Saturday, July 19, 2014
Another Life-Affirming Cancer While Pregnant Story
I am always happy when there is another article discussing cancer while pregnant and that abortion is not an option. When I was diagnosed in 2009, I'd never heard of any one having cancer while pregnant. If I'd strained my brain, I probably could have speculated that it happened, but it was not something on the my radar. I think that's true of most people -- cancer happens and women get pregnant, but those are separate entities. So any awareness of cancer while pregnant is good. Awareness of treatment choices for cancer while pregnant being better than abortion is excellent.
Awareness does not always lead to the broadcast of correct medical information about all the viable options - surgery, chemotherapy, or surveillance until the natural end of pregnancy. Many articles give hero status to women who refuse any treatment (including abortion) during pregnancy. It is obviously an excellent decision to continue the pregnancy despite a cancer diagnosis. However, the awareness of chemotherapy's safety while pregnant suffers when pregnant women are quoted as refusing chemotherapy due to its 'risk' to the baby. Obviously, these women are brave for continuing the pregnancy and they are also brave for making the decision to wait until after their baby's birth to begin treatment. I have no issue with women who choose this option. It is equally brave and heroic to continue the pregnancy while choosing to receive chemotherapy. My issue stems from the implied or blatant dismissal of this latter choice.
"chemo is safe during pregnancy but “any time you place chemicals into your body you are placing your child at risk and even possible miscarriage.”" (From this article: http://www.lifenews.com/2014/07/18/mother-pregnant-with-her-10th-child-refuses-cancer-treatment-and-abortion/ )
are misleading at best and derogatory at worst. Many people will completely miss the admission that chemotherapy is safe during pregnancy due to the wording of the rest of the statement. These people will only remember that this woman was a brave hero for refusing to 'risk' her baby's life to save her own. They'll take her opinion* that chemicals (chemotherapy) increase the risk of miscarriage and other harm to heart. This particular woman had surgery while pregnant -- most likely with chemicals (sedatives and anesthetics) given during the operation -- apparently without problem or risk of her child. Little or no thought will be given to the actual medical facts of chemotherapy while pregnant. That lack of thought can be dangerous and discouraging for women who choose chemotherapy while pregnant based on their doctor's advice and their situation.
Every pregnancy is most vulnerable during the first trimester. Women have a higher risk of miscarriage in the first trimester. Once the second trimester begins, the miscarriage risk decreases significantly and continues to decrease as pregnancy progresses. The risk of birth defects is also most significant in the first trimester. Most of the vital forming of the baby happens in the first trimester - differentiating a single cell into various organs and putting all body parts in the right anatomical place. Various chemicals, whether in abundance (alcohol) or not enough (folic acid), can create life-long errors in formation during this trimester. For that reason, to my knowledge, chemotherapy will only be initiated after the vulnerable first trimester of pregnancy.
I was pretty high risk for miscarriage without addition problems (I miscarried 4 times prior to my last pregnancy), but when I was given the option of chemotherapy while pregnant, I was reassured that doing so would not increase my risk. Both my Oncologist and the Maternal-Fetal OB were asked a bazillion questions about that aspect intentionally. An increased likelihood of early contractions were one of the biggest 'risks' associated with chemotherapy during pregnancy according to the Maternal-Fetal OB that I saw in Houston, TX. She actually didn't bring it up until I told her I'd been noticing contractions ever since my diagnosis. However, she again assured me that a) any time you stress a pregnant woman she's likely to have contractions and b) those contractions are rarely 'productive' and therefore not a true risk to the baby. All other risks during chemotherapy pregnancy were similar whether chemotherapy was used or not. My increased risk of miscarriage remained whether I had chemotherapy or not.
