Ten years ago, Elisa Caleb was 18 and a student embarking on a law degree in Sheffield. With impeccable A-level results under her belt, but still not knowing quite what she wanted to do with her life, she was enjoying her lifestyle, making the most of her new-found freedom, the busy social life and an ample loan. It would have been hard to find a more typical student but within a matter of months, Elisa made a discovery which would change her life and how she felt about it forever.
One evening in October 1999, as she got changed for bed, Elisa noticed a lump in her right breast. Immediately, panic set in. Although the chances of it being anything too serious for someone so young were actually extremely low, her first thought was simply: "I'm going to die."
She recalls: "I immediately felt that this was something big," though she adds that she had no idea at the time just how big things would get.
Not knowing what else to do, Elisa rang her best friend Joe, who reassured her that it would likely be nothing to worry about. Calm down, go to sleep and see your GP in the morning, was his advice. The next day, a fretful Elisa went to her doctor, who, perhaps unsurprisingly, didn't show much concern.
"The GP was quite blasé," Elisa explains. "She said it was common for teenage girls to have lumps in their breasts, but that breast cancer in young girls is terribly rare." All the same, as a matter of procedure, Elisa was given a fine needle test then and there – which involved taking a few cells from the affected area using a small needle. The results later came back saying the lump was a benign tumour: nothing to worry about. The doctor said she could have it removed if she wanted, but as she'd been told it was nothing serious, she declined. This, it transpired, was not the best decision.
Over the next few months, Elisa's life went on as normal. She carried on at uni, spending long afternoons rummaging through shops, building up her record collection. But all the while, there was a feeling of unease that she couldn't shift. "Every day, I kept telling myself it was nothing," she says. "But every day as I dressed I'd feel the lump there. I had to keep reminding myself that the doctors had done tests and they'd said it was fine – so how could it not be?"
Despite her attempts to ignore it, the lump kept growing. "Eventually it was so big that it had started to protrude through the skin; it was so uncomfortable that I couldn't sleep," Elisa recalls. "The tiredness was affecting my performance in exams and lectures, so I decided to have it removed." Her GP booked a routine lumpectomy to remove the tissue. She had a general anaesthetic for the operation, which went smoothly, and for the next couple of days she felt a bit tender but reassured by her decision. Then she got a call from her GP, asking her to come into the surgery – straightaway.
"I was told that the results from the operation had come in: I had advanced cancer and needed treatment immediately. I remember that moment vividly; I held the phone and felt completely numb. I couldn't believe what I'd heard. I'd been telling myself for months it was nothing, only now to be told that all that time it had been growing and becoming more aggressive. How could this be?"
The answer was that because of her age – and the fact that breast cancer in someone so young is so rare – doctors had concluded that although the result of her original fine needle test had come back as unclear – which Elisa says she had not been told at the time – it was unlikely to be malignant. This was not the case. In fact, despite having no history of breast cancer in her family, Elisa says she had become one of the three youngest people in the UK to suffer from the illness.
Once Elisa's breast cancer was finally diagnosed in June 2000 – when she was 19 – things started to move quickly; she deferred her university place and moved back to London to start treatment at the Royal Marsden within a week. Here she was given a lymphoid biopsy, where dye is injected into the body, and by observing which way the dye moves, medics are given an idea of the most likely path the cancer will take. Elisa was assigned a team of doctors who decided that the best form of treatment would be a strong round of chemotherapy. Because she was young and otherwise fit, it was assumed she'd bounce back with relative ease.
Looking back, Elisa says she felt a mixture of relief that the tumour had finally been identified and that she was now receiving treatment, and anger at what was happening to her. "It's inevitable that in such situations you find yourself asking, 'Why me?'" she says. She was in a state of limbo: she'd deferred her place at university, but had no idea how long she'd be away; she still didn't understand much about her illness or what it would mean long term, and because of the rarity of the condition in someone so young, doctors were unsure about the prognosis.
