Cancer During Pregnancy
- Danielle Emery, of Reading, England, was diagnosed with laryngeal cancer, a type of head and neck cancer, when she was pregnant at age 39. Now she’s a mom of two healthy children and sharing her story to inspire others to be your own best advocate.
- Advocating for your health is extremely important. You never know when speaking up about issues with your body can make a world of difference for health outcomes.
- Fertility struggles are a fact of life for some cancer patients because certain cancer treatments, including chemotherapy and radiation, can affect both men’s and women’s fertility. Thankfully, in Emery’s case, her cancer didn’t impact her ability to get pregnant.
- It’s recommended that before undergoing cancer treatment, patients talk to their doctors about fertility preservation if they wish to have a family in the future.
- Egg, sperm, and embryo freezing are common approaches to fertility preservation, but other options exist.
Emery, who learned she was 11-weeks pregnant with his first child prior to undergoing surgery to remove the cancer, is now a mom of two healthy children four years after her diagnosis and hoping her cancer journey will help others better advocate for themselves.
Read MoreEmery was first diagnosed in April 2019, and following her life-saving surgery, her cancer returned when she was six months pregnant—which left her concerned about her unborn baby’s health.
“I wasn’t worried about myself anymore, but I was petrified about the safety of my baby. I cried when I heard that it had come back, as it wasn’t the news I wanted to hear,” Emery explained.
“I feared it had spread further in my throat, but luckily it had just come back on the left vocal cord again. I was very scared that going under an anesthetic again would harm my baby and I’d risk never being a mom.”
She continued, “Being pregnant made me strong, though, and determined to fight the disease. I had to have more surgery, such as laser removal, which aimed to remove the cancer permanently. Luckily, my baby’s heartbeat was strong and once again, I was given the all-clear.”
Then, in June 2020, Emery’s cancer returned for a third time, prompting her to worry her son would never be able to hear her voice again if she needed more surgery.
However, they moved forward and decided it was best to remove her vocal chord. Thankfully, her voice returned hours after the surgery.
She’s since been cancer-free and enjoying life as. a mom for her four-year-old son Callum and her one-year-old daughter Sienna-Rose.
The thankful mom concluded, “I’m sharing my story so others who have worrying symptoms will seek advice, get checked and won’t leave it until it’s too late.
“Cancer kills, you lose loved ones like I have and I’m very lucky to be a survivor. I’m grateful for life and extremely happy to have two beautiful and healthy children.”
Helping Patients With Fertility Resources
Understanding Head and Neck Cancer
Cancer of the larynx, which is also considered throat cancer, falls under the umbrella of the general classification term head and neck cancer.
According to the American Society of Clinical Oncology (ASCO), head and neck cancer is “a broad term encompassing a number of different malignant tumors that develop in or around the throat, larynx, nose, sinuses and mouth. Oral cancer is the most common type of head and neck cancer.
Artist Michael Rees shares unique outlook on facing throat cancer
The two main risk factors for this group of diseases include the following:
- Tobacco use. This is the single largest risk factor for head and neck cancer with researchers estimating that 70 to 80 percent of head and neck cancers being linked to tobacco use. Also worthy of note is that secondhand smoke may increase a person’s risk of developing head and neck cancer.
- Alcohol use. Using alcohol and tobacco together increases your risk even more.
“Head and neck cancer patients, we know that tobacco smoking is a risk but also heavy alcohol use,” Dr. Jessica Geiger, a medical oncologist specializing in head and neck cancer at Cleveland Clinic, previously told SurvivorNet.
“So, drinking more than two or three drinks if you’re a man per day, in addition to smoking. Smoking and alcohol are sort of additive carcinogens. Especially in cancer of the larynx or the voice box, we know that drinking heavily, heavy alcohol use, is just as important of a risk factor as tobacco smoking is.”
According to the National Cancer Institute, laryngeal cancer is a disease in which cancer cells develop in the tissues of the larynx. Additionally, signs and symptoms of this disease include sore throat, like Danielle Emery experienced, and ear pain.
Other symptoms of laryngeal cancer include:
- A cough that does not go away.
- Difficulty or pain when swallowing.
- A lump or mass in the neck or throat.
- Hoarseness, or some type of change, in the voice.
“The larynx is a part of the throat, between the base of the tongue and the trachea,” the cancer institute explains. “The larynx contains the vocal cords, which vibrate and make sound when air is directed against them. The sound echoes through the pharynx, mouth, and nose to make a person’s voice.”
