When Linsey Sowinski was told about the aggressive tumor growing inside her chest, she was scared about more than just the cancer. She was three months pregnant and she worried that doctors were going to give her a wrenching choice: risk her own life by delaying treatment until her baby was born or terminate the pregnancy and start chemotherapy right now.
But these days, increasingly, cancer stricken mothers-to-be are being told that there might be a third choice. Doctors have learned that it’s possible to keep going with a pregnancy and time the chemotherapy so it does the least amount of damage to the growing fetus.
That may be the best news possible for the 1 in 1,000 pregnant women who are diagnosed with cancer each year.
For Sowinski the strategy seems to have paid off. Her cancer is in remission and her baby girl Lena Kate, born by C-section in May, seems to be perfectly healthy even though she spent several nerve wracking months with a depressed immune system.
“The timing [of the chemotherapy] is really important,” Dr. Nancy Snyderman told TODAY’s Savannah Guthrie. “The doctors were really smart. They waited till she was through her first trimester when most injuries can happen to the fetus. And then as soon as they could get the baby out, they went ahead and sectioned her.
“Twenty years ago, Savannah, the choice would have been to a mother: Do you want to go through the entire length of the pregnancy and risk your being cured or do you want to abort now and save your life?”
Linsey and her husband Scott could never have imagined that they would be embarking on this journey when they planned their dream wedding.
But even as Linsey was getting ready for the ceremony, there were hints that something might not be right. Her dress seemed to have somehow gotten so tight around her chest that it was making breathing difficult.
“It was, kind of cutting off my air and I wasn’t able to breathe real deep,” Linsey told TODAY. “So we loosened it up and went on with the day. “
Doctors diagnosed Linsey with a lung inflammation and gave her antibiotics and antacids to treat it. The pain seemed like an afterthought when Linsey discovered she was pregnant the day after she and her husband Scott came back from their honeymoon.
But the pain kept getting worse. Though the Sowinskies had initially decided against getting a chest x-ray for fear that it would hurt the baby growing inside Linsey’s belly, they realized they needed to find out what was wrong.
Just three months after the couple had said “I do,” doctors diagnosed Linsey with lymphoma.
“I got the call from my doctor that night about 8 p.m.,” Linsey told TODAY. “And she said to me that there was definitely something on my x-ray. I was just scared to death. I mean, I was pregnant.”
And because the tumor seemed especially aggressive the Sowinskies were told they’d have to do something soon. The mass in Linsey’s chest was growing rapidly, doubling in size every six weeks.
“Knowing that time was against us and Linsey’s condition was worsening daily, we got on the phone and got second and third opinions,” Scott wrote on the couple’s website. “Dealing with the cancer was one thing, but we found there wasn’t much information about dealing with cancer during pregnancy. Our initial fear was that we would have to terminate the pregnancy.”
The Sowinskies eventually found a doctor who told them it would be possible to treat the cancer and continue the pregnancy. But they would have to be careful about the timing of the treatments.
While research shows that certain chemotherapy drugs are safe during pregnancy because the drug molecules are too large to pass through the placenta and reach the baby, others have received black-box warnings forbidding use during pregnancy because of their toxicity.
“Pregnancy is a whole mass of rapidly dividing cells,” their specialist, Dr. Douglas Barber told TODAY. “And chemotherapy is not compatible with pregnancy. As she was being treated for her own symptoms, the baby was also getting the same chemotherapy load.”
Linsey was scared for her daughter.
“Every time we saw her, Linsey wanted the best thing done for little Lena,” said Barber, a maternal fetal medicine specialist at Providence Sacred Heart Medical Center in Spokane. “And I had to remind her that sometimes we had to think about the best things for Linsey as well. And she didn’t want to hear that.”
Doctors waited till Lena was developed enough to survive outside the womb and then delivered her three weeks before her due date.
“I was so, so happy that she seemed to be doing well and she wasn’t inside me anymore,” Linsey told TODAY. “I wrote in her baby book 'Mommy loves you so much.'”
As soon as little Lena was delivered, doctors started Linsey’s radiation treatments.
The radiation made Linsey tired and weak. But she wasn’t the only one who was having problems.
Lena’s immune system had been knocked back by the chemotherapy and she had no defense against viral and bacterial infections. She was soon back in the hospital where she could be monitored and treated until her immune system could recover.
“We were assured that this was not permanent and it would correct itself in four to six months,” Scott wrote on the website.
But it took only a month for little Lena to improve enough to go home. And on Sept. 27, the family got the good news that Lena’s immune system had bounced back to normal.
“The great thing is that the prognosis for the child is super,” Snyderman told Guthrie. “That part of the immune system comes right back to normal. For the mom we’re just going to have to wait and see.”
For his part, Scott has faith that the future will bring good news. Recent tests show Linsey is on the road to remission.
“It’s a wild ride to watch anybody go through,” he said, looking over at his wife. “But you know, you can’t help but stand in awe. She’s amazing.”