Adrienne has been a bit of an outlier when it comes to her breast cancer diagnosis. She was the first experience for so many medical professionals who participated in her care. She was the only person her radiation oncology team had ever seen have a huge skin reaction to the mouthpiece and it forced them to adapt. No one in her mom/baby groups had ever known someone as young as she was with breast cancer. And now we find, once again, she is a bit of an outlier.
I didn’t share the news about Adrienne’s first pregnancy until after her little one was safe in the world and we knew she was okay. We are choosing this time, now that baby has reached viability if birth happens tomorrow, to let you know that she is pregnant with baby number two.
Like many young women in her shoes, Adrienne suffered miserably with the side effects of the ovarian suppression drugs she had to take to reduce the risk of recurrence from her triple positive breast cancer. She told me that at times it felt so awful, she might as well have still been doing chemo.
That told me a lot.
Adrienne knew she wanted to try for a second baby, but the study that she and her team used to allow her to come off the ovarian suppression to try for baby number one had followed women who had been on the drugs for two years, come off to conceive and have baby, and gone back on them. The assumption, then, was that she had to be back on the drugs for at least two years before she tried again.
But you know what assuming does…right?
Because Adrienne is all about the science and is a strong advocate for herself in her cancer care experience, she decided to ask her oncology team what evidence there was that staying on ovarian suppression for two years versus one year between pregnancies would keep her safer. Her survivorship oncologist spoke to her medical oncologist who reached out to one of the authors of the Baby Study (POSITIVE trial) the answer was…
There is none.
Researchers have not gone forward from studying young women having one pregnancy after pausing ovarian suppression. The challenge in that is that for women as young as Adrienne at diagnosis (she was 27!), they have a lot of potential childbearing years ahead of them and there may be many more, like her, who want to try again.
I have written before of the degree of admiration I feel for the young women who have gone before my daughter and established scientific boundaries that have hugely impacted Adrienne’s cancer experience. The ones who participated in the clinical trials that established Herceptin as a valuable tool for oncologists treating HER2+ cases. The ones who had breast-conserving surgeries instead of mastectomies. The ones who went off ovarian suppression to try to get pregnant two years into treatment, not knowing if it would mean recurrence came along with biological motherhood.
And now I know one of these young women very intimately. Someone who looked at the science and decided it was worth the risk to be an outlier and pause the ovarian suppression a little early, give her daughter a sibling, then move forward with removing her ovaries as a permanent solution to stop estrogen from feeding a recurrence. Someone who decided that no evidence suggesting it was a BAD idea meant no evidence she shouldn’t. Someone who is looking cancer straight in the eye and saying, “I dare you.”
I don’t remember ever being this proud AND this terrified all at the same time. The breath that I had slowly been exhaling as we move further away from March 15, 2019 got pulled back in with a mighty gasp and a big part of me right now wants to go throw up. But…
This has always been Adrienne’s diagnosis. This is her risk to take. I have to trust that she has put weight on both sides of the scales and made the best decision for her and her little family. So, I will put my hand on her belly and feel the life growing inside of her bump into my palm and smile. I will do everything within my power to live inside this joy and not let the fear diminish the miracle happening a second time.
And I will hate that cancer means that sometimes it means swallowing a lump as big as an elephant that she will lose on this roll of the dice.
I am glad that I have reconciled that two things can be true at the same time or I’d be done for.
Mother…Grandmother…Librarian…Military Spouse…Caregiver…Family Life Educator…take your pick! Debbie Legault was born in British Columbia, Canada to a former RCAF airman father and a Scottish War Bride mother and has lived in other Canadian provinces, Germany and California. She has been married for 36 years to a Canadian Air Force Veteran and credits him with filling her life with adventure. When Debbie Legault’s children look at family photos they often comment on how many different hairstyles she has had and that pretty much is her story, that her life has taken as many turns and led her down as many paths as her hair has changed! Her latest role is as the author of Mom…It’s Cancer, the story of supporting her 27-year-old daughter as they experienced breast cancer diagnosis and treatment. Read more of Debbie’s blogs here.