Coping With a Breast Cancer Diagnosis While Pregnant
- At 19 weeks pregnant, Dr. Christina Ortega, 34, learned she had stage 2, HER2-positive breast cancer, meaning her cancer had high levels of the HER2 protein on the outside of their cancer cells. Her mind quickly worried about her baby’s safety.
- Ortega underwent six rounds of chemotherapy during pregnancy and gave birth to a healthy daughter before continuing with radiation, surgery, and reconstruction. She’s now in remission and encourages other patients to never let go of hope.
- Chemotherapy’s side effects include fatigue, gastrointestinal effects, nausea, and more. Chemo drugs designed to kill cancer cells also impact healthy cells, leading to side effects.
- To better manage chemotherapy side effects, experts recommend exercising and eating a nutritious diet with enough fruits, vegetables, and protein. Getting enough sleep helps with fatigue and allows you to recover quickly. Your doctor may also recommend medications to help with side effects.
- Radiation helps kill cancer cells in a targeted way. With breast cancer, it is often used after surgery to kill off any cancer cells that may remain in the breast or surrounding area. Possible side effects may include swelling, fatigue, and scar tissue.
- She also underwent a double mastectomy, a procedure in which both breasts are removed to get rid of cancer. The roughly two-hour procedure may also be performed as a preventative measure for women who are at a very high risk of developing breast cancer.
At 34, Ortega—a pediatric neuropsychologist—was suddenly facing a battle she never imagined, one that threatened not only her own life but the future of her unborn child and young son.
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But Ortega wasn’t alone. Her care team mobilized quickly, offering answers and mapping out a treatment plan. Radiation would have to wait until after delivery, but chemotherapy could begin immediately. And so, every three weeks, she underwent six rounds of chemo—while still carrying her daughter.
WATCH: Understanding HER2-Positive Breast Cancer
Prayerfully, she gave birth to a healthy baby girl. Yet the emotional toll lingered.
“When I gave birth, I felt all the anxiety really hit me again because now the second baby is here, and again, I don’t want to leave her here without a mother,” Ortega said.
Her treatment journey stretched over three years and included chemotherapy, radiation, a double mastectomy, and reconstructive surgery. Today, Ortega is in remission—and her message to others facing a frightening diagnosis is one of resilience and grace.
“I would say hang on to any hope that you can and, as cliché as it sounds, really try to take it one day, one step at a time,” she explained.
Helping Patients Cope with a Breast Cancer Diagnosis
What was Ortega’s Breast Cancer Treatment Experience like?
Ortega began by undergoing multiple rounds of chemotherapy.
Chemotherapy is an effective tool for oncologists to help treat cancer by stopping cancerous cells from growing, dividing, and spreading to other organs. Chemo works by traveling through the bloodstream to kill cancerous cells. However, the process also impacts healthy cells, leading to side effects.
Patients almost universally experience fatigue, often alongside gastrointestinal side effects, such as nausea. Doctors have many effective medications to combat chemo-induced nausea. “But mitigating that fatigue often depends on the patient,” Dr. Urban said.
“Neuropathy is probably one of the most challenging side effects,” Dr. Urban continued.
Neuropathy results from damage to the peripheral nerves. It usually resolves after chemotherapy treatment, but sometimes symptoms can persist. While it’s typically characterized by numbness or a pins-and-needles sensation in the hands and feet, neuropathy can have several different symptoms, including:
- Weakness in the hands or feet
- Stabbing or burning pain in the hands or feet
- Difficulty gripping, such as when holding a fork
- Difficulty with fine motor skills, such as writing or buttoning a shirt
Nausea and vomiting are common side effects of chemotherapy. When chemotherapy affects the rapidly dividing cells in the stomach lining, the resulting cellular havoc in the gastrointestinal tract can lead to side effects such as nausea and vomiting. However, doctors can help patients mitigate the hit with various medications before, during, and after treatment.
“Part of the chemotherapy prescription includes a set regimen of anti-nausea medications…We also ensure patients have medications at home that they can use should they develop nausea after treatment,” Dr. Urban added.
Tips for Navigating Chemo Side Effects
Doctors don’t have an arsenal of prescription medications to combat fatigue. However, you can do several things to help minimize the hit and restore your energy.
- Exercise: While it may be counterintuitive, physical activity can help alleviate side effects, especially fatigue. “Although ovarian cancer is not common, we often draw upon the experience of patients with breast cancer and colon cancer, who have shown that physical activity can not only improve quality of life but may also have beneficial impacts on cancer outcomes,” Dr. Urban says.
- Eat well: Even though nausea may interfere with your ability to eat a healthy diet, it’s essential to ensure you’re eating appropriately, getting enough protein, and not losing weight. Not only will nourishing your body support your recovery, but it may also help you feel more energized.
- Sleep: Want to mitigate fatigue? Be sure to maintain your regular sleep-wake cycle while on treatment. Sticking to a set sleep schedule helps reduce fatigue by ensuring enough hours for your body to heal and restore itself each night. It may also help you recover more quickly by keeping energy levels high during the daytime.
Treating Neuropathy Symptoms
Doctors have several strategies for helping patients deal with this side effect. Once a patient begins experiencing the symptoms of neuropathy, they’ll be carefully monitored to ensure they don’t get worse. Before each chemotherapy infusion, the attending oncologist will assess whether the symptoms have progressed. If the symptoms worsen, they may adjust the dose or delay treatment. They may also try switching to another chemotherapy drug.
