Choriocarcinoma, Cancer From Pregnancy, Hope

By Larry Puls @larrypulsauthor

Choriocarcinoma; Cancer from Pregnancy

It is tough enough to be pregnant, what with the backaches, the nausea, and the getting up and down all night. Guys like me will never really comprehend it, though we appreciate some of it while watching our sweet wives endure it. But I would say to those who have been pregnant, imagine how much tougher those inconveniences would be if the events surrounding that joyful time turned tragically against you. A life full of hope transforming into just hoping for a chance, all in the blink of an eye. Those are the events that shake our very foundations. That is what tests our faith. And interestingly, but not surprisingly, that is what grows us.

Sixteen, scared, and single described the young woman I met. And we didn’t meet on her terms. She was thrust into our relationship against her desires. If she had been offered a choice, she would have never met someone like me--and I wouldn't have taken it personally. She represented a life serendipitously, but providentially, forced into a trying scenario that ultimately turned her from child-mother to adult in a few short months.

Alone, living with her mom, questioning how she would care for her new baby and survive. Her life trajectory was not where she would have wanted it--at least not at that very moment. Each night, I imagined, she wondered about her next day, her next meal, her next purchase of diapers. But all those concerns were eclipsed by a physical symptom that could not be ignored.

Two weeks after arriving at home, a growing shortness of breath became evident--and it became impossible to function with the anoxia. Perhaps it was just fatigue. Perhaps too little sleep. Maybe angst about her life made it all seem worse than it really was. But with each passing hour, the breathing worsened. In a few short days, nothing could account for what was happening to her little body. Something was terribly wrong.

Her mother drove her to the emergency department. Upon exiting the car, the world spun around the young woman. Cars looked like they were speeding past her, and yet, they were parked. Was it all a bad dream? 

Entering the hospital's waiting room, she sat, almost gasping for a breath, while her mother checked them in. The line before her was unusually long, a sea of humanity wanting to be seen for their own emergencies, their own pains. But with each passing moment, the air was harder to find. Breath became exceedingly precious. Each successive gasp was less satisfying. The lack of air could not satiate her. She felt like she was in a vacuum. If only she could get a little more air in her lungs.

Nearly collapsing, her mother's panic kicked in. A near scream. Now moved to the front of the line. Her color grew paler. Her chest wall labored and even scooting in her chair became difficult. The air moving through her was was too little, and now almost too late. Nurses place oxygen on her face. One breath. Then two. Oxygen began to permeate the young mother. Her face shows instant signs of relief. Her chest slows. The lungs now scream with less pain. But as sweet as the oxygen was, it was only a bandaid, not a cure. There were still no answers. Just a young woman with breathing issues.

The next hour was about piecing the puzzle together. It was filled with a flurry of every imaginable test. X-rays. Blood tests. Physical examinations. Why does a sixteen-year-old non-smoker fight for breath? Blood clots? Pneumonia? Why? The x-rays were now ready to review. Lungs? What lungs? Spaces that were supposed to be filled with air were now filled with white patches of solid material. Something bad was in her chest cavity. Infection? What was it? The doctors desperately searched for answers. Could it be worse? No, surely not. Sixteen-year-olds don’t get cancer, do they?

The second wave of tests were ordered. CT scans of everything. Chest. Abdomen. Pelvis. Head. Now more blood tests--tubes and tubes of blood.

The results begin to trickle in over the next hour. The first set reveals nothing. The next set reveals a little something. But finally, with time, something big shows up. And it is almost too devastating. Two areas worrisome for, but not diagnostic of, cancer in her liver. A sixteen-year-old with liver cancer--never even heard of it. Then the CT scan of the chest comes up on the screen. The suspicious solid areas offer only more discouragement. The same as the liver—probable cancer, the report says, "too many areas of cancer to count". And just when it all seems too much, the real hammer drops. The CT of her head. Her brain has malignant process, maybe, and possibly, the starting point of everything bad.

Sixteen. Alone. Baby back at the house. Cancer in the brain. Cancer in the liver. Cancer in the lungs. Try spinning that into any good news. The first doctor walks in, shakes his head, and wonders where to start. There is nothing promising here. Nothing. After some time, the word hospice is dropped onto the table. Do sixteen-year-olds even know that word? There are no biopsies--yet. But the CT pictures are bleak. And they are truthful. Whatever that monster is in there will likely be terminal, and fast.

But there is always hope. And like a seed under the ground in the cold of winter, something unknown to all of us was going on in a back room. A lab technician without the privilege of attaching a face to a blood test, is perplexed by one of these blood results. The technician and her boss decide to repeat it. Maybe it's a mistake. Oh sure, she was just pregnant, maybe that explains it. But should her pregnancy test still be positive two weeks after the baby was born? They run it again. And wait. The young mother is still praying for air. Hospice is on the table. The second run of the perplexing blood test comes up on the computer screen. There is no way it is correct. No way... And yet maybe it is.

The patient, somewhere in the hospital, looking for hope, pondering the word hospice, will like this result. Even though at the present moment, tears must be streaming down. She wonders, who will raise her child? Pain so deep a soul cannot absorb it. I still have not met her. Our paths will cross in the next twenty-four hours.

The lab result says her pregnancy test is still positive. No one is terribly surprised given she just delivered this child two weeks ago. But this test is not positive in the way we normally think of positive. The number from the blood test is so high it pierces the the stratospheric clouds. No one has ever seen anything like it. It is far north of a million. Let's put that in perspective. A number equal to fifteen babies all at once. And yet we know, she is not pregnant. That baby is at her home.

This number though unexpected, and scary in some ways, is in fact the first glimmer of hope. Though she didn't know this yet. This was not a brain cancer. This was not a liver cancer. This was not lung cancer. The blood test has given a diagnosis even without a biopsy. She has choriocarcinoma. Cancer as a result of pregnancy. Yes, the cancer comes FROM the pregnancy, not just a simultaneous event.

And there is a treatment for that.

Suddenly the death sentence is put on hold. Somehow, someway, there is a shot at life here. The simple test tells a different story. Hope will be infused into her next visit. Hope for a mother's life. 

Next time we will take her off hospice and look at her options.

Have you ever thought all hope was lost only to find a way out? Tell me what was running through your mind.

Choriocarcinoma and Pregnancy From Cancer, Larry Puls, Click to tweet