fertility

Fertility, Family & Cancer

Four months after our beautiful beach wedding in Tulum, I was diagnosed with early stage cervical cancer.  I had a longstanding history of high-risk HPV and abnormal Pap smears, but it was still a shock for me because I had done everything “right”.  I’m a healthcare professional and was familiar with HPV and the risks of it lingering in my body.  I never missed a Pap smear, biopsy, procedure or follow up, and I still got cervical cancer.  Fortunately, my gynecologic oncologist understood how important fertility was to both myself and my husband, and so I was planning to undergo a fertility-sparing surgery called a radical trachelectomy, where they remove the cervix but not the entire uterus and ovaries.  I met with the onco-fertility team approximately three days after my diagnosis.  They offered to get started right away with egg retrieval and egg or embryo freezing.  I didn’t want to do that unless I absolutely had to since the average cost is about $15,000, and I was still going to have my ovaries after surgery.  In the worst case scenario in which I would need pelvic radiation after surgery, I had six weeks between surgery and the start of radiation to do egg retrieval.  This was a great plan in my mind.

I have always wanted to be a mom.  I’ve been a dog mom for 13 years and have never been more ready to be a mom (to actual people) until I got married in February 2017 to my best friend and partner in life.  We met online, were each other’s first date on one of those popular dating websites, and the rest is history.  We had talked about our future family on multiple occasions prior to getting married, and we wanted to start trying to build our family about a year or so after getting married since I was 32 and not getting any younger.

Three weeks later at my pre-op appointment, I had the shock of my life.  My tumor had doubled in size in only three weeks from three to six centimeters.  My cervix was completely covered in cancer, and I was no longer a surgical candidate since my cancer now had “high risk” features based on how fast it was growing and was now considered locally advanced.  Also, given that my cancer was growing so quickly, it was the recommendation from my gynecologic oncologist and radiation oncologist that I proceed with treatment ASAP.  Given the circumstances and our fear, my husband and I were in agreement to move forward with treatment without doing egg retrieval.  My last resort was to undergo a bilateral ovarian transposition (move my ovaries out of pelvic area) to try to save at least some small piece of my fertility, but more realistically, to attempt to preserve some ovarian function so I didn’t become post-menopausal at age 32.  It was a 50/50 chance to try to preserve my ovarian function and much less of a chance to preserve fertility. 

The ovarian transposition wasn’t successful, and now I’m 34 and post-menopausal.  Fifteen months after the completion of chemo-radiation, my hormone levels are still post-menopausal, and my ovaries don’t show any eggs ready to retrieve.  Sometimes, I feel like my body failed me again (cancer being the first fail), but I have to remind myself it wasn’t me, it wasn’t my body – it was the treatment that did this to me.  The odds were against me, but it wasn’t anyone’s fault, especially my own.

I’ll never know why this happened to me.  Nobody deserves to lose their chance to have a biological child.  Fertility is a loss so great that it cannot be put into words.  I will forever be grateful for my treatment team, support system and my body for healing me, but this loss is permanent and at times, has overshadowed the amazing response to treatment that I was so fortunate to have.  I have gone through every emotion possible over the past 15 months.  The grief that follows is extraordinary.  It is a pain and grief that nobody can fix and no one can comfort.  It is not just my pain though; it is my husband’s pain too.  It is the loss, pain and grief of so many young adult cancer patients and so many couples.  

This past year has been a process.  A process of grief, depression, anxiety, anger and many tears, as well as gratitude, blessings and opportunity.  I have done a lot of personal work, some of which was by myself and some of which involved other people including my husband, family, friends and a counselor.  My onco-fertility team was thoughtful enough to suggest a grief/infertility counselor to help me through this loss.  In seeking the help of a counselor, I have begun to learn to accept my feelings.  I try not to be angry with myself for not pursuing egg retrieval the day I was offered it.  I am trying to practice self-compassion.  

I realize I can and will have children and the family I dreamed of, although not in the way in which I planned.  I acknowledge that sometimes it still hurts, and I will continue to have moments and even periods of time that I will still grieve this loss and re-experience the anger, sadness and hurt all over again.  I understand that this is a part of my life and that’s okay.  I will carry a piece of this grief with me for the rest of my life.  It is not something that goes away, but it is more of something that you learn to live with and something that becomes part of who you are.  It is also a part of my relationship with my husband and will help shape our relationship.  Nothing can prepare you for a cancer diagnosis, and nothing can prepare you for fertility loss.  These life-changing experiences know no boundaries and do not discriminate.  What I have realized though, is fertility loss doesn’t mean I can’t have children or a family.  Cancer has changed my life, but it can’t take this away from me.

Megan Tanner is a 1.5 year cervical cancer survivor, nurse practitioner and pug-lover.  She lives in Houston, TX with her amazing husband, Greg, and their two perfect pugs.  She hopes to one day see full infertility coverage by all employers and health insurance plans in all 50 states.

