As if finding out that you have cancer isn't hard enough, imagine if on top of that news you learn that you might not be able to have a baby. About 63,000 women under age 45 will be diagnosed with cancer this year, according to Fertile Hope, a nonprofit organization that provides fertility resources to women with cancer. And while recent research has shown that becoming pregnant after cancer doesn't cause recurrences, or health problems in children, many survivors struggle with fertility complications—and all have to wrestle with the idea of that, at some point, the cancer could return. "A woman has to acknowledge the reality that she could die. She and her partner have to weigh the risk of recurrence and address the possibility that her child could be raised without her," says Charles L. Shapiro, M.D., director of breast medical oncology for the Arthur Jean James Cancer Hospital in Columbus, Ohio. "It's a very personal decision."
Many women also have to face the judgment of others, who question their choice to have a child when their future isn't guaranteed. "Having cancer is not a crime," says Douglas Moss, M.D., an ob-gyn at Mt. Siani Hospital in New York City. "These women have had a bad break and they deserve to have an opportunity to make the choice to become parents."
We spoke with remarkable survivors about their struggles with cancer and how they beat the odds to have a baby. Here are their stories.
Jennifer Rand, 32, is a kindergarten teacher from Long Island, New York. Her husband, Ricky, 34, is a customer representative for the local electric company. Their daughter, Faith, was born five months ago.
You know it's not good when you're sitting on a table after a medical test and they say, 'Did you come with anybody?' I was 29 years old and the diagnosis was colorectal cancer.
We were trying to get pregnant at the time, so right away I asked about having children. Because the doctors weren't sure if I'd need chemotherapy after surgery—which can lead to infertility—my husband Ricky and I went to a clinic to look into egg freezing, and were told he had a low sperm count. We were concerned, but had so much else on our minds, we just thought, okay, we'll deal with that later.
As it turned out, my cancer was stage 1 and I didn't need either chemo or radiation, but I had to have a massive colon and rectal resection. Two top surgeons on Long Island refused to do the operation because they said it was too risky and I'd end up with a permanent colostomy bag. I didn't want that at 29! I found Dr. Michael Harris at Mt. Sinai Hospital in New York City, who was wonderful.
The recovery was hard, but my husband was amazing. When we first found out, he was devastated of course, but then he and my sisters just rallied. They became so informed—I think they knew more than some of the doctors. Ricky had a backpack with a sticker that said "Project Hope" and held all of my scans and medical information. He stayed with me on a cot in my hospital room for eight days. Since he knows I'm into my hair and makeup being just so, he would wash my hair every day. An orderly showed him how to slide the bed up, hang my head over the edge, and use a bucket to wash it. He bought me cute pajamas and matching robes. My doctor said I looked so good he wanted to wheel me around to show his other patients!
Ricky and I were told to wait two years after the surgery before trying to have a baby because I needed time to heal. In a situation like this, you have to be positive. A little less than two years later—we were anxious—we started trying. When nothing happened, we remembered about that low sperm count and Ricky visited a urologist for a routine procedure. While Ricky was recovering in the other room, the doctor told me, "I felt a mass." I was sitting there alone, stunned. They removed the testicle with the cancer mass and took tissue samples from the other, which had precancerous cells. Most men have between 20 and 150 million sperm at any given time—they found only one viable sperm.
Learning that Ricky had testicular cancer was horrible. My husband and I had been together 12 years—we dated a long time before we got married—and in all those years we dreamed of the house and the family. It was totally crushing, not just crushing for him to have cancer, but to be told you can't have children either.
We had one shot to try to conceive with that single sperm because he needed to start radiation soon. We planned to have my eggs retrieved, fertilized and then implanted, so specialists recommended we also purchase donor sperm. Well, when we got to the fertility place for the procedure, the delivery service had lost the donor sperm! I was boosted up on injections and this was it, so the doctor said, "Let's see what we find in Ricky."
I look back on it and it was funny, actually. Ricky and I called it "Project Nemo," after the Disney movie Finding Nemo. I'm lying on a gurney and my husband is doped up on anesthesia and we hear the staff calling to one another. "We have three sperm!" "We have ten eggs!" "We have six sperm...eight...ten!" "Okay, we have ten eggs and ten sperm, let's go!" Three of those made it and were implanted, and out of those three, I got my daughter Faith.
