Headlines
As reported by CNN, March 23, 2008.
Post-Cancer Pregnancy: 'Little Message That I Was Going to Live On'
By Judy Fortin
ATLANTA, Georgia -- Daphne Babrow's son, Evan, is only 5 months old and she's already thinking about getting pregnant again. The decision won't be easy.
At 41, Babrow is also a recent survivor of ovarian cancer. She feels lucky to be alive and doubly blessed to be a new mom. "I knew if I ever had a baby, it was God's little message that I was going to live on."
Babrow, a public health consultant from Fayetteville, Georgia, is part of a growing number of cancer survivors who are not only winning the battle against the disease, but who also are going on to have safe and successful pregnancies.
"If you maintain some part of your fertility, pregnancy is clearly an option," said Dr. Carolyn Runowicz, a gynecologic oncologist and director of the Neag Comprehensive Cancer Center at the University of Connecticut in Farmington.
Runowicz, a breast cancer survivor herself, has encouraging news for many women who want to get pregnant when their disease is in remission. She said, "It's absolutely possible depending on what cancer you had."
There are no specific guidelines or timetables for women wanting to get pregnant after cancer treatment, she said. Some breast cancer survivors are told to wait at least two years to make sure aggressive tumors don't recur.
"Pregnancy is an enormous surge of hormones," added Runowicz. "If you have a cancer that is hormone sensitive, you just worry that you can exacerbate a recurrence."
Runowicz warns patients up front that some cancers and cancer treatments may leave a woman infertile. For instance, certain chemotherapy and radiation procedures can send a woman into premature menopause. Other gynecologic cancers may require removal of reproductive organs.
For those reasons, Runowicz said, it is very important for women to discuss fertility options with a doctor before undergoing cancer treatments.
Unfortunately, she said, the conversation is sometimes forgotten when a doctor delivers a cancer diagnosis. "Once you hear the three words, 'You have cancer,' panic sets in. You feel like you need to be treated yesterday and in that frame of mind, issues like fertility are often not right up front."
Runowicz reassures patients by telling them, "Cancer is not an emergency in most cases. They have time for a second opinion. They have time to discuss fertility options."
In vitro fertilization is a popular choice for some women, Runowicz said. However, she cautioned "it can be a lengthy and expensive process. Both patients and doctors get nervous about the built-in delay in cancer treatment."
It takes time to harvest a woman's eggs, fertilize them with sperm and create an embryo that would be frozen for implantation later on.
Fertility sparing is another option being offered to some women at select cancer centers. Runowicz described one example: When surgery is required, specific organs are removed and others are spared, allowing a woman to remain fertile.
Babrow underwent emergency surgery when one of her ovaries ruptured. The other ovary was saved. She knew her chances of having a baby were small, and after learning she had cancer, getting pregnant was the last thing on her mind.
"I was in a fight for my life, so that all the strength I had was just cancer," Babrow said. "I had to fight it and I had to win."
Babrow endured three rounds of chemotherapy and survived a series of complications. Not long after she learned she was in remission she found out she was pregnant. She conceived without intervention from a fertility specialist.
Her husband, Victor, was ecstatic, but worried. "I said, 'Please God, don't let there be any complications with the baby, any birth defects or miscarriage.' I was crossing my fingers."
Runowicz said it's natural for people to worry about those issues, "but the reality is that the data don't show any higher incidence of any malformations in women who have chemotherapy or in men who have fathered babies after chemotherapy."
She recommends her patients undergo genetic testing and counseling during the pregnancy.
She also encourages pregnant moms to seek treatment not just from an obstetrician or high-risk pregnancy specialist, but also from an oncologist.
Dr. Jessica Arluck of Emory Crawford Long Hospital in Atlanta, Georgia, is Babrow's OB/GYN and part of the team that managed her pregnancy.
"We went through all the risks with her and said we would work with her and we would do everything we could. We were a team," Arluck said.
The efforts paid off. Babrow delivered a healthy baby boy in November. "I counted the fingers and toes so many times I couldn't believe it," she recalled. "Finally, I realized, it's true, I did have a baby."
Now, Babrow is focusing on staying healthy so she can be around to watch her son grow up. She admitted she worries about the cancer coming back.
"The cancer diagnosis is not going to change -- it's for the rest of my life," Babrow conceded.
It also weighs on her husband's mind, but Victor Babrow tries not to dwell on the future. He's too busy helping raise his son. "After all we went through, this is the pot of gold at the end of the rainbow. We had to travel a long way to get there, but once we got here it's the best gift we ever had."