I ran into people online and in real life that told me I made a selfish decision to have chemo while I was pregnant based on this thought. It made my reality even more difficult as people questioned my respect and love for my unborn baby. In fact, at one point I had (a few) someone(s) baldly tell me that my decision was *not* pro-life or even Catholic based on their perceived risk(s) posed to the unborn child during chemotherapy. To them, it did not matter that I had an oncologist who specialized in pregnant patients receiving chemotherapy. Her reassurances and research in this area was dismissed based on their ignorance and perception of what was 'healthy' for me and my unborn child. My referral to a Maternal-Fetal OB specialist and her advice was also dismissed. Constant monitoring, measuring, and visualizations ordered by this specialist amounted to nothing in the eyes of my detractors. Life-long respect for life, adherence to the teachings of the Catholic Church, and my own bio-medical education meant nothing to these detractors as they were obviously more pro-life and Catholic than I. I could go on and on, but suffice it to say that while I knew I'd made the best decision for me and my baby, these words of detraction resulted in increased fear, stress, doubts, depression, and anxiety. These derogatory words were probably more detrimental to my pregnancy than the actual chemotherapy was.
I'm all for awareness of cancer while pregnant and chemotherapy while pregnant. While I hate that women face such struggles, I'm always happy to read an article giving the true life-affirming options of continuing the pregnancy with or without chemotherapy. Such articles will hopefully educate people about this devastating situation and give these women hope for their baby's and their own lives. However, I am saddened when opting for chemotherapy while pregnant is indirectly implied to be as bad a choice as abortion. Nothing could be further from the truth. While everyone is entitled to their opinions, it is crucial that medical realities aren't supplanted by emotional opinions. A devastating cancer diagnosis while pregnant is difficult and stressful enough without adding further confusion to the matter based on erroneous opinions. Let everyone know that a diagnosis of cancer while pregnant isn't a death sentence to either the woman or her child - both can live through chemotherapy, surgery, or the natural end of pregnancy.
Moral of the story: Abortion is *never* in the baby's best interest. Cancer during pregnancy can be survived by both. Viable options include chemotherapy, surgery, and surveillance until the natural end of pregnancy. Mother and baby can survive and thrive despite a cancer diagnosis regardless of which of these treatment options is chosen.
*I am in no means trying to denigrate this woman for her opinion or choice. Nor am I trying to lay guilt on her doorstep for her choice or opinion. She is a brave and heroic woman for resisting the oft-repeated option of aborting her child. I give her great kudos for that decision alone. I also give her and her family my prayers as they continue through this struggle. She has as my full sympathy and support during this time of difficulty. May God bless her and keep her healthy.
Medical and Media References to Chemotherapy During Pregnancy
http://breastcancer.theoncologist.com/article/case-control-study-women-treated-chemotherapy-breast-cancer-during-pregnancy-compared - I'm more than likely included in the number of pregnant women treated with chemotherapy in this journal article by my Breast Oncologist, JK Litton. This one also shows that there is improved outcomes in pregnant patients verses non-pregnant patients.
http://www2.mdanderson.org/depts/oncolog/articles/11/10-oct/10-11-1.html - My Breast Oncologist at MD Anderson is in this one too.
http://connection.asco.org/magazine/article/id/2857/active-cancer-treatment-during-pregnancytwo-perspectives-on-timing-and-drug-choice.aspx - Another article by my Breast Oncologist. The second half of the 'debate' on this page, to me, displays someone desperate to find an excuse to worry. Note the large number of references used by my Breast Oncologist verses the solitary reference used by her 'opponent'.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2753540/ - Another article by my Breast Oncologist in full text presentation.
http://www.mdanderson.org/transcripts/Breast_Cancer_and_Pregnancy_Transcript.html - Another interview with my Breast Oncologist. This is a terrible transcript with numerous typos, but the gist is the same as the others.
http://www.news-medical.net/news/20120822/Chemotherapy-during-pregnancy-an-interview-with-Professor-Sibylle-Loibl.aspx - The doctor interviewed here said that she hopes no more "unnecessary terminations" are carried out on pregnant women with cancer.
http://www.cnn.com/2011/HEALTH/05/16/pregnant.with.cancer/index.html - Another one with my Breast Oncologist in it.