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I didn’t sleep for two weeks while waiting for the verdict
According to the mother of two, she found the formula on her chest herself. At that time it was the 22nd week of pregnancy.
“The breast ultrasound showed that it is not a fibroma or a lipoma (benign tumors – ed.). The doctor simply advised to check the derivative and, if it grows, to consult oncologists. However, I did not wait, I enrolled in the National Institute Cancer (IMI). Here I had an ultrasound again, I had a biopsy and it turned out to be a very aggressive, first-stage HER + carcinoma. A medical council was immediately convened and decided what to do with me. The doctors warned that It might be necessary to terminate the pregnancy, but they planned a second council where they wanted to hear the opinion of the OB-GYN.
While waiting for the second tip for two weeks, I could hardly sleep. It seemed to me that it was the end of everything for me and the future baby. Every night I go to bed with a mobile phone in hand and read all the information I can find about how the world treats cancer during pregnancy, ”Anna recalled the painful moments.
From the beginning of the diagnosis, it seemed that I was living in a dream: I would wake up early and things would be different.
During the second council, it was decided that the woman would not need to terminate the pregnancy. The operation was performed first. Since the patient wanted a respectful procedure, the breast was preserved. A month later, during which it escalated again, chemotherapy was started. Before giving birth, she received three courses of the so-called red chemistry (the strongest). She is then allowed to get stronger, recover, and give birth again.
“From the beginning of the diagnosis, it seemed like I was living a dream. I gave birth in the same dream: I will wake up immediately and everything will be different. At that time, all my hair had been removed due to chemotherapy, so the image was not consistent with the delivery. I was still afraid that something would happen and that the delivery would not go smoothly, I was afraid of what kind of baby would be born. But I gave birth very quickly, the baby was completely healthy and was still growing well, he is a very calm child ”, said the mother of little Ariana, who is now nine months old.
After giving birth, she was given another course in red chemistry, followed by four courses in white chemistry (less strong), radiation therapy, biological therapy, and hormone therapy. Ana is still in treatment. Hormone therapy has given him a menopausal condition that does not manifest itself in the most pleasant symptoms, but, as the woman herself says, the most important thing is that everyone is alive and well. And she advises all pregnant women, not just pregnant women: “Check your breasts prophylactically!”
Even men have more breast cancer than pregnant women
Head of the Department of Breast Surgery and Oncology at IMI prof. skilled. Dr. Valery Ostapenko, who performed the operation on the woman, emphasized that breast cancer during pregnancy is rare.
Photo by Julius Kalinskas / 15min / Valery Ostapenko
“About 10 thousand people are registered in the Vilnius region per year. Cancers related to childbirth and pregnancy vary from 1 to 3 cases. In three years, we had 6 patients. Therefore, it occurs less frequently than the Breast Cancer in Men It is also worth knowing that this is no longer a tragic situation these days.
Of course, much depends on the stage of the disease and the biological variant of the disease. There are more aggressive forms of cancer, as in the case of this patient, but we were also able to do an oncoplasty and, as the woman herself says, and now, after giving birth, the image of the breast is not bad.
As this example shows, chemotherapy is allowed during pregnancy. All other treatment options have been used postpartum, as they are not recommended during pregnancy. However, we have all the drugs for breast cancer that are available in the European Union, “said the doctor.
Can a mother transmit cancer to a newborn?
Oncology Department of the IMI gynecologist oncologist dr. Kastytis Žilinskas recalled that 35 years ago, when he started working, the prevailing opinion was that pregnancy and cancer were incompatible. If the pregnancy was severe enough, the woman was rescued and all patients were advised to terminate it early in pregnancy.
“Of course, there was a desire to save the life of both the mother and the newborn, but there was a great dilemma as to which life to choose first. Everything has changed a lot now. It is now known that normal pregnancy and cancer are Very similar biological conditions. In the past, pregnancy was widely thought to promote the progression of a malignancy. This is partially true, but we cannot say it directly based on recent research.
In the past, pregnancy was widely thought to promote the progression of a malignancy.
During pregnancy, the immune and hormonal status of the woman’s body changes, the production of certain hormones that inhibit immunity begins, and early in pregnancy the placenta produces substances that help prevent miscarriage, that is, rejection of a foreign body. At the same time, it can promote the progression of malignancy. In thyroid, liver, and colon cancer, pregnancy promotes disease progression, but it has not been possible to find such data on breast cancer, ”said K.Žilinskas.
Women often wonder if a mother can pass cancer to a newborn. According to the doctor, the placental barrier completely protects the fetus from malignancy, so it is not worth fear. It is true that in some tumors placental metastases can occur, so an additional examination of the placenta is recommended in a sick woman.
“As older women give birth, cancers increase with age. Therefore, before preparing to give birth, especially since pregnancy is generally planned today, it is worth taking all the preventive examinations: cervix, breast, etc. At present such opportunities really exist in Lithuania ”, advised the speaker.
According to a gynecologist and oncologist, there is a certain risk of such consequences of cancer treatment for the fetus, but today it is already known what tests can be performed and what drugs can be given to a pregnant woman. The most dangerous time is the first trimester of pregnancy, when even surgical treatment options are limited, as it can lead to miscarriage. However, studies show that the risk of preterm labor and miscarriage does not increase after treatment.
Technologies are being developed to preserve fertility
With the emergence and increase of young people with cancer diseases, modern treatment technologies have helped them to heal and return to normal daily life, according to Dr. Živilė Gudlevičienė, another problem emerged. Young patients often face a problem of decreased fertility or infertility that poses enormous psychological challenges in life.
Photo by Sigismund Gedvila / 15min / Živilė Gudlevičienė
That is why the world has started developing technologies to help them. At the moment, the choice is really limited, from simpler methods, such as additional drugs that inhibit ovarian function so that they do not suffer during chemotherapy, or the transplantation of ovaries by relocating them, to various biotechnologies (ovules, ovaries, embryo freezing) .
As the patient mentioned, she is in menopause due to the treatment she is receiving: her ovaries are suppressed. And if she wanted to get pregnant again, there would be many problems, she would have to give her additional hormonal treatment, which could be dangerous for her health, considering that she already had an oncological disease, “said the doctor.
NVI in 2014 began the study “Fertility preservation program for cancer patients.” Its objective is to develop technologies to freeze and thaw reproductive tissues, to evaluate the viability of these tissues and the possibility of transplantation. Over five years, the study included more than 30 young women (under 40 years old) and about 30 men.
“Before treatment, a small piece of ovarian tissue is taken from the woman, it is treated with certain substances to preserve its vitality, it is frozen and stored in our biobank. After a few moments, we thawed the tissues and checked if they were still viable. We were very pleased with the results: technology saved them and, more importantly, no metastases were found. So the technology is safe.
Today, we already have two patients who have passed five years after a successful treatment and could already receive an ovarian tissue transplant. We were going to do it, but so far COVID-19 has ruined the plans, ”said Ž.Gudlevičienė.
By the way, new technologies are being developed around the world to help women avoid tissue return surgery – attempts are being made to activate and mature ovarian tissue in a test tube.
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