All of our family and friends were really eager for Faith to be born, and everyone is in love. It is so nice to be able to care for my own child—it's unbelievable. I look at her each day and I can't believe she's here after everything. Her dad is doing great and he's ecstatic—he loves his little girl.
Heather Pick, 35, is a news anchor in Columbus, Ohio. She and her husband, Joe Cygan, 33, a graphic animation artist, have two children: Julia, 4, and Jack, 15 months.
I was 28, I had only been married a few months, and my husband Joe and I had just bought a house, when all of a sudden I began feeling really tired. As a TV journalist and evening news anchor, I was used to long hours and a hectic schedule, but this was different. Everything I did made me tired. I would exercise, which usually picks me up and gives me energy, but afterward, instead of feeling better, I'd be exhausted. I knew something was wrong.
Although I was so young, I actually was worried that I might have breast cancer because my grandmother had it. Later I learned that many elderly women get breast cancer and it doesn't affect a relative's risk. But I'm glad I didn't know that, because I started doing self breast exams and found a lump.
My first thought when I was diagnosed was "I always wanted to be a mom." I'd been warned about the risks of infertility, but obviously we had to get through the therapies that would save my life first. My husband and I decided that if we couldn't have children, we'd be happy to adopt.
Although I had four cycles of chemotherapy and five rounds of radiation, my periods came back fairly regularly. My cancer was estrogen receptor positive, so I started on tamoxifen. But I was diagnosed as a stage 1 and my chance of getting cancer again was so low that my husband and I decided to try to have children, rather than wait through five years of treatment. I went off the tamoxifen and Julia was born on September 19, 2001. We had our son, Jack, on June 24, 2004. It was what I'd always wanted, to have children and to watch them grow up. My pregnancies were so easy, my deliveries were so easy, and everyone was healthy.
Five months after Jack was born, I went in for a five-year post-cancer checkup, and the doctor was stern with me. He told me I really needed to have some scans done. When I did, they found the cancer had metastasized to my bones. What I couldn't wrap my mind around was how sneaky this disease is. I'd only been stage 1, with two small tumors with precancerous cells. I started tamoxifen again; and at first it seemed to be working, but then my tumor markers began going back up. I'm on a hormone therapy now and we're in kind of a waiting game. If the doctors see an immediate danger, they'll throw me back on chemo.
I don't know if it's harder knowing or not knowing whether you are going to survive. For me the biggest priority is not letting it get the best of me. I don't regret our decision to have children for a second. That's what keeps me positive and keeps me fighting. I work mornings, so we have the afternoons together, and I sit there and lick up every moment. I want them to remember me. I want to be with them when they graduate from high school. I keep a journal to tell them about themselves and a little bit about what their Dad and I are dealing with. I give a lot of credit to my husband; he's amazingly supportive and has been my rock.
I've had several beautiful years and I was able to become a mom. I don't want to leave yet, but I feel pretty blessed.
Stefanie Spielman, 38, is a stay-at-home mom who volunteers for the Stefanie Spielman Fund for Breast Cancer Research, which she started with her husband, Chris, 39, a former pro football player. They have four children: Madison, 11; Noah, 9; Macy, 4; and Audrey Grace, 3.
About seven years ago, when Chris was playing for the Buffalo Bills, I miscarried our third child. At the same time, I found a lump in my breast, so while I was being examined after the miscarriage, I said, "Would you mind looking at this?" The mammogram showed DCIS, ductal carcinoma in situ, a non-invasive early stage cancer. It was hard to believe because I ate organic food, I stayed in shape—I had to, I was married to a jock!—and I had no family history of breast cancer. Because of the size of the lump I needed a mastectomy.
When I was diagnosed, Chris quit football for a year and stayed home, took care of the kids, and learned how to cook and do laundry. He was my nurse and Mr. Mom. I had to have chemotherapy, but after that I thought our life would roll forward. We weren't going to let cancer stop us from having the life we wanted.
