What Dobbs v. Jackson Means For Cancer Patients
- On Friday, the United States Supreme Court overturned Roe v. Wade, which for almost 50 years made abortion a constitutional right.
- The American Cancer Society did not take a position on the ruling, but warned that the court’s decision could lead to some negative outcomes for cancer patients.
- Some pregnant cancer patients could face new challenges if their state has placed restrictions on abortion. Sometimes cancer treatments can result in terminating a pregnancy. Doctors can also recommend ending a pregnancy in order to better treat or even save the life of a mother with cancer.
- Some doctors are also warning of other far-reaching effects, as the court’s decision paves the way for some states to crack down on egg and embryo freezing and in vitro fertilization. These common fertility treatments are often sought by cancer patients seeking to preserve their fertility after cancer treatments such as chemotherapy and radiation.
In a statement published on June 24, the American Cancer Society stated that the Supreme Court's ruling in Dobbs v. Jackson, which found that abortion is not a constitutionally guaranteed right, will "impact cancer patients and their families and is likely to disproportionately affect communities of color."
Read MoreLoss Of Access Could Be An Issue
The Dobbs case centered around a lawsuit over a Mississippi law that would have outlawed abortions after the first 15 weeks of pregnancy. In their decision, five of the Supreme Court justices ruled that states could pass their own abortion laws, including outright bans.Several states immediately moved to enact stringent restrictions or bans on abortion after the ruling, with others indicating they would soon do so as well.
That loss of access could put lives in danger, warned the ACS, noting that one pregnant person out of every 1,000 will receive a cancer diagnosis while pregnant each year.
Abortions can be strongly advised or even medically necessary over the course of treatment for some cancer cases, said Dr. Diana N. Contreras, a board certified obstetrician-gynecologist and chief healthcare officer for the Planned Parenthood Federation of America.
“This puts patients in a difficult position to either risk not undergoing treatment that could save their life in order to try and continue their pregnancy something we cannot guarantee as the cancer itself can pose a risk to the pregnancy or decide to end the pregnancy to undergo cancer treatments that could save their life. In either scenario, the chance of miscarrying is high,” she said. “The overturning of Roe v. Wade means that decisions about whether and in what cases abortion is allowed are left up to the states, which will only contribute to fear and confusion around potential civil and criminal penalties against pregnancy outcomes including but not limited to abortion.”
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Dr. Erin Medlin, a gynecological oncologist at the Colorado Permanente Medical Group, warned that states enacting abortion bans could be putting lives at risk. As one example, she pointed to gestational trophoblastic diseases, a group of tumors that mimic pregnancy. Laws against abortion could keep women from being prescribed drugs that would be harmful to an actual pregnancy but potentially life-saving for women with the disease.
“They look like pregnancy, women have a positive pregnancy test, the uterus will grow, but it is not a true pregnancy,” she said. “Because of some of the restrictions in some states, it could hinder or delay treatment, which could prove to be life threatening.”
The Society of Gynecologic Oncology also condemned the ruling in a statement posted to their website, saying the organization "opposes any ruling that restricts a person's access to health care and criminalizes the practice of medicine."
"As practitioners who specialize in the treatment of female reproductive cancers, we should be free to provide whatever care is in the best interest of our patients."
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Worries Over Post-Cancer Fertility
In an op-ed published by Bloomberg, law professors Sonia M. Suter and Naomi Cahn expressed concern that the impact of the SCOTUS ruling could go beyond just abortion, as states could move to ban processes such as in-vitro fertilization, which require the creation of human embryos.
"Because IVF also creates excess embryos that might be destroyed or frozen after fertilization, states might ban this process," they wrote.
The American Cancer Society echoed this concern in their statement, noting more than 60,000 people between the ages of 20 and 39 are diagnosed with cancer each year and that as treatment can often affect fertility, freezing embryos for IVF can often be the best hope for having biological children.
Contreras noted that even before the ruling, different states had different regulations, creating a legal and medical framework that was “purposefully confusing.”
“(The Supreme Court’s ruling) will make it very difficult for people with cancer to get the care they need, whether abortion care or cancer treatments.”
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