chemo while pregnant???

kiwi72 · July 2008

I recently found out I had breast cancer, the same day I found out I was pregnant. This is my first pregnancy and will probably be my last. I am 35 years old and will go on Tamoxifen after the baby is born.

I was diagnosed with cancer and it started to spread quickly so had to do the bilateral mastectomy at 9 weeks (instead of waiting till my first trimester was over). The baby is fine so far and I am now 14 weeks pregnant. I saw the oncologist the other day and they recommended chemo (while still pregnant and then Tamoxifen after the baby is born). I have breast cancer in my family and none of them have had reoccurance (also none of them have had more than a lumpectomy with radiation). I feel that I have already exceeded what they have done as far as removing my breasts. They said I was node negative and ER+, Her-2 negative. They said there is a 25% chance of it coming back without doing anything else. They said with Tamoxifen alone, that drops to 16% and with chemo alone, it drops to 17%. Doing both would bring me to 10%.

Under normal circumstances, I would do both but I just don't know in my case. I saw the baby on the ultrasound yesterday and it made me ache. I do not want to put the baby through all of this. They say that it is not too bad for the baby but it still looses all of its hair and has a lower white blood cell count. Some cases also report babies that are stillborn and who have either congenital malformations and heart problems (even though these are to women in the first trimester).

I am trying to decide whether to risk it or not. As I said, I would do chemo if I was not pregnant but I don't know if we (the baby and I) are up to it physically and emotionally. I will deliver early (usually at about 7 1/2 months; all mothers that have had chemo go into labour early) and I can not go into labour while I am on chemo. If I start when my appointment is I will be done at about 7 months. I will be about 41 after I am done chemo and so feel like the options of having another child will be more limited.

I feel horrible and just want to make the right choice but don't know what it is. All of the doctors recommend it but the case studies for my situation are so limited that I just don't know if 6% is worth all of the risk. I have even found some information that shows that these "chemo babies" are sometimes more at risk for cancer themselves in the first 20 years of life. As there is such a small pool of people to infer information from, they cannot rule or rule out what the true diagnostic effects are.

Most people say, just listen to your heart and that is the right decision but that is not working for me. I don't know what I expect to hear that will make me feel I am making the right decision but I do feel completely helpless to make the right decision for both of us.

So if anyone has any suggestions, that would be great. I already can't breastfeed. I just think that going through chemo while 5,6,7 months pregnant will be so difficult. Especially with the 6% decrease in risk.

Traci-----TripNeg · July 2008

Oh man, kiwi....you sound really strong considering....

My 'lil sis found out about her BC when she was about 6 months pregnant. They ended up enducing (sp?) labor because the tumor was growing so fast. Doing chemo while she was pregnant was never considered. She had the baby, then a mastectomy two days later, then started chemo a month or so after that.

You'll be happy to know that momma and baby are doing good almost 10 years later.

Good luck girl. You'll be in my thoughts.

Hugs, Traci

Jen44 · July 2008

Hi kiwi72,

I wish I had the answer for you but sadly I don't anyone will be able to. This is definitely one that you will have to decide for yourself. I can tell you what I think I would do if I were in your spot, but no one really knows for sure unless they are in the same spot. I will be praying that God will show you what is best and that with all that is going on that you will be able to hear him. I also wish I knew how this will affect the baby, but you are right when you there isn't a lot of things out there about this. About the closest situation I know of is my friend that has Lupus. She had been on steroids for about two years when she found out she was pregnant, they didn't think she could get pregnant. There was a lot of concern about how the steroids would affect the baby, short and long term. Well the baby was born very healthy. She is now almost 11 years old and she had no more health issues than any other child her age. I wish you the best and I will keep praying for you and your baby.

Keep laughing,

Jenny

nash · July 2008

Kiwi, there are women on this board who have gone through chemo while pregnant. Hopefully one of them will check in here and share how she came to her decision. You also might want to check out www.youngsurvival.org--it's a board for young women with bc, and there are apt to be many pregnant ladies over there.

You have a tough decision to make--it's hard enough to make the chemo decision in general w/o having to factor in a little person inside of you. Wish I had more words of wisdom for you. It does sound like your gut is telling you "no", though, and although I know you said you feel helpless right now, I do think you'll come to a decision that you're comfortable with.

gracejon · July 2008

MD Anderson in Texas has a special interest in women who are pregnant with breast cancer. Perhaps googling to get more information and giving them a call may be helpful.

