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40-year-old Seema Sharma can’t wait to hold her baby as she enters the last trimester of her pregnancy. She has just been told that all her signs look good, the fetus is normal, and that she can carry it to term. For someone who had recovered from breast cancer and was told that chemotherapy and radiation usually made people infertile, getting pregnant naturally was nothing short of a miracle. The decision to continue the pregnancy was also not an easy one to make, given that, like any other cancer survivor, she had anxiety about relapse and wondered if she could be fit and active enough to raise her child. “The post-cancer counseling really helped me. I have started working again and am fitter than I have ever been,” says Sharma.
She had trouble coming to terms with her condition when she was first diagnosed in 2019. “I’ve always lived a healthy lifestyle, been conscious about diet and exercise, checked all the boxes,” Sharma tells us. Her case was taken up by Dr Rohan Khandelwal, Principal Consultant and HOD, Breast Centre, CK Birla Hospital, Gurugram. “I had always been a strong-willed woman when it came to making decisions, but cancer makes you so uncertain.” I had emotional support from my family but it was the doctors who opened up a world of possibilities with counseling at every stage. They first told me how not to be afraid of the word ‘cancer’. Then they told me about recent advances that made it possible to survive cancer. So, when I told them about my desire to become a mother, they put me through treatment after treatment to prepare my body for pregnancy. Both the oncology and gynecology teams informed me about labor and delivery complications. “They relieved the disease so well that even during cancer treatment I was able to go to work and continue my daily activities,” she says.
Sharma’s treatment lasted about 10 months and ended in 2020. But she was cleared to conceive only after a few more months of close monitoring to ensure she was cancer-free. She finally got pregnant in October last year. What worked in Sharma’s favor was the fact that her cancer was confined to the local area and no metastases were seen. She was treated with chemotherapy, breast cancer surgery and radiation therapy.
Dr Khandelwal explains why it is a myth that young cancer survivors cannot become mothers. “Natural conception is difficult immediately after chemotherapy as it kills cells. We therefore advise patients to wait at least two years after treatment, so that its side effects can be neutralized, before trying to conceive. In this particular case, the patient was diagnosed with localized breast cancer (LABC) and was concerned about her chances of conceiving due to her age. But our team was able to explain what treatment options were available. She went through chemotherapy, then breast cancer surgery and radiation therapy to eliminate the cancer cells in her body. She was able to conceive naturally without any IVF treatment five months ago and is now doing well. Unmarried or single breast cancer women may also choose to preserve eggs and embryos before receiving treatment so they can become pregnant in the future,” he says.
According to the recent Globocan 2020 reports, the prevalence of breast cancer is increasing in the country, accounting for over 13.5 percent of the total cancer burden in India.
Dr Khandelwal says debunking myths related to breast cancer treatment, “It is a common misconception among the masses that women have to face fertility problems while breastfeeding after suffering from breast cancer. However, that is not the case. With treatment modules such as surgery, radiation therapy and chemotherapy, we are now able to provide the best patient-centered treatment plans. They can conceive naturally without complications after surgery and can live a normal life.”