When I became pregnant again, I wasn't considered high risk. It was almost strange how normal it was. I loved being normal! It was empowering. But during the pregnancy I developed a cough. Seven weeks after having our third child, Macy, I learned the cancer had returned to my lungs. It was an aggressive form, so I was put on six months of chemo plus a new "wonder drug," Herceptin, which is an antibody therapy to prevent tumor growth. A month after dropping chemo, I had my period, the next month I didn't. I thought my system was going wacky. A couple of months later, I felt a strangeness in my abdomen. I thought I had ovarian cancer, but instead I was already four months pregnant.
No one had ever been pregnant on Herceptin as far as we know, and in my stage of disease, it was not the time for me to be having another baby. But we got a scan done and we prayed a lot. We really believed it was God's plan for us to have our fourth child. I stayed on the medicine. It was a decision that was very difficult, but I had three kids at home who needed me. I was scared to death, but I just really believed it was out of my hands and so much bigger than me, and I trusted in that, truly.
Audrey Grace came two months early, but she is perfect in every way. I had to take steroids to develop her lungs and she was only four pounds. I usually have these big babies -- the third weighed nine pounds. When she came out we knew she was going to be small, but she looked so normal. That was a good sign for us. I was happy on so many levels. Happy that she was healthy, happy that it was over, and happy we had had the faith to go through with it all. And happy to have a complete family.
Last year there was a little growth in the same spot in my lungs, so I went through eight months of chemo again. I've been off since May and life is good now. I couldn't wait to have the summer with my kids—I wanted to enjoy every day in the sun.
My father died of cancer when I was 20 and my sister was 15, so I know what it's like growing up without a parent because of a disease. There is a fear there for me every day—it's a huge reality. But I also know this can give my kids the ability to face adversity head on, the will to survive, and a trust in God and the plan he has for you. As a kid, I saw my dad, a physician, fight a good fight and love his family. When I was diagnosed, I wanted to turn this bad situation into good, and make it not so scary for my kids.
I can't believe this is my life, because it's shocking. I have an angel child and a miracle baby. I call Macy, who's 4, my angel child because without her being in my stomach and pushing on my lungs, I would never have known that my cancer had returned. And Audrey Grace, who just turned 3, is my miracle.
I'm looking forward to staying healthy so I can just watch my kids grow. Right now I live in very short intervals. I feel like I can't look five years down the road, but I can look three months down the road.
Dina Melendez, 38, an at-home mom and part-time dog groomer from Buckingham, PA, is married to Michael Melendez, 42, a state horse racing official, and mother of Nicole, 12, and Matthew, 4.
It was a Friday night in October. I was getting in the shower when I ran my hand across my breast. I felt a pea-sized lump. Right away my heart sank. I had a very bad feeling about it. I was 28 years old and my daughter, Nicole, had just turned 2. Monday morning I went in for an exam even thought I'd just been there a month prior and they'd found nothing. The doctor said, "You're too young for breast cancer. If the lump doesn't dissipate in a month, get a mammogram." Well, I didn't wait. Right away, I got a mammogram, a sonogram and a biopsy. And it turned out to be malignant.
I couldn't believe this was happening to me at age 28. Young women weren't supposed to get breast cancer! And we had so many stresses in our life, so many new things, so many great things: We were raising a toddler, we were deciding on when to have our second child, we were trying to buy a townhouse, I was just beginning my dog grooming career. And now this.
I didn't discuss fertility right away with my doctors. I was so overwhelmed by the fact I had cancer that fertility wasn't in the forefront of my mind. I just felt I needed to save my life for my husband and my daughter. Then after a year of treatment and chemotherapy it suddenly occurred to me I might never be able to get pregnant again!
Today there is a wealth of information for young women going through breast cancer. Many women have had pregnancies after cancer, and women's issues are discussed more openly. Ten years ago, I didn't know where to start. The Web wasn't the resource it is today, and support groups for young women didn't exist. When I did go to a breast cancer support group, everybody was over forty! There was nobody I could relate to. Until I met women through the Young Survival Coalition (a nationwide support group for young breast cancer survivors), I didn't really believe other young women had breast cancer.
My daughter really kept me going during treatment: wondering why mommy was so sick, rubbing my head when I lost my hair. I just had to look at that little face, so full of innocent support, and it gave me strength. I promised myself that if I was able to get pregnant again, I wouldn't miss a thing while that child was growing.
