health

She had a mastectomy 30 minutes after giving birth

Images via Sarah’s JustGiving fundraiser profile (see end of article for details)

Pregnancy, and everything associated with it, is an enormously daunting experience for any woman, even when nothing goes wrong.

So imagine having to come to terms with a cancer diagnosis and the agonising decision about whether to have chemotherapy, while you were pregnant.

This uncommon, nightmarish occurrence happened to a 40-year-old mother from Wales who has spoken for the first time about the ordeal of giving birth to her second child and having a mastectomy 30 minutes later.

Sarah Williams found out she had an aggressive form of breast cancer when she was 20 weeks pregnant with her son Joshua. She first noticed changes in her right breast in January last year, but assumed they were caused by the IVF treatments she’d finished a month earlier and hormonal shifts in her body when she fell pregnant.

The cancer diagnosis came as a complete shock, and nobody could tell Sarah and her husband Carl whether their unborn baby would live through it. “I’d already felt the baby kick — he was a little wriggler — and so the thought of having to put chemicals in my body that could kill him was just horrible,” Sarah tells the Daily Mail.

“There was no question of getting rid of the baby. We’d already been told there was a one in 66 chance of it having Down’s [Syndrome] and decided that we’d love it whatever happened.”

Her own mortality also crossed Sarah’s mind. “Until that moment I’d been at one of the loveliest points in my life— pregnant with a baby we’d tried so hard for, a beautiful little girl and the best husband in the world. I couldn’t get my head around the fact that I might leave them.”

In the remaining weeks of her pregnancy Sarah endured five bouts of chemotherapy, which she describes as “a nightmare physically and mentally”, all the while terrified that the treatment could harm her baby.

Several doctors formulated a treatment plan for Sarah, and in October last year Joshua was delivered via C-section.

She had just thirty minutes to meet and hold her baby son for the first time before she had her breast removed in the same operating theatre. During the surgery, doctors removed 29 lymph nodes from Sarah’s body – 22 of which contained live cancer cells.

“The thought of losing the baby and not coming through this to see my little girl Sasha grow up was sickening. But I tried really hard to push those thoughts to the back of my mind and focus on the treatment,” she tells The Mirror.

Sarah with Sasha and Joshua

Dr Bronwyn King, a radiation oncologist at Epworth Healthcare in Melbourne, says while it’s not common for women to be diagnosed during pregnancy, it’s not unheard of.

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“Most women are able to enjoy a very happy and healthy pregnancy, but occasionally you do see women diagnosed with cancers during pregnancy, and it’s not uncommon for breast cancer to be one of those,” Dr King tells The Glow. Women who have breast cancer occasionally receive their diagnosis later on in their pregnancy, like Sarah Williams did, because they might assume changes in their breasts are directly related to their pregnancy, rather than lumps that have developed.

Dr King says that in addition to the treating obstetrician, there are three main cancer specialists who need to be involved in determining the best treatment for a pregnant patient: a specialist breast surgeon, a radiation oncologist, and a medical oncologist. Generally all three treatments will be required, but the nature and timing of each treatment needs to be modified to be safe for a body carrying a developing baby.

“Radiation is always delayed until after the baby has been delivered, because it’s not safe to be given when a patient is pregnant,” Dr King explains. “The surgical technique is usually modified, and the chemotherapy drugs are selected keeping in mind that they need to have been proven to be safe to be delivered to a patient who is pregnant. The most important thing we’re aiming for is not just the good outcome for the mother, but we’re aiming for a good outcome for her developing baby as well.”

Having a breast removed after giving birth doesn’t necessarily impede a woman’s ability to breastfeed on the other side; however, Dr King says she may be advised not to breastfeed if she undergoes more chemotherapy post-birth. A patient may require further treatments, including radiation, chemotherapy, or biological or hormonal therapies after the birth of their child.

Dr King stresses that along with their physical health, it’s essential for medical staff to look after the psychological health of their pregnant patients: “It’s always a devastating diagnosis for the patient at a time that should otherwise be very happy and very special for the family.”

Almost a year on from her son's birth, Sarah Williams wants to raise awareness of breast cancer and encourages women to check themselves regularly.

"I know I’m not in the clear just yet. I’ll occasionally have wobbles about whether [the cancer] will come back but I have a gorgeous husband, an amazing little girl and a miracle baby. I feel very lucky," she tells the Daily Mail.

 Next month, Sarah is taking part in Cancer Research UK's Race for Life - you can make a donation here. 

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