Liz08 · July 2008

Kiwi-

Congraulations on your pregnancy. How about getting a 2nd and 3rd opinion regarding treatment or going a to a large cancer center that has experience treating pregnant women with cancer. I got several (10) opinions regarding my treatment, it's a long story but the good news is the same recommendations were made by all the doctors which made my decision easier. Also, how about waiting to do chemo till after you have the baby, what would the chances of recurrence be then? You did have a grade 2 tumor not grade 3, which is good too. I'm a little confused with your node status; your signature states that you had 1 out of 3 nodes + but in you posting you indicated that you were node negative. Having a positive or negative node does make a difference on how agressive you should be in your treatment. You do have some difficult decisions to make, I pray that you do make a decision that you will be at peace with. Take peace in the fact that this cancer was caught very early and that it's very treatable.

(((Hugs)))

Liz

kiwi72 · July 2008

When they did the initial node biopsy, while I was in surgery, they said there was nothing there. Upon further looking into it, they said that there was a spot in the first lymph node but they still consider it negative if it is that far from the mean where they cut the node. They said in every patient they have seen that seeing a cell in that spot has never developed into anything more. So they said it is negative but you always wonder a little about those types of conclusions.

They also said that they could only do chemo for the first three months after the surgery. That only brings me to month 5 in the pregnancy and is too early to go into labour. I wish I could just be monitored until the end of pregnancy and then if I have anymore then do another surgery and by the time the surgery is over I could do chemo after the baby is born. I am just worried that in that time, it will metastisize and go somewhere where they won't be able to fix it.

I have been doing more research and it is so inconclusive as to whether it harms the fetus or not. There are case studies that show weird and terrible problems (anal fistulas, stillborn, hear problems, testes and vaginal opening problems) and then they go on to conclude that in most cases in teh second and third trimester, it is relatively safe. These seem so contradictory to me. I know most of the problems are from the first trimester but all of these things can still happen in the second and third, as shown in the case studies.

I feel like I am deciding for the possible death of either of us. It is very difficult. :-(

Anonymous · July 2008

Im sorry you are in such a rough spot!!!!! Right now you should be glowing in the joy of your pregnancy, not worrying about bc or chemo Cry

As someone already suggested.....a 2nd or 3rd opinion might be whats called for here...possibly even a therapist to help you deal with the feelings you are having. Im saying that because no matter what decision you make here I think in your shoes I would need a 3rd party to talk about these feelings with....Im sure you husband and family are all very understanding but I also know how much we dont want to worry them more so hold things in.

Of course you always have us here, but sometimes a face to face with someone is better.

I wish I had the words and the knowledge to help you but I do know that I can lend a listening ear if and when you need one....

Hugs

Jule

SISKimberly · July 2008

Kiwi-

Congratulations on your pregnancy.

Crapinola- when you dress it up like that it isn't really swearing, right? Wink - on the breast cancer!!!!

My oncologist's nurse found out she had cancer while pregant and did chemo. Baby was born as you stated, early, but healthy.

I had a bilateral mastectomy and chemo, but chose not to do radiation or hormone suppressing drugs as my chance of recurrence, like yours, was 25% without those and doing those 'may' take me to 10%, which is still a chance of recurrence. I decided on not dealing with all the side effects and believing the surgery got it all to start with and then my aggressive chemo swept up what may have been left behind. I choose to believe I'm in the 75% category.

This isn't an easy decision, but listening to your heart/gut is good advice. Good luck to you.

SIS(sister in survival) Kimberly

imissmyaunt · July 2008

hey kiwi,

im doing a project for school about breast cancer. And i came across your story im so sorry for what happened. i was talking to my teacher about your situation. (oh by the way im in medical assistant class) she was think that u should keep us post on what is going on with u and the baby. i hope all is well.

imissmyaunt · July 2008

hey kiwi,

im doing a project for school about breast cancer. And i came across your story im so sorry for what happened. i was talking to my teacher about your situation. (oh by the way im in medical assistant class) she was think that u should keep us post on what is going on with u and the baby. i hope all is well.