My oncologist said I needed a waiting period of two years before I tried to become pregnant; the breast surgeon and ob-gyn said five. I don't like to be told I can't do something, but I had a close relationship with my surgeon, so I trusted his opinion. Still, because I didn't have good info, I spent the next five years worrying that the child I brought into the world would be affected by my chemo.
Almost immediately after the five years were up we started trying—the doctors said there was only a certain window of time for it to work. We got pregnant within the second month of trying!
First, we found out the baby was a boy; then we found out through the ultrasound that he looked healthy. It was so overwhelming for my husband and me. Just to see the baby inside me and to know we had done this again—it felt like the cancer situation had been put behind us. Even so, I still had to see my breast surgeon once a month for an exam, as well as my ob-gyn.
The moment when Matthew was delivered was incredible. At the time, I felt that I had beaten the odds. Not only had I survived for five years, but I had produced another child and a healthy one. I was even able to breastfeed for a short time. Of course, since I'd had a mastectomy with reconstruction, I was a B-cup on one side and a D on the other after Matthew was born. It made for a very interesting bra situation!
Sue Lustig McPeek, 46, is a full-time mom who helps out her husband, Kenneth Grey McPeek, 43, in his business buying, selling, and managing racehorses. They live in Louisville, Kentucky, with their daughter, Jenna, who turns 5 on October 9.
I just knew something wasn't right: For quite some time, I'd had a slight thickening at the roof of my mouth where the hard palate meets the soft palate. I'd already been to several doctors and had a CAT scan, only to find nothing. Meanwhile, after several years of trying, I'd discovered I was pregnant. As you can imagine, cancer was the farthest thing from my mind! Still, something in me didn't feel comfortable about the thickening. I mentioned it to my hygienist while having my teeth cleaned. "Why don't you get it biopsied?" she said. It might just be a cyst." She set up an appointment for the following week, and a malignancy was found. Here I was, 40 years old, 26 weeks pregnant with my first child and facing cancer.
Suddenly, my life was full of fears, complications, and decisions. I was one more unwilling member of the "cancer society," the ones who spend their lives in, and money on, doctors offices and hospitals. The pathologists weren't sure exactly what kind of malignancy they were seeing, so they wanted a more extensive biopsy to be done under general anesthesia. They then said I had a PNET tumor, a peripheral neuroectodermal tumor, in the perimaxillary region of my head. It's a very rare, aggressive form of cancer, normally found in people far younger than myself.
A plan was formed. I began to receive injections of a steroid that would increase the development of my daughter's lungs so we could induce labor early. I was also given two treatments of chemotherapy while we waited. The drug was Vincristine, which the doctors felt had a low enough toxicity to leave my child unharmed while affording me some protection. After my second amniocentesis showed Jenna's lungs to be ready, we prepared for her birth. It was done by c-section, and it was a beautiful experience, an island of joy in a sea of uncertainty and concern. She weighed 4 pounds, 11 ounces and she has not missed a beat since joining us. She's healthy, happy and my special gift from God.
Now the attention turned to my cancer. Two weeks after Jenna was born, surgery was performed to remove my tumor. The procedure, called a midfacial degloving, resulted in minimal physical aftereffects and was done by Dr. Jeffrey Bumpous, one of my many heroes in all of this. The pathology of the tumor showed that no live tissue was left in what had been removed, the best news possible. Apparently, the chemotherapy I had received was very effective. That, or all the prayer lists I was on, worked! I followed up with a heavy-duty regime of chemotherapy suggested by my doctors, to ensure that the cancer cells didn't travel and pop up somewhere else in my body. I was able to continue through only 4 of 11 treatments before I ended up very sick in the hospital, close to death from the toxins inside me. The treatment I was receiving was one usually reserved for children. Because children have faster metabolisms than adults, the chemo drugs move out of their bodies more quickly. I'd taken control of my treatment from the beginning, and I knew that it was right for me to end my chemotherapy at that point.
