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Mother-to-be sacrifices her chance of surviving cancer for her baby
By Linda Reid Chassiakos
May 11, 2009
She leaned on her husband, using his strength to hide her unsteadiness. Her steps were tentative, measured, cautious, with her gait more typical of a woman decades older than her late 20s. She could still walk, shake hands and almost smile, at least with one side of her mouth; she couldn't let the tumor take those gifts away -- not yet. She had to stay healthy another few weeks, until her baby was born.
The father-to-be gently guided his wife into her chair, helped her adjust her sari and, still clutching her hand, eased into the seat next to her. The neurosurgeon waited for us all -- oncologist, neurologist, obstetrician, pediatricians -- to be seated, before giving a brief update on his patient's diagnosis: astrocytoma, an aggressively malignant cancer of the brain.
For the neurosurgeon, the verdict was clear: An immediate operation was needed to remove the growing tumor. The invasive and complicated surgery -- under many hours of general anesthesia -- was likely to greatly increase the risk of fetal injury or death.
I couldn't keep my eyes off the mother-to-be's burgeoning belly. My mind struggled for alternatives: Could we not deliver the baby by C-section as soon as possible so she could have neurosurgery?
But as a pediatric resident working in the neonatal intensive care unit (NICU), I was sadly aware that -- at the time -- few infants younger than 28 weeks or weighing less than 2 pounds typically survived. This woman was 24 weeks pregnant, and her baby weighed only a little over a pound.
The oncologist said that if the surgery were delayed until the child was ready for life outside the womb, the cancer would probably be untreatable. The obstetrician said that if the mother-to-be agreed to the recommended surgery and subsequent chemotherapy, the fetus was unlikely to survive. The woman was faced with a heartbreaking choice -- her own survival or her child's.
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