ST. LOUIS, Mo. (Ivanhoe Newswire) — Wonderful news followed by gut-wrenching choices. These days, more women are being diagnosed with breast cancer at a younger age. Eleven percent of all new breast cancer cases are in women under 45. As a result for some patients, pregnancy and cancer come at the same time. Thankfully, there are treatment options that keep mom and baby healthy until delivery and after.
For Sarah and Thomas Phares, the best end to a long day is time with baby Ruby and big sister Hazel.
Last year, doctors determined a lump in Phares’s breast was cancer. She was 28 and eight weeks pregnant with her second child.
“With me being in my first trimester everyone suggested terminating the pregnancy and that wasn’t something I was willing to do,” Phares shared.
Michael Naughton, MD, a medical oncologist at Washington University in St. Louis, said it is possible to cure cancer and have a healthy baby.
Dr. Naughton said “Beyond the first trimester we really can offer many of our standard treatment options including chemotherapy and surgery.”
Dr. Naughton prescribed two drugs: Cytoxan and Adriamycin for six rounds of chemo. He explained “We focus on drugs that have a reasonably proven track record of not being adverse for the baby.”
At 34 weeks, doctors induced Phares. Little ruby was small, four pounds, 12 ounces, but otherwise born healthy.
Phares told Ivanhoe “Two weeks after I delivered, I went in and had a double mastectomy with reconstructive surgery.” Phares is getting stronger every day, and so far she’s cancer-free.
“I feel great. I’m running after my two little girls, and I couldn’t ask for anything more,” Phares said happily.
Phares will continue with another chemotherapy drug (Herceptin) until October to ensure the cancer does not return.
Contributors to this news report include: Cyndy McGrath, Producer; Roque Correa, Editor and Videographer.
TREATMENT FOR TWO: BREAST CANCER DURING PREGNANCY
BACKGROUND: Cancer during pregnancy is uncommon, but recently more women are starting or continuing treatment while pregnant. Breast cancer is the most common cancer diagnosed during pregnancy, and affects about 1 in 3,000 women who are pregnant. Sometimes being pregnant can delay the cancer diagnosis for several reasons. Some cancer symptoms such as bloating, headaches, breast changes, or rectal bleeding are also common during pregnancy. Breasts enlarge and change texture during pregnancy, so a cancer symptom might be mistaken as just a normal part of being pregnant. On the other hand, the doctor visits that include pap smears and ultrasounds may be able to detect some types of cancer. CT scans are usually a safe way to check for breast cancer while pregnant. Scans of the head or chest are typically safe because they do not directly expose the fetus to radiation. MRIs, ultrasounds, and biopsy’s are also safe during pregnancy because they do not use ionizing radiation.
TREATMENT: There are treatment options for pregnant women with breast cancer, but it is more complicated. Surgery is usually safe while pregnant, but it is advised to have a mastectomy (removing the entire breast) compared to a lumpectomy (removing just the part with cancer). Lumpectomies usually require radiation therapy afterwards which could affect the unborn baby. Chemotherapy may be used after surgery but not during the first three months of pregnancy. The baby’s internal organs are developing during this time so the effects of chemo have not been studied in the first trimester. Studies have shown that certain chemo drugs used during the second and third trimesters don’t raise the risk of birth defects, stillbirths, or health problems shortly after birth, though they may increase the risk of early delivery. Treatments that must wait until after delivery include radiation therapy (it can cause miscarriage, birth defects, and slow fetal growth), hormone therapy, and targeted therapy using certain drugs that have been determined as unsafe for the baby. There are no reports that breast cancer hurts the baby but it would be unwise to wait all nine months before starting any treatment.
BREASTFEEDING DURING TREATMENT: If you undergo radioactive isotope therapy or chemotherapy, you must stop breastfeeding until the radioactive elements or medications are completely gone from your body. Many chemo, hormone, and targeted therapy drugs can enter breast milk and be passed on to the baby. Radiation therapy can limit the milk production, but as soon as the medications have left your system, it is fine to breastfeed.
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