There are several things I did that helped me through the whole ordeal. My husband, who is an avid reader of self-help books, gave me Dale Carnegie's How to Stop Worrying and Start Living. That book helped me survive the fear that threatened to take over my life. I also used the Internet to educate myself about what was known about my type of cancer. Finally, I allowed an article to be written about me in our trade journal, the Daily Racing Form (DRF). My husband trained thoroughbred racehorses at the time, so it was easy to approach my friend, Marty McGee, a reporter for the DRF, to ask for his help in spreading the word of my upcoming battle. By sharing my story in this way, I didn't have to answer the constant question "When are you due?" with my tale of horror. I was unprepared for, but extremely appreciative of, the outpouring of support from those who read about me. My openness about my cancer has given me great gifts and continues to do so even now, four and a half years later.
I wouldn't have asked to have cancer, but having had it, I can say that I have grown from the challenge, and I am proud to be a member of the cancer community, brave souls who have a chance to learn the true value of life.
Leslie Cornell lives in Las Vegas, Nevada, with her husband, Stan Cornell, Jr., a counselor for the developmentally disabled, and her son, Hayden, 1 1/2. She plans to return to school in the spring to resume her studies in music.
I was diagnosed with thyroid cancer in January of 2002, at the age of 29. I had papillary carcinoma, which had spread to my lymph nodes, muscle and soft tissue in my neck. In March of 2002 I had my thyroidectomy. Two weeks later my doctors performed a radical neck dissection to remove the lymph chain and a lot of soft tissue and muscle in my neck.
My husband and I had only been married for two years when all this happened. We'd tried to have a baby six months into our marriage, but I'd miscarried at six weeks. We continued to try and try, with no luck. My obgyn considered us infertile because we'd tried everything, and there wasn't any explanation as to why we couldn't conceive.
In March of 2003 I was due for my first yearly radioactive I-131 scan, which tests for thyroid cancer. The scan requires you to get off thyroid hormones beforehand, allowing your TSH (thyroid stimulating hormone) levels to rise. The doctor then administers a radioactive iodine pill that travels through your body, and if anything lights ups, that indicates the thyroid cancer has returned. I had been off my thyroid medication for six weeks, and I wasn't feeling well.
I happened to see my obgyn before I had the scan. She said she wanted to make sure all my blood levels were okay. She did not tell me she was running a pregnancy test. It's almost impossible to conceive a baby with high TSH levels, and besides, we thought we were infertile, so pregnancy didn't even seem a reality. But my obgyn called me the next day to tell me that I was approximately five days pregnant!
We were in total shock—and scared too. What was going to happen? This was to be my first scan after being sick, but now I couldn't have it because the radiation would damage my baby. Would the fact that I'd been off my thyroid hormones when we got pregnant mean the baby was going to be okay? What would happen if the cancer was back—would the baby survive?
We'd wanted a baby so bad, I decided to take the chance: I told my doctor I was going to put off my scan till after the baby was born. I had other doctors telling me that my baby was going to be slow ¿ because my thyroid levels were so high when we conceived, and that the baby would probably have a low birth weight as well. One doctor even suggested I terminate the pregnancy. It was all so frustrating—but I did not listen to those doctors. I took care of myself the best I could. I saw a perinatologist (maternal-fetal doctor specializing in high-risk pregnancies), who was very positive and who guided me through the process with care.
Nine months later, I delivered a very healthy 9 pound 3 ounce baby boy! He was perfect in every way. He made me believe in miracles. He is our miracle.
I had my thyroid scan last June 2004. I am still in remission. And I couldn't be happier.
Elizabeth Jurenovich, 42, is the executive director of Abrazo Adoption Associates. She lives with her sons, Matthew, 2, and Christian, 3 1/2, in San Antonio, Texas.
In August 2001, I had my first-ever mammogram at age 38. The doctors found a malignant tumor in my breast. My mother had been diagnosed with breast cancer one year earlier, so I sort of saw the writing on the wall. Rather than doing radiation or chemo, I decided to have a bilateral mastectomy. On the day the surgery was set to happen, I was in pre-op being prepped, when one of my tests came back with unexpected results: I was pregnant with my first child!
