School counselor ‘too young’ for breast cancer survived – and is thriving

Cancer isn’t the first trauma Chenay Kelly has survived.

Her dad is serving a life sentence in prison. And her childhood and teen years were full of obstacles, but she says they shaped her into the resilient woman she is today.

She calls breast cancer “the most awakening of any trauma.” In other words, cancer had lessons to teach her.

Kelly’s cancer was unusual: She’s just 33, and she had no family history of breast cancer. Mammograms aren’t typically recommended until women turn 40.

In late 2022, the Greensboro middle school counselor was on a high after completing course work for a master’s degree in counseling, even as she juggled her full-time job, a part-time job and raising a daughter, 11, and son, 6. Two weeks after graduation, she learned she had cancer.

Kelly is one of a growing number of people thought “too young to get cancer” who are nevertheless getting that surprise diagnosis. The Washington Post reported on Aug. 22: “A study published last week in JAMA Network Open showed cancers are on the rise for … Americans under 50, particularly among women. Between 2010 and 2019, diagnoses among people ages 30 to 39 increased 19.4%. Among those age 20 to 29, the increase was 5.3%. Breast cancer accounted for the highest number of cancer cases in younger people.”

The story goes on to say the “rate of late-stage breast cancer diagnoses in young women has been climbing.”

Kelly first felt a lump in her breast last June when she was moving into a new home – the first she’d ever bought. She knew she needed to see a doctor eventually but didn’t imagine it was anything serious. “Because of my age, I was not thinking breast cancer,” she said. “I didn’t have any of the criteria – no family history, no pain, no discharge.”

Two days before Thanksgiving 2022, she felt sharp pain over the entire left side of her body. “It was like being stuck with a knife,” she said. “I had a little discharge, but even that didn’t worry me. I breastfed my two kids and had seen that before.”

She was preparing for her Dec. 9 graduation around the same time she had a biopsy scheduled. “I figured something was wrong when they told me at the imaging center to just go and enjoy my graduation,” she said. “I had worked super hard; I’m the first in my family to earn a graduate degree. I didn’t want anything interfering with that.”

Her best friend, Ebony Pittman, was with her on Dec. 29 when she got the diagnosis. “You hear that word – cancer – and you automatically go to the deep end,” Kelly said. “You think all the bad things, but Tori (Wall), my nurse navigator, was so encouraging and supportive. When I left the office and walked through the lobby, I saw the head nods and felt the silent support of the women in there who were in treatment or about to find out they had cancer. I didn’t feel I was doing this alone.

“I never felt fear,” Kelly added. “There was a calmness about Tori, and I held on to that.”

Wall is one of three breast oncology nurse navigators for Novant Health in the greater Winston-Salem region. Together, they support more than 300 patients at any given time. As the name implies, these nurses help patients know what to expect, coordinate care, answer questions and often accompany patients to key appointments such as chemo infusions and surgeries.

Wall, who’s been with the Novant Health Cancer Institute in Kernersville since 2020, said delivering that news never gets easier. “It’s my job to share the news in a way that focuses on the good and opportunities for hope. I can’t tell them that it will all be OK, because I don’t know that it will be. But I can share my confidence in our team.”

Deciding how to treat it

Figuring out treatment was the next step. A mastectomy was a medical-must. So was radiation – to ensure the cancer cells are gone. (Kelly received radiation via a new, state-of-the-art linear accelerator at Kernersville Medical Center. See sidebar.)

Although the cancer was in only one breast, Kelly wondered if she needed a double mastectomy as a preventive measure. But given her lack of a family history, that wasn’t recommended. She also considered – and rejected – a lumpectomy. It was a good decision. During Kelly’s Feb. 1 mastectomy, breast surgeon Dr. Jennifer Christman of Novant Health Breast Surgery - Ardmore discovered more cancer than appeared on the scans. A lumpectomy wouldn’t have gotten it all.

A tumor board, comprised of breast surgeons, breast oncologists, radiation oncologists, physical therapists and nurse navigators, discussed Kelly’s cancer. The board meets weekly to discuss complex cases – and hers was certainly that. “She is indeed unusual,” Christman said. “There were a total of five tumors, as well as extensive noninvasive cancer in the form of an 11-centimeter tumor. But she had about that in invasive cancer, as well.”

The tumor board looks at all the imaging and comes up with a recommended game plan, Christman said. “Instead of just one opinion, the patient is getting a consensus based on multiple opinions.” It’s part of Novant Health’s commitment to multidisciplinary medicine to make sure patients get the expert care they need and deserve.

The board recommended chemotherapy and post-mastectomy radiation, but Kelly was hesitant. She may want another child, so preserving her fertility was important. Chemotherapy can sometimes affect the ovaries, “causing them to stop releasing eggs and estrogen,” according to the National Cancer Institute.