The chemotherapy was incredibly aggressive: "The first night was the worst," Elisa recalls. "Afterwards, I was in a crazed fever; I didn't know what I was saying or doing. My mum was heartbroken to see me that way." The plan was for Elisa to have a course of six injections – one every three weeks – and with each injection, she was attached to a drip for three hours while the heavily diluted solution entered her system. "By the end of it, my veins had collapsed, I looked like a junkie," she says. "At one point they said they couldn't find another vein and would have to put a line into my heart, but I couldn't take that. I said, 'You will find a vein, put it in my neck if you have to.'"
Elisa's body didn't react well to chemotherapy, and after four rounds of treatment, she decided to stop. "My white blood cell count wasn't high enough to handle another: I'd lost all my hair and I was very weak, I had to rest a lot," she explains. Her friend Joe was adamant she must finish the course, but she couldn't: "It simply would have killed me." The doctors decided that Elisa would have to have another precautionary treatment to prevent the cancer spreading. They settled on a course of more injections, this time once a month to the stomach of Zoladex. This lasted from October 2001 to 2003. As Elisa's cancer was oestrogen-fuelled, the desired effect of the Zoladex was to shut down her ovaries completely. This resulted in menopausal symptoms such as hot flushes and, more worrying, a risk that her periods would never return.
Elisa had radiotherapy for some months in conjunction with the injections, and finally it was decided that the treatment had been effective; the cancer was found not to have spread. Although an all-clear signal was too much to hope for at this stage, the signs were good. After three years of intensive treatment, in 2003, Elisa was told she would only need an ultrasound check-up every 12 months.
Elisa eventually started to feel better; her hair started to regrow and her energy came back. And it was then that she realised that the experience had changed her for ever and she couldn't pick up where she'd left off. Having been told by Sheffield that having been away so long she'd have to resit her first year, Elisa decided to start afresh in London, and draw a line under the horror of the past few years. "I'd had a lot of time to think and reassess what I wanted from life," she says. In September 2003 she enrolled for a degree in theology, having become a committed Christian during her illness. "I started to look at things in a different light," she says. "Life is so short, I want to spend mine in meaningful ways with the people I love."
Today, at 29, Elisa has been pretty much given the all-clear, and despite fears about whether she'd be able to conceive, she has a two-year-old daughter with Joe, the friend who was there from the very beginning and who is now her husband. Joe runs a music agency called Jazz Talent, and with his help, Elisa has built a career as a singer – something she says she wouldn't have had the confidence to try before her illness. While others in Elisa's position might understandably feel angry at what they've been through, in the long run Elisa wonders whether her illness was a blessing in disguise.
"Through all this, I think certain things have been made clearer to me," Elisa concludes. "Before, I was living a life that wasn't going to give me long-term happiness; my breast cancer gave me reason to sit up and think about a lot of things. Maybe getting so close to death was what I needed to make that change."
Elisa Caleb's album 'Carry Me Home' is out now. Elisacaleb.com
Breast lumps in young women: the facts
* Breast Cancer is extremely rare in women under the age of 20. According to Cancer Research UK, there were four cases in women aged between 15 and 19 who were diagnosed with breast cancer in 2007 (the most recent figures available).
* Any lump should be investigated. Doctors suggest all women should check their breasts regularly. If you discover what you think is a lump in your breast, you should see your doctor straightaway. The earlier they identify a problem, regardless if it is cancer or not, the easier the treatment and the higher the chances of success of recovery.
* The doctor will examine your breasts, armpits and the base of your neck. For the under 35s this is often followed by an ultrasound scan. You may have a biopsy, where a small sample of tissue is taken for cell analysis.
* In younger women a lump is much more likely to be non-cancerous. Common non-cancerous lumps include breast cysts (fluid-filled sacs), and fibroadenomas (benign lumps).
* Many breast lumps need no treatment, though some lumps will need to be surgically removed.