Cancer in Pregnancy; A Young Mother Fights for Her Life

by Larry Puls @larrypulsauthor

Pregnancy and Cancer

Even now, I still remember the unspeakable sadness and the tragic outcome. It was twenty years ago, and counting. The events still flash back into my mind every time I walk onto the floor where the saga culminated... And ended... The beginning of the two-year journey started something like this--as my mind remembers it anyway: A colleague called and asked me to see a patient she believed had cancer... And was thirty-six weeks pregnant. 

Within an hour, a young woman walked into our facility. She was graced with beautiful long blonde hair, a subtle trace of a German accent, and a very gravid abdomen. Her pleasant smile and handshake could not hide the trepidation I sensed was trickling through her veins. I'm just sure that that morning when she woke, her life had felt so full of promise. And now in the blink of an eye, it was marked with a growing sense of uncertainty.

When I sat and interviewed her, she told me about her pregnancy. I felt her joy, her excitement. The anticipation of delivery was palpable. Vivid images flooded into my mind from how she described everything she had already done for her coming child. The nursery was completed; pink sheets and frilly drapes lining the windows. Stuffed animals lining the bedspread. 

After my interview, we got to the needed exam. Her cervix was large, very cancerous, and bled way too easily. Biopsies were taken. A multitude of questions and thoughts stirred inside of me when I  debated this complicated, life-threatening situation. I wanted to know exactly what kind of cancer it was, and I would in time. And her being pregnant wasn't going to make this any easier. Were any other areas involved with metastasis? By the looks of what I saw, I didn't really want to answer that question. I needed to fill in a lot of blanks over the next few days. Pregnancy complicates everything cancer and cancer complicates anyone pregnant. I then let her go and waited for the biopsy results. So I could ruminate. So I could run it by my partners. Two days later, the call came. Her cancer of the cervix was a small cell, the worst of the worst. Somehow everything I saw now made sense. I sat in my office and shook my head.

Vaginal delivery would not be an option. The sheer size of the malignancy and its bleeding potential made a cesarean necessary. Delivery occurred a short forty-eight hours later. If there was any highlight to the whole situation, it was seeing that beautiful little girl take its first breath. Its color was prefect. The baby was screaming, probably mad at the world for taking it out of the safety of its mother's womb four weeks early. But even premature, the child was very healthy.

Once the delivery was completed, I turned my attention to the cancer, to the lymph nodes, to see there were any visible signs of cancerous spread. My intuition said I didn’t really want to know the answer to that one. 

I opened the spaces in her pelvis where the lymph nodes lived. Staring, I saw the collection of lymph tissue looking back up at me. My mind said they looked too large, and they appeared to have a grayish-white pallor which did not look healthy. Was that a pregnancy thing? I doubted it. The ugly version was probably right; it was a cancer thing.

One by one, I plucked them out. Big, hard, and scary. They were stuck and tenaciously trying to hold on with their roots. They were full of death. I knew too much information. Lymph nodes tell a story. Lymph nodes can suggest a future. Suddenly sadness swept through me. I felt like I knew the end of the story, and yet we were just at the beginning.

My head turned back towards the pediatricians. I saw that child. Her crying has softened to a whisper. She was under the warmth of the heat lamp. Flashing forward in time, I envisioned her first steps, her first words. Yes, I knew too much information. Thinking beyond her second birthday, I looked back at her mother, wondering if she would ever see those days. Would Mom be there when she scraped her knees or needed to be held?

My mind was desperate to go somewhere else other than where it was. But I was in that painful moment, that time when reality slaps you back. I knew the diagnosis. I knew the enemy. My eyes started to tear up. Mom, on the other side of the surgical drapes, could not see inside my head. I did not want to rob her of her precious private joy, not today. For just this second, I wanted her to savor her child, to feel its warmth, to create that unique bond of love that comes from a mother. The nurses then laid the swaddled child on her chest. It was a beautiful scene. My worried thoughts remained my own. My humanity was consumed by a troubled heart.

Turning back to the surgery at hand, I committed myself to pushing for a cure. Every bit of medical knowledge I possessed would be applied in the coming months. And I would see what would come. Maybe it would be a different outcome than the one my mind saw. Soon enough, I would know.

To be continued…

Cancer in Pregnancy; A Young Mother Fights for her Life, Larry Puls, (Click to tweet)