Having Children after Chemotherapy
By Maritoni Fernandez
When I was asked to write about having children after chemotherapy, my first response was to refuse because I've only been a survivor for a little over a year , and that option isn't even in my dictionary just yet. However, Imust admit that having only one seven-year-old daughter, it is a dream of mine to someday have more children. Okay, at least, one more, if God is willing. So I reluctantly accepted the challenge and here are some of the things I discovered.
My first and biggest discovery is this. No two doctors will ever respond to you the same way when it comes to having children again after breast cancer. One may say no problem, just come and discuss with your oncologist before you go ahead, more to take you off certain drugs than anything else that be harmful to your fetus, while another will you that it is a definite no no. At least not for the next five years you are on tamoxifen. This of course left me completely confused so I delved into the books that be… knowledge is power after all and I figured, what better way to enlighten myself than to use every breast cancer survivor's greatest weapons, books.
From the book, "The Breast Cancer Survival Manual," by John Link , it says "we know that younger women who have had breast cancer and then go on to become pregnant, with the associated levels of estrogen and progesterone, do not have a worse prognosis or earlier relapse of breast cancer than women who do not experience pregnancy." In other words, there is nothing that can or cannot guarantee a relapse of breast cancer, pregnancy or none. Each woman is different and I suppose it all boils down to whether you are willing to take the gamble or not.
From the book, "A Breast Cancer Journey," written by the experts at the American Cancer Society, "Doctors often counsel women to wait until at least two years after breast cancer therapy (whether they've undergone surgery, radiation, or chemotherapy)before becoming pregnant. The two year period is used because most recurrences of breast cancer happen during this time." It further goes on to say that "because of the well established link between estrogen levels and the growth of breast cancer cells, some doctors have advised breast cancer survivors to avoid becoming pregnant indefinitely. However, nearly all studies have found that pregnancy does not increase the risk of recurrence after successful treatment of breast cancer. So here we go again, another book that says it is dangerous but you take your chances as you will!
In "Dr. Susan Love's Breast Book," it says there are no studies that show women who have had pregnancies after breast cancer have had lower or higher risk or recurrence. It simply says that "we know that getting pregnant won't cause the cancer to spread; either it has spread or it hasn't before you've gotten pregnant. But if you had a tumor that left microscopic cells in your body, it's possible that pregnancy, with its attendant hormones, could make them grow faster than they would have if you weren't pregnant. This could decrease the time you have left, so that for example, if you would have died of breast cancer four years from now, you'll die in three years instead."
In this I understand clearly that once you are a breast cancer survivor, or have ever been diagnosed with breast cancer, that there is never going to be such a time when a doctor can tell you straight that you'll never get a recurrence again. It's simply not like getting any other sickness, there is no cure. There is also no guarantee that having done all your treatments, there isn't some hibernating breast cancer cell lurking around in there just waiting for a power hormonal surge to reactivate them. That power surge needed could very well be that pregnancy. So, in my opinion, we must ask ourselves, is it worth it? That of course is a very individual decision.
After having said all that, ultimately, it is a decision no one can make for you. No doctor can discourage you, nor husband can convince you, if you know what you want as a woman and are determined with your choice. However, whatever your choice may be, remember to balance the fear of unknown potential risks of recurrence with the psychological benefits and joy of having a baby. There is also the moral issue at hand.
My oncologist said it better than any book, Dr. Coonley of United Hospital Center in Clarksburg West Virginia told me that yes, I could have more children, that that isn't the problem at hand, it is whether I thought it was wise or not. A child needs a mother, not just a father and once you are a breast cancer survivor, as much as we'ld like to think we'll live full lives, we are a higher risk of not being able to. Would that be fair to the child we bring into this world? That's food for thought.
Then again, I say, there's that healthy man who had a stroke last night who thought he would live to be a hundred. No one knows what will be, it is I suppose a matter of choice and faith. A child is the best reason to stay alive and in my case, that has been so. I already have a beautiful seven-year-old daughter who has been my inspiration throughout my whole bout with cancer and is my reason for fighting to stay healthy and alive each day. Perhaps I am the wrong person to write about this. After all, I can't be fair to women who have never had a child yet. I can't imagine my life without my little Alexi, but then again, I can't imagine her growing up without me being around either. So, it is a dilemma even for me. Do we simply take the doctors word and be wise? That's difficult when you have no child yet. As for me, I'll just wait and see. Perhaps sit out the five years of tamoxifen before even entertaining that thought again. Then, maybe.
Maritoni Fernandez is an actress and businesswoman. She is a volunteer for the I Can Serve foundation and a breast cancer survivor. She can be reached at firstname.lastname@example.org