Cancer Treatment’s Potential Impact on Fertility for Men and Women
Cancer treatments like chemotherapy can damage sperm in men, and hormone therapy can decrease sperm production, according to the National Cancer Institute. Radiation treatment can also lower sperm count and testosterone levels, impacting fertility. These possible side effects of cancer treatment should be discussed with your doctor before starting treatment. For male cancer patients, men may have the option to store their sperm in a sperm bank before treatment to preserve their fertility.
This sperm can then be used later as part of in vitro fertilization (IVF), a procedure in which a woman’s egg is fertilized with sperm in a lab. The embryo is then transferred to a woman’s uterus to develop.
WATCH: Fertility after Cancer
Just as cancer treatment can impact men’s fertility, women may also be affected. Some types of chemotherapy can destroy eggs in your ovaries, making it impossible or difficult to get pregnant later. Whether or not chemotherapy makes you infertile depends on the drug type and age since your egg supply decreases with age.
“The risk is greater the older you are,” reproductive endocrinologist Dr. Jaime Knopman told SurvivorNet.
“If you’re 39 and you get chemo that’s toxic to the ovaries, it’s most likely to make you menopausal. But, if you’re 29, your ovaries may recover because they have a higher baseline supply,” Dr. Knopman continued.
Radiation to the pelvis can also destroy eggs. It can damage the uterus, too. Surgery to your ovaries or uterus can hurt fertility as well.
Meanwhile, endocrine or hormone therapy may block or suppress essential fertility hormones and may prevent a woman from getting pregnant. This infertility may be temporary or permanent, depending on the type and length of treatment.
If you have a treatment that includes infertility as a possible side effect, your doctor won’t be able to tell you whether you will have this side effect. That’s why you should discuss your options for fertility preservation before starting treatment.
Research shows that women who have fertility preserved before breast cancer treatment are more than twice as likely to give birth after treatment than those who don’t take fertility-preserving measures.
Most women preserve their fertility before cancer treatment by freezing their eggs or embryos.
After you finish your cancer treatment, a doctor specializing in reproductive medicine can implant one or more embryos in your uterus or the uterus of a surrogate with the hope that it will result in pregnancy.
If you freeze eggs only before treatment, a fertility specialist can use sperm and eggs to create embryos in vitro and transfer them to your uterus.
When freezing eggs or embryos is not an option, doctors may try these approaches:
- Ovarian tissue freezing is an experimental approach for girls who haven’t yet reached puberty and don’t have mature eggs or for women who must begin treatment immediately and don’t have time to harvest eggs.
- Ovarian suppression prevents the eggs from maturing so they cannot be damaged during treatment.
- For women getting radiation to the pelvis, Ovarian transposition moves the ovaries out of the line of treatment.
In addition to preserving eggs or embryos, positive research has shown that women with early-stage hormone-receptor (HR) positive breast cancer were able to safely pause endocrine therapy (ET) to try to get pregnant, and they did not have worse short-term recurrence rates than people who did not stop endocrine treatment.
Questions for Your Doctor
If you’re wondering how your cancer treatment may affect your fertility and what options are available to you, consider asking your doctor these questions, according to the National Cancer Institute:
- Could my treatment lead to infertility?
- Are there other recommended cancer treatments that might not cause fertility problems?
- Which fertility preservation options would you advise for me?
- What fertility preservation options are available at this hospital? At a fertility clinic?
- Would you recommend a fertility specialist (such as a reproductive endocrinologist) I could talk with to learn more?
- What are the chances that my fertility will return after treatment?
Preserving Fertility During Cancer Treatment
Advocating for Your Health
Whether you are currently battling cancer or worried that you might have it, it’s always important to advocate for your health. Cancer is an incredibly serious disease, and you have every right to insist that your doctors investigate any possible signs of cancer. Or, if you simply have no idea what’s causing issues with your body, you should still seek professional help.
Be Pushy, Be Your Own Advocate, Don’t Settle
“Every appointment you leave as a patient, there should be a plan for what the doc is going to do for you, and if that doesn’t work, what the next plan is,” Dr. Zuri Murell, director of the Cedars-Sinai Colorectal Cancer Center, told SurvivorNet in a previous interview.
“And I think that that’s totally fair. And me as a health professional that’s what I do for all of my patients.”
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.