hundred times or to answer even one of the simpler questions on a test.
A few months after her last chemo treatment, Langlois opted for a double mastectomy because she didn’t want to be “lopsided” followed by breast reconstruction surgery. She had just turned 21.
With the exception of a three-week break during the most aggressive testing and treatment immediately after her diagnosis, Langlois said she still attended classes and still swam.
“I was in every machine in the hospital, I’m pretty sure,” she said with a chuckle.
She dialed back her swimming to save energy so she could get up for classes in the morning.
Doctors ordered Langlois, a freestyle distance swimmer, to stay out of the pool for one month after her breast surgery. She was back in the water a month later — to the day — she said.
Support from coaches and teammates on UMaine’s Division I swim teams helped her get through the worst times.
When she shaved her head, three girls on the team followed suit, along with several swimmers on the men’s squad. The teams held fundraisers to help her offset medical costs and to make donations to cancer research and support organizations
“The team was overwhelmingly just so supportive and so thoughtful. We all came together for her,” UMaine women’s swimming coach Susan Lizzotte said Friday.
The team wasn’t surprised by Langlois’ determination to stick with her sport and continue to participate, in spite of the fact that chemo had taken its toll on her performance in the pool.
“Nicole is determined,” the coach said. “She, in a good way, knows exactly what she wants and that she’s going to do it.”
Lizzotte said the team would continue to draw inspiration from Langlois’ resolute battle with cancer.
“We’re always going to think about her, miss her, and worry about her in years to come,” she said.
Langlois said defiant tenacity and positivity helped her make it to graduation. Her cancer is in remission. Doctors say she no longer shows evidence of disease, but she is still tested every three months.
“I fought every doctor that told me I couldn’t do something,” Langlois said. “As soon as they said I couldn’t do something, that’s all I wanted to do.”
After taking a semester off from school, Langlois hopes to attend graduate school closer to home. She would like to become a pediatric oncologist — helping children fight their own cancer.
For information or to donate to cancer research, visit the American Cancer Society website at www.cancer.org.