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A mammogram showed the underarm lump was a cancerous tumor.

When she first felt the tenderness under her arm, Kim Petraglia thought maybe she’d pushed herself too hard, maybe she’d pulled or strained a muscle while working out.

The tenderness was not enough to worry her, but when Kim went for a routine checkup, her doctor surprised her by discovering a lump.

Kim did what she had to do: She underwent surgery. Half her right breast was removed, as well as 14 lymph nodes under her arm. To keep the cancer at bay, she submitted to a grueling battery of drugs and radiation treatments.

Kim, who moved to Philadelphia from Virginia in her senior year of high school and graduated from Cardinal O’Hara and Widener University with a degree in hospitality management, had just turned 27. She was a hard-charging retail manager for Aramark, the food services company.

Her bout with cancer, she decided, would be a bump in the road, not the end of the highway. Promoted, she moved to Baltimore to tackle a new assignment. The cancer was behind her, she told herself. She plunged back into work, putting in her customary 12-hour days.

But then came the headaches–terrible, overwhelming migraine headaches. Kim moved back to Philadelphia and again sought medical help. This time the news was really bad: The cancer had spread to Kim’s brain stem and frontal lobe. There were more surgeries, small victories, then demoralizing defeats, a hemorrhaging tumor, a mini-stroke that temporarily paralyzed Kim’s left side and destroyed her sense of balance.

Kim is 31 now, far too young to have been through so much. She has bright eyes and a radiant face. She wears a jaunty black Stetson over what’s left of her hair. Over the last four years, she’s had three breast-cancer operations, three brain operations and a hysterectomy (her particular cancer is “estrogen receptive”–stimulated by the presence of the female hormone). Now the cancer has spread to the lymph nodes of her chest and throat. It is crushing her vocal cords and esophagus, making it hard for her to breathe and speak.

Kim is the oldest of four girls. “There’s not a cell of cancer anywhere else in the family,” she says.

She’s the victim of a baffling accident, the cruel roulette of mitosis gone awry. Thousands of times she must have asked herself, in those lonely nights of darkness visible, when the imminence of death seems palpable: Why me?

Yet she shows no trace of self-pity. Her cancer may be fierce and relentless, but so is Kim’s resolve. She exults in her daily triumph: She’s still alive. Her story is not about cancer or surviving cancer. It’s about the invincible spirit of a remarkable young woman who’s living an active, healthy life “with cancer.”

Yes, you read it right. Despite the cancer that has ravaged her body, Kim considers herself strong and “healthy.” And she’s determined to stay that way.

Richard Gibson got a taste of that determination two years ago. He had met Kim through a 12-step program and decided to visit her in the hospital.

“You’re a trainer, aren’t you?” Kim asked Gibson. “I’m really worried about losing muscle mass and putting on weight. When I get out of here, could you give me a few pointers?”

“I’ll do better than that,” said Gibson, 59. “I’ll work with you one on one.”

Gibson kept his promise. Two or three times a week, he leads Kim through a series of strength-building exercises. Sometimes they meet at Maxercise, the gym Kim belongs to. Other times, they’ll meet at Gibson’s house or Kim’s house in South Philly.

At the gym, they’ll hit the machines, performing six to eight exercises in about 20 minutes. The in-house workouts are usually longer and more improvised, involving maybe 14 to 15 exercises with dumbbells, strap-on weights and exercise balls. Gibson is an advocate of slow movement and pushing the targeted muscles to exhaustion. Kim usually meets the challenge, and then some.

“From the very first workout, I was astonished at how hard she worked,” says Gibson. “I would show her how to do something, and she would do it almost immediately in perfect form. I’ve never had anybody who, every single workout, would say, `How many of these have I done? I’m going to get one more. I’m going to get one more.’ And she usually does. Even during weeks when she’s undergoing chemo or she’s had a setback, if she doesn’t set a new personal record, she’ll at least equal what she did before.”

She’s not trying to be a hero or a saint, says Kim. She’s just making the best of the hand that’s been dealt her. “I don’t want to be miserable for however long I exist,” says Kim. “I’d rather participate in life than give up and surrender to the disease. By exercising, I’m saying, `There’s still life to be lived.’ “