Liz08 · July 2008

Kiwi-

please contact the http://www.youngsurvival.org/young-women-and-bc/ this is a group of women who had/have BC and are under 40 you can read some of their stories on their website. Ask if they know of a forum for women pregnant with BC or if they can direct you to someone who can help you. If they can't help you contact the American Cancer Society, also you can see if the http://www.networkofstrength.org/ formally Y-me can assist you. The Y-me was a good resource to me when I was initially diagnosed. Another resource is John Hopkins in Maryland, they have an ask an expert forum help by Lilly who is a nurse and a 2 X breast cancer survivor, she usually opens the forum for questions on Saturdays.

http://www.hopkinsbreastcenter.org/services/ask_expert/

I know you want to make the best decision which involves the least risk for both you and your baby, just keep praying for God to help you make your decision, that's what has helped me.

If you have any questions about the above just e-mail me privately and I'll try to help you the best I can, I got diagnosed with BC when my baby was only 8 months old so I too had breast cancer while I was pregnant but was not aware of it.

(((Hugs)))

Liz

Anonymous · July 2008

Kiwi,

I'm just so sorry you are going through such a scary time. It's hard enough to worry about your baby, but to make such a decision about chemo, knowing it may affect your child as well....that would make me crazy. Like Traci said, you are one strong cookie.

I was TRYING to get pregnant the month I was diagnosed-in fact, I thought I was pregnant. I read your post, and put myself in your shoes, and honestly understand what you feel as far as, "COULD SOMEONE PLEASE MAKE THE DECISION FOR ME?!?!" That is really quite how I'd respond, too.

If you could, PM me, and I will forward you the information regarding a beautiful woman who was pregnant and had cancer. She had very advanced cancer, and her baby was a miracle baby. I "met" the family through the Young Survival Coalition. Perhaps this family can offer you some insight.

Love and prayers, Deb

kiwi72 · July 2008

Thank you all so much for your support. I have a few more weeks to decide what I am going to do. I will continue to look into it. Deb, you had said in your message to PM you....but I am not sure what that means. hahahaha. If someone could let me know, that would be awesome. And thanks again for all your love and prayers.

Jen44 · July 2008

Hey kiwi72,

To send a PM to someone go to your home page and press on the black Private Message box. You just need to now the screen name of the person you want to send it to. It is very much like sending an email.

Keep laughing,

Jenny

Elliemae32 · July 2008

Kiwi,

I am in the same situation you are in. I found the lump just after my + pregnancy test in Feb but wasn't diagnosed until late may after the lump was removed. In my case I am triple negative so I can't take tamoxifen after wards and chemo is my only "drug" to keep this from coming back. I had a mastectomy at 18 weeks. My oncologist didn't want to start chemo until after 20 weeks. By then all of the organs are developed, the baby is just getting bigger. I also got a second opinion at a large teaching hospital and she recommended a more aggressive chemo than my local oncologist. They also said that they schedule the delivery around your blood levels and chemo. The goal is still a 39 week baby.

I started FAC chemo (you can google it) on 6-27. I also joined both pregnant with cancer network and young survivors. Both are GREAT!! Pregnant with cancer matched me up with a woman who has been through it already. My mentor's chemo baby is now 14 and perfect!! Young survivors has a pregnancy board. Most of the posters are trying to get pregnant after chemo but there are a few like me who are going through it now. I just posted there about starting chemo and at least 10 women responded who have been through it. All of them said the them said that the hormones from pregnancy "protected" them from the nausea and yucky feelings. I will also say that I had no problems with my first treatment also aside from falling asleep at 8:30 on the couch the week after treatment.... was it from the chemo or being 5 months pregnant with a 20 month old toddler? Who knows. Most of them also said that they were bald mamas at delivery while their baby had a full head of hair!!

Most pregnant women get AC therapy since they are old effective drugs. There are many case studies that these drugs are safe for the baby after the first trimester.

Let men know if I can help you in any way, I have done ALOT of research.

Ellen

Anonymous · July 2008

Kiwi - the cure magazine a couple of years ago had some articles about chemo during pregnancy and links to resources (I've included a link to the articles below)

There are some chemos which can be used which are not damaging to the fetus ...

It totally sucks that you have such an amazing experience (pregnancy) being clouded by a cancer diagnosis .. I can't imagine the emotions you're experencing right now ..

Hugs to you .. and wishing you a healthy, happy baby and minimal sideeffects from the treatments to knock that cancer out for good.

http://www.curetoday.com/backissues/v4n4/departments/facingchallenge/index.html

be sure to check out the links on the left hand side of the page for more resources - in particular the link for information and support and the recommended resources.

Doreen

chemo while pregnant???

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