She chose surgery, radiation and a drug called Zoladex, a once-a-month injection that stops estrogen production, said Christman. “The drug reduces the risk of early-stage, hormone-receptor-positive breast cancer (which Kelly had) recurring in premenopausal women.”

Kelly said her care team, which included Dr. Judy Hopkins, a medical oncologist in Kernersville, fully supported her decision to forgo chemotherapy. “I had the best caretakers anybody could have,” Kelly said. “They prayed with me. They held my hand. It didn’t matter how many times I asked the same questions; they were patient with me.”

Kelly, who returned to school in 2016 to earn a bachelor’s degree in psychology while working in the mental health field, is a good student. She learned as much as she could about her disease and how doctors were treating it. Although she joked with her doctors about practically being one of them based on her years of watching “Grey's Anatomy,” she recorded their conversations during her appointments so as not to miss anything. (Read about Novant Health’s policy on recording here.)

Telling her kids

Kelly, who’s used to helping students cope with and address their problems, suddenly had a big one of her own.

At first, she kept her diagnosis a secret. But she found she needed to share it.

She told her kids in late January – after her daughter began to notice her frequent doctors’ appointments. Her son, who was 5 at the time, was less aware. Using resources Novant Health provided, she told them separately, since each had a different level of understanding. And she didn’t use the word “cancer” with her son.

“I sat my daughter down, shared it with her and allowed her to ask questions,” Kelly said. When she asked, “Are you going to die?” Kelly assured her: “Not anytime soon.”

Kelly also learned to lean on others – something that didn’t come easily.

“I’ve always been so independent,” she said. “But having cancer taught me to ask for help. I’d never been this vulnerable before. I couldn’t drive, couldn’t dress myself, couldn’t pack my kids’ lunches. I had to lean on my village.”

Kelly’s mom lives in New York, but she’d stay up late some nights and talk or FaceTime with her daughter. “I really needed her,” she said. “Mentally, I was not OK. This was life-altering surgery.”

The school adjusted Kelly’s schedule so she could get to her daily treatments, but she still worked throughout her ordeal. “My school is a ‘high-needs school,’” she said. “Parental engagement is low. Our families call for help with food, clothing, shelter. Parents know I’m here for a variety of needs – not just talking to their student. I’ve helped parents with getting furniture and paying for haircuts, hotels, shelters.”

Cancer also gave her a new perspective she shares with her students: Nothing is permanent. It’s a mantra she’d hold on to as she went through treatment: “I try to remind my students that whatever issue they’re dealing with is only temporary,” she said.

She also realized, she said, that people too often answer the question, “How are you?” with an automatic, “Oh, fine.”

“And that can be a lie,” she said. “We’re accustomed to saying everything’s OK even when it’s not. We need to learn to verbalize when we’re not OK – and give each other grace.”

Look out for yourself

Kelly’s case is instructive for young women.

“A major take-away message from Chenay’s story is the importance of self-exams,” Christman said. “She was too young to need a routine mammogram. And still, her tumors were quite large – 11 centimeters total, which is unusual. Had she not discovered a lump, it might have been a couple of years before they’d been detected. There is no risk involved in self-exams, and you might find something.

“I tell patients – even those in their 20s – to become familiar with their breast tissue and what it feels like so they’ll recognize if there’s a change.”

Even though Kelly didn’t think the lump she felt could be cancer, she still took it seriously. She went first to her Greensboro-based, longtime OB-GYN, Dr. Cecilia Banga, who ordered a mammogram and biopsy and referred Kelly to Novant Health.

Banga is African American herself, and Kelly inherently trusts her.

Mistrust of the medical establishment is widespread among people of color. And studies show there’s reason for that lack of trust. “As African Americans, it’s important that we listen to our bodies and advocate for ourselves,” Kelly said. “Our health concerns are too often overlooked. As a result, there are many of us who just don’t go to the doctor. We have to fight sometimes to be taken seriously. You have to learn to say: ‘I live in this body, and I know something isn’t right.’”

In less than a year, Kelly’s gone from being in disbelief over her diagnosis to helping newly diagnosed women deal with their own disbelief.

“A few months ago, I thought cancer could never happen to me,” she said. “Now, two people I work with are going through it. One out of eight women will. We have to change the narrative; it’s time to bring awareness to the forefront.”

For Kelly, it’s also time for fun. The past year has been one of upheaval and uncertainty. Now, she’s making joy a priority. “I told the kids that we’re going to live life and make up for what we missed,” she said. That includes travel. Ghana and Kenya are on Kelly’s bucket list. Her daughter wants to see China and Japan.

“I can truly say that I did not let cancer destroy me,” she said. “I have conquered it. I don’t mind tooting my own horn about that.”

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