For the first time in the three weeks since her daughter was born, Lisa Peterson Bender might actually get more than two hours of sleep.
Propped on her back in a hospital bed, with an IV line pumping a cocktail of anti-cancer drugs into her veins, the 32-year-old Minneapolis mother may as well rest, says Amy Graham, a registered nurse at the Masonic Cancer Center at the University of Minnesota.
“Who would have thought coming to chemo would be a break for you?” Graham teases after sliding the needle into Lisa’s left hand.
It’s a joke, of course, a way to lighten the seriousness of the moment. There’s nothing restful about breast cancer treatment, especially for Lisa, who already has endured surgery and chemotherapy and eight months of anxiety wondering whether fighting the disease would endanger her unborn child. She was diagnosed with Stage II breast cancer 11 weeks into her first pregnancy. Msnbc.com first reported on her in March, before her baby was born.
She had four chemotherapy infusions during her second trimester, but stopped the drug treatment in December in order to allow the baby to thrive and grow.
“I didn’t even realize how stressed out I was during my pregnancy until now,” says Lisa, who last week launched a new, more aggressive course of cancer treatment aimed at eradicating the disease entirely.
For now, however, the worst of the worry is over. Her daughter, Alice Virginia — named after a favorite aunt and a grandmother — arrived on March 13, four days before her due date. She weighed 7 pounds, 7 ounces and was 19 ¾ inches long, with dark hair, her grandfather’s nose — and a clear bill of health, doctors confirmed.
"She’s perfect,” says Lisa, adding: “I just feel confident that she’s fine.”
That relief is real, not just for Lisa, but also for the growing numbers of women diagnosed with cancer during pregnancy. Doctors say that as many as 1 in every 1,000 pregnant women gets cancer, with about 3,500 cases identified in the United States each year.
As more women delay childbirth until they’re older, the number of those diagnosed with cancer during pregnancy, especially breast cancer, is going up. A Swedish study found that incidence of cancer more than doubled over 40 years, partly because of births to older moms. In the past, many doctors advised women to end their pregnancies because of the disease.
Prognosis good for moms, babies
The good news, however, for Lisa and women like her, is that recent research shows that pregnant women with cancer have a good prognosis — and so do their babies.
Women treated with chemotherapy for breast cancer while pregnant appear to do no worse —and perhaps better — than non-pregnant patients, says Dr. Jennifer K. Litton, an assistant professor of breast medical oncology at the University of Texas MD Anderson Cancer Center.
In her recent study of 75 pregnant and 150 non-pregnant breast cancer patients, nearly 74 percent of the pregnant women survived cancer-free for five years, compared with about 56 percent of non-pregnant patients, Litton found.
“To date, there’s been nothing from what we’ve found that shows that there needs to be any different follow-up,” says Litton, one of the nation’s top researchers on cancer during pregnancy.
The same goes for the children exposed to cancer drugs in the womb, especially those whose mothers undergo treatment in the second trimester, Litton adds. Research shows that certain chemotherapy drugs, such as Cytoxan and Adriamycin, which Lisa was treated with, are safe during pregnancy because the drug molecules are too large to pass through the placenta. Unlike other toxins, they're prevented from reaching the baby.
In Lisa’s case, her HER2-positive breast cancer should respond well to the new one-two punch of anti-cancer drugs, says her oncologist, Dr. Douglas Yee, director of the Masonic Cancer Center.
“We’re trying to push all the buttons we can push to kill the cancer cells,” Yee says.
For the next three months, Lisa will receive weekly doses of the drugs Herceptin, or trastuzumab, and Taxol, or paclitaxel, regarded by doctors as the best bet against recurrence. After that, she’ll undergo six weeks of daily radiation therapy, followed by more Herceptin and hormone therapy. It'll likely be five years before she can be declared cancer-free, Yee says.
In the baby’s case, Dr. Mike Pleasants, a Minneapolis family practitioner, will follow Alice’s progress closely, but not any differently than he would a normal newborn.
“Our pediatrician says she’s perfectly healthy. We talked about her diaper rash. We talked about the normal newborn things,” Lisa says.
Cancer drug halts breast-feeding early
At the same time, Lisa and her husband, Ryan Bender, a 32-year-old software engineer, recognize that everything is not normal — and won’t be for a long while.
“Today's an emotional day. I had to stop breast-feeding today,” Lisa says before heading to the hospital. “It feels like the cancer is taking it away from me.”
Women who take Herceptin can't nurse their babies because it’s not known whether the drug may wind up in breast milk. Instead, Lisa has breast milk from friends and trusted donors waiting in her freezer.
For the next several months and, perhaps, years, cancer will determine the couple’s life: their social schedule, when Lisa can return to work as a city planner, how much energy she has for her husband and daughter. In two years, when they plan to halt treatment and try to get pregnant again, cancer may decide whether they’re able to have another baby.
“Fertility problems are one of the most difficult things young cancer patients face,” she says.
For now, however, Lisa and Ryan are focusing on how far they’ve come. Like all new parents, they’re both delighted and exhausted by their daughter’s care.
“Before, I worried about my mortality,” says Lisa, settling back for more drug treatment. “I don’t spend a lot of time thinking about cancer now. I’m too busy being a mom.”