Mother’s Day and Survivorship

Life after cancer can easily be compared to a snow globe.  One that has been shaken vigorously. It can feel like we are plopped down, left to figure out every aspect of life. The cancer community regularly refers to post-cancer life or living life with cancer, as “survivorship.” It certainly is a process and one that comes with some amazing days and moments, but also extremely dark and lonely ones as we adjust to this new life and grieve our old one.

For gynecological cancer survivors, especially survivors of cervical cancer, Mother’s Day can come with an array of feelings. It can be one of the harder days for us, where we find ourselves digging deep for joy. Cervical cancer treatment, more often than not, steals reproductive ability leaving the patient with the decision to pursue fertility preservation or to begin treatment right away. This decision alone can be extremely overwhelming and is one of the first ones the patient must make. Unfortunately, not all patients are given the option, and if they are, not all can afford the cost, leaving the patient to decide….life or death.

Cervivor Dusty & her mom

We recently asked the Cervivor community how they were feeling about the upcoming holiday. As expected, we received a wide range of responses. Prior to asking our community, we thought that perhaps it all depends on where you are in your survivorship. However, most all responses conveyed loss. Even those who had chosen not to be mothers prior to their diagnosis and those who were already moms acknowledged that there is loss and pain in our community that centers around this choice that is often snatched from our hands. For many women in our community, they choose to focus on their own moms and find joy in those relationships. Dusty and her husband chose not to have children prior to cancer, but she recalls her mother’s loving kindness on this day, “My mom spent Mother’s Day the year I had cancer with me, taking care of me as the painful side effects of my treatment became too much. It’s a bittersweet memory that reminds me just how wonderful my mom really is.”

Paulette and her husband (far right) with her mother and extended family.

Paulette is another cervical cancer survivor who made the decision long before cancer, that she did not want to be a mother. Her approach to the holiday is to honor her own mom,” I chose to not have children, so I’ve never felt the loss of never being able to be a mom. I have a difficult at times relationship with my mom, but I do respect her and celebrate that day with her.”

Sadly, there are also women in our community who have both lost their mother’s and their own ability to have children, making Mother’s Day doubly difficult. Heidi lost her mom nearly eight years ago, but the grief is still vivid, “Mother’s day is very difficult. I lost my own mom in 2000. And because of the cervical and uterine cancer, I lost the chance to get to have kids of my own that I really wanted.”

Being a mother prior to cancer doesn’t exempt you from the pain of losing fertility. These women can be overlooked in the discussion.

Cervivor Ana and her two children.

Ana, who was a mom at the time of her diagnosis confesses, “I grapple with being grateful for what I have and sad for the loss of not being able to have more children.”

Mary and family.

Mary is another survivor who had children prior to her treatment. She admits that having that decision taken out of her hands feels unfair,” I am grateful for the two I have and, I considered myself done so I’m at peace with what it is. I hated that the option was taken off the table for me, but I had to live for the ones I have.”

Like all other aspects of survivorship, grieving fertility and/or motherhood looks different for everyone. It’s not linear. Some days are just better than others. For some women, like Tina who never had the opportunity, reminders are always there but it can hit harder and out of the blue like in this conversation with her neighbor.  “When I first moved into my neighborhood one of the moms said to me ‘my daughter can’t wait for you to have kids so she can babysit.’ I was at a loss for words. I love celebrating my mom, but I find it to be a hard reminder of what was taken from me.”  There are many Cervivors like Lauren. Lauren lost her fertility at a very young age. She chose treatment to save her life, but not without costs that she lives with daily. “Mother’s Day hits hard for me. As do pregnancy announcements and baby showers. Lost my fertility due to cervical cancer at 23. Knowing I won’t ever be pregnant is hard sometimes.” 

Tina and her fur babies

Cancer is just unfair. The diagnosis, the treatment, and the life you’re left with after can feel like a shell of who you were before. Survivorship is hard, and many days can feel harder than cancer itself. Like all other aspects of our new life, we must find ways to process, heal, and exist in our new bodies and minds. Often it comes down to choosing how we will approach Mother’s Day and what is best for us. It’s not a one size fits all. Some of us will find it is best to avoid certain places, while others are able to lean into celebrations of mothers in our lives. Some Cervivors will go about their day as any other day, while some will find healing in the shear acknowledgment that they are alive. Cervivors like Danielle will hold their children just a little closer that day, “I got my first all clear of stage 3b March 20th. I am a mother of 3, not only is this the most beautiful Spring I have ever seen, but the most precious Mother’s Day I will ever know.”

Wherever you find yourself this Mother’s Day and however you are choosing to spend it, Cervivor wishes you a day of peace and joy! We are Cervivor.