WATCH: Managing chemo side effects.
How to Get a Handle on Nausea
Most of these anti-nausea medications last for more than eight hours. One of the infusions commonly used reduces the degree of nausea for up to three days.
Complementary approaches may also be helpful. A few favorites:
- Ginger: Studies consistently show that ginger helps alleviate chemotherapy-induced nausea. The powerful herb appears to have an anti-spasmodic effect on the gut. Not a fan of raw ginger? Suck on ginger candy, sip ginger ale, or make a steaming cup of ginger tea.
- Pressure bracelets: at your local pharmacy, these bracelets provide consistent pressure on a particular acupressure point on the wrist to reduce nausea.
- Deep breathing: Moving air in and out of your lungs with a few deep breaths can help relieve nausea, particularly if you pair deep breathing exercises with meditation. It can also help you relax and release stress and anxiety.
How Exercise Can Impact Your Chemo Experience
The National Cancer Institute recommends cancer survivors maintain “some level of physical activity.” The NCI cites a 2018 report by the American College of Sports Medicine International Multidisciplinary Roundtable on Physical Activity and Cancer Prevention and Control, which found “strong evidence that moderate-intensity aerobic training and/or resistance exercise during and after cancer treatment can reduce anxiety, depressive symptoms, and fatigue and improve health-related quality of life and physical function.”
Additional research published in “Cancers” last year noted, “Physical activity has been shown to reduce the side effects of treatment and fatigue in cancer patients.”
WATCH: Exercising and Cancer
“Lack of exercise actually begets fatigue,” Dr. Marleen Meyers, a medical oncologist and Director of the Cancer Survivorship Program at NYU Perlmutter Cancer Center, told SurvivorNet in a previous conversation about how to deal with some of chemo’s most challenging side effects. “So the best treatment for fatigue is exercise. And what we have to do is get people over the hump, to get initial exercise going.” Dr. Meyers treats patients with breast cancer, but she said her advice applies to many other cancers as well.
Ortega’s Double Mastectomy
A double mastectomy is a procedure in which both breasts are removed to get rid of cancer. The procedure may also be performed as a preventative measure for women who are at a very high risk of developing breast cancer.
WATCH: What Happens During a Double Mastectomy?
“A double mastectomy typically takes about two hours for the cancer part of the operation, the removal of the tissue,” Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, tells SurvivorNet. “The real length, the total length of the surgery, can often depend on what type of reconstruction [a patient] has.”
Dr. Port adds that most women opt to have some reconstruction after a mastectomy.
“When it comes to radiation therapy for the breast, what we’re learning is that shorter courses of radiation, like short courses whole breast, may be associated with equal clinical outcomes and even the potential for reduced side effects,” Dr. Chirag Shah, director of breast radiation oncology at the Cleveland Clinic Cancer Center, explains to SurvivorNet.
WATCH: Debates Around Radiation for Breast Cancer
Navigating the Emotional Journey of a Breast Cancer Diagnosis
Receiving a breast cancer diagnosis can be overwhelming, and it’s completely natural for emotions to fluctuate throughout the process. Psychiatrist Dr. Lori Plutchik explains that emotional responses can shift from day to day, sometimes bringing unexpected waves of stress or uncertainty.
“The patient or person going through the stressful event should accept that emotions will be fluid,” Dr. Plutchik says. “You may feel fine one day and then feel a massive wave of stress the next. It’s also important for those you look to for support—whether that’s a therapist, friends, family, or both—to understand the fluidity of stress-related emotions.”
If your emotional well-being begins to feel significantly impacted, seeking mental health support may be beneficial. Options for care include traditional talk therapy, medication, lifestyle changes such as exercise and diet modifications, joining a support group, or other personalized approaches.
Here are a few ways to help manage the emotional toll of a breast cancer diagnosis:
- Lean on loved ones. Open up to your family and close friends, allowing them to step in and offer support. Many cancer survivors express a strong need for assistance but struggle to ask for help—encourage those around you to offer practical aid, whether it’s meals, transportation, or simply a listening ear.
- Keep a journal. Writing down your thoughts and emotions can be a powerful way to process feelings. A journal provides a safe space to express yourself and reflect on your journey.
- Join a cancer support group. Local and online groups offer an opportunity to connect with others who are facing similar experiences. Learning from others and sharing your story can provide comfort and strength on difficult days.
- Consider therapy. Speaking with a mental health professional can help you navigate fears and concerns in a safe, supportive environment. Sometimes, vocalizing emotions rather than keeping them inside makes a meaningful difference in coping with stress.
While the path may feel uncertain, finding the right support system and coping strategies can make a profound impact on your mental and emotional well-being. Breast cancer is a challenge, but you are not alone—and healing happens in many ways beyond the physical.
Questions to Ask Your Doctor
If you have been diagnosed with breast cancer, you may have questions about how to keep your strength through treatment. Here are a few questions to help you begin the conversation:
- What treatment will I be receiving?
- What side effects are associated with this treatment?
- Are there steps I can take daily to help minimize these side effects?
- What physical activity routine do you recommend for me during treatment?
- Do you have recommendations for someone who doesn’t particularly enjoy exercise?
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