My surgery was postponed until February, late in my second trimester. Meanwhile, in January 2002, I tested positive for BRCA-1 (a breast/ovarian cancer susceptibility gene). I had the mastectomy on Valentine's Day 2002, and my son, Christian, was born just six weeks later. Knowing the BRCA-1 status increased my risk for ovarian cancer, and contemplating the possibility of a prophylactic hysterectomy, I opted to birth my second son, Matthew, soon thereafter, in August 2003. Just one year after his birth, I was diagnosed with thyroid cancer. Fortunately, it was also successfully treated, with radiation therapy and a thyroidectomy.
Christian and Matthew were born so close together, I call them my Irish twins. They're even the same size: Christian was a preemie and Matthew has never met a food group he didn't like! Though Christian has hydrocephalus and his motor skills were slightly developmentally delayed, he has caught up, and he's now a busy 3-year-old—going on 14. Matthew developed meningitis after he was born, but today he's thriving.
I know that I am one of the lucky ones. I am so thankful for both of my sons and all of my doctors, and for the continued good health which allows us to enjoy every day we have together. God is good...and parenting is wonderful!
Jill Hymer, 34, a marketing consultant, lives in Columbus, Ohio, with her husband, Larry, 36, vice-president of a software development firm, and her children, Kennedy, 4, and Zach, 2.
While I was pregnant with my first child, Kennedy, I had all these weird things going on with my left breast. It got a little larger than my right; then it got very hard and hot. The skin on the outside was like an orange peel and they had to give me antibiotics. It didn't even dawn on me that it could be breast cancer. I just thought it was normal pregnancy stuff. I was so young-I really had no fears.
I had my daughter on June 18, 2001. Afterward, while I was still in the hospital, I was trying to breastfeed but it wasn't working on the left breast. My doctor had to aspirate (drain fluid from) what they thought was a cyst on that breast. They aspirated three times, but every time it filled back up. I wasn't really focused on the cyst, but my doctor said, "Let's go ahead and do an ultrasound." They didn't see anything on the first ultrasound, but when they did a second, they saw a solid mass. The diagnosis came on July 6, the day after I turned 30. It was inflammatory breast cancer—which is often misdiagnosed because there is no lump.
My husband and I wanted more children—originally we had wanted to have three or four. But the doctors said that since I was close to 30, I might go into menopause after treatment. I had less than two weeks to decide what to do—that's not a very large window to think about my options or do much research on freezing my eggs or anything. So we just went ahead with treatment and hoped it wouldn't push me into menopause.
I really think having my daughter helped me get through this. I was lucky—the treatment didn't make me that sick—but also, I didn't let myself waste time lying around feeling bad. I focused on Kennedy and being a good mom, and I tried to make my cancer treatment secondary.
I had chemotherapy before surgery to shrink my tumor, and radiation after. I was put on Xeloda (a chemotherapy pill), which I was scheduled to take from April through September of 2002. Then in August 2002, my husband and I found out I had gotten pregnant (a happy accident!), and the doctors gave me the okay to stop treatment early.
The main thing we had to figure out was whether the fetus had been harmed by the drugs—but, of course, there was no information. I called the maker of the drug and they had no record of anyone becoming pregnant on Xeloda. All we could get were studies on mice that showed them being born with webbed feet and cleft palates. All throughout the pregnancy we were worried something could be wrong with the baby, but we were constantly consulting with my oncologist, surgeon and ob-gyn. Since I was seeing so many doctors during the pregnancy, I was sure that if something was wrong, someone would catch it.
Although my pregnancy was high risk, amazingly enough, it turned out to be very normal. One morning, a couple of weeks before Zachary was due, I went to the doctor and it turned out I was already dilated five centimeters. I had some contractions, checked in to the hospital, had an epidural, and just one hour later, at 3 p.m., Zachary popped out! It was a quick and painless delivery.
We were very excited. It was such a relief just to see him and to make sure everything was there and that he was fine. Of course, we were also worried about me, since my cancer first came out during my pregnancy with Kennedy, but there was no research that getting pregnant could cause cancer or a recurrence. Frankly, though, I don't think there's enough research out there.
It's been four years this week since I was diagnosed and I'm feeling fine. I'm just a tired mother of two toddlers! I don't know if I would have been a different mom if I hadn't had cancer. I just know that I want to spend as much time with them as I can, taking them to parks, the library, and on trips. We're going to Niagara Falls for the first time since the kids were born. I think they'll love it.