She had chemotherapy while pregnant: A 37-year-old mother's fight against breast cancer
One year after finding out she had an aggressive form of breast cancer, Nooridah Bte Mohd Noor shares her story with CNA Women, from the shock diagnosis to finding out she was pregnant just before her chemotherapy started and her baby's premature birth.
When Nooridah Mohd Noor found out that she had breast cancer in October last year, she broke down at the corner of the hospital.
Through her shock, she barely heard her doctor say she had second stage triple negative breast cancer – an aggressive type.
“When you hear about cancer, it depends on the stage you are at,” said the 37-year-old administrative manager, who goes by Idah.
“And if you are at the later stages, sometimes you may not be reacting as well to treatments. There are so many uncertainties.”
My biggest fear was if my doctor were to tell me ‘you only have one month to live’.
Recalling that “very, very dark period” of her life, she told CNA Women that she also wasn’t sure to what extent the cancer had affected her other organs.
It didn’t help that her son Aidan was only two years old then.
“My biggest fear was if my doctor were to tell me ‘you only have one month to live’ or something like that,” said Idah.
ANGRY-LOOKING BREAST LUMPS
Aidan was born in August 2018 and like many new mums, Idah experienced breastfeeding issues like blocked milk ducts and breast engorgement every few days.
She recalled developing mastitis in October that year. This breast inflammation is common among breastfeeding women.
To resolve the issues, she went for massages and took lecithin, a nutrient said to help lactating mums avoid blocked ducts.
A month later, after she had made the decision to stop breastfeeding, Idah noticed two “angry-looking” lumps protruding from each breast. The lump on the left breast was the size of a 50-cent coin, “significantly larger” than the one on the right breast.
In December, she went to see a general practitioner, who referred her to a breast surgeon.
DEALING WITH BREAST ABSCESS
A breast ultrasound revealed that she had developed breast abscess, pus-filled lumps that were causing her pain and discomfort.
Her doctor scheduled a fine-needle aspiration biopsy on both breasts in December to drain the pus.
The American Cancer Society describes it as a procedure where a doctor uses a thin needle attached to a syringe to withdraw a small amount of tissue or fluid from a suspicious area. It takes only 15 minutes.
After the extraction, Idah’s biopsy sample was sent to the lab to determine the type of infection she had and the type of antibiotics needed to treat it.
When the lab results were out two weeks later, Idah was called back for a second extraction to drain the remaining pus and prescribed antibiotics to clear up the infection.
The doctor told her that the lump would “resolve on its own” after she had completed the medication.
Because it was only a slight lump, I didn’t think much about it.
Idah said that while the lump on the right breast disappeared, the one on the left was reduced to the size of a 20-cent coin – it did not subside completely.
Since the lump didn’t grow bigger and no longer looked red, she wasn't concerned. Her doctor had also advised that things should be fine if the lump didn’t get larger.
Everything seemed normal, and she didn’t visit the breast surgeon again.
PINS AND NEEDLES AT THE LUMP
It wasn't until two years later in June 2020, when Aidan was almost two years old, that she felt “pins and needles” where the lump on her left breast was located. She would experience the sensation about five to six times a day.
“Because it was only a slight lump, I didn’t think much about it,” Idah said.
Although she recounted having occasional “slight discomfort”, she didn’t think it was painful.
She would have ignored the sensations if not for a conversation with her mum that month, where she casually mentioned it. Idah’s mother persuaded her to get her breasts checked.
I don’t have a family history of cancer, so that would be the last thing on my mind.
So in mid-September, Idah got a referral from a polyclinic for an ultrasound at a hospital, followed by a consultation with a breast surgeon.
“The breast surgeon said that (the lump) looked very suspicious and irregular, so she sent me for a biopsy.”
Two weeks later, on Oct 6, Idah went with her husband to discuss the biopsy results.
“They told me it’s triple negative breast cancer, and explained that it’s an aggressive form of breast cancer,” said Idah.
“Once I heard the words breast cancer, I totally shut down and couldn't hear what she had to say after.”
“Furthermore, I don’t have a family history of cancer, so that would be the last thing on my mind. I wouldn’t even be thinking about it,” Idah recounted.
“Everything was going so fast, and as it was an aggressive form (of breast cancer), my doctors wanted me to start treatment as soon as possible,” she added.
Idah's doctor also mentioned that it wasn't the previous abscess which turned cancerous – as cancer is “totally a different thing”.
“We went out of the (doctor’s) room, and that’s when I broke down.”
EGG-FREEZING AND FINDING HERSELF PREGNANT
Things moved quickly. In that same week, Idah underwent a series of tests, including a heart scan and mammogram, and her first chemotherapy session was planned for the following week.
Idah also opted for egg-freezing, which, while banned in Singapore, is offered to women of reproductive age who are undergoing cancer treatment, to preserve their fertility.
Chemotherapy and radiation therapy work by killing the cancer cells in the body that are dividing quickly, affecting hormones needed for pregnancy and, at times causing a woman to have early menopause, said American Cancer Society on its website.
The egg-freezing process involves retrieving the eggs from the ovaries and freezing them. The retrieved eggs can then be stored, warmed and fertilised with sperm when needed.
Idah, who had been trying to conceive again, agreed immediately.
So a week after the breast cancer diagnosis, she met with a gynaecologist at Sengkang General Hospital who would see her through the egg retrieval process.
This included administering at-home injections for two weeks to quicken the process of turning the egg follicles into mature eggs, after which, the eggs would be retrieved through a half-day surgical procedure.
To prepare for egg-freezing, Idah also had to take various blood tests to determine the size and quality of eggs needed for the process.
“(My gynaecologist) told me that my hormone levels were high, but I didn’t think much about it,” she said.
Idah had only started her injections for three days when she received a call from her gynaecologist.
“You have to stop the medications now, because you tested positive for pregnancy,” she heard her say. Idah was four weeks pregnant.
“When I heard the news, I started crying,” said Idah.
But it wasn’t from the joy of getting pregnant, but her concerns about the scans she “should not be doing” while pregnant, including the mammogram and heart scans she did the week before.
“I was very worried about what (the scans) were doing to the foetus,” recounted Idah. “I was supposed to start cancer treatment, and now I am pregnant, so what’s going to happen?”
Whether the baby survives or not, I will still try to give birth and give my child a chance to live in this world.
Idah’s was a unique and unexpected case for her doctors, and they wanted to monitor her closely.
“I feel that I am gifted with such a unique situation, so whether the baby survives or not, I will still try to give birth and give my child a chance to live in this world,” said Idah.
Her surgeon and oncologist later told her that she should not worry about her previous exposure to the harmful radiation from the scans, as they had amounted to “almost negligible”.
“(My breast surgeon) was worried that if anything happened to the foetus along the way, I would be even more devastated and depressed,” said Idah.
CHEMOTHERAPY WHILE PREGNANT
Idah started chemotherapy in December, two months after her diagnosis. She was then in her second trimester, which is deemed a safe period for pregnant mums to undergo cancer treatment.
Calling it a blessing in disguise, Idah said she was thankful that the egg-freezing process gave her the “extra time” to find out that she was pregnant.
I was supposed to start cancer treatment, and now I am pregnant, so what’s going to happen?
“If I didn't go for the egg-freezing process, I'd have started on chemotherapy the very next week (while not knowing I was pregnant).”
However, the one-month delay in beginning treatment saw the breast lump growing from 3cm to 4cm.
That aside, all seemed to be going according to plan.
Idah’s chemotherapy would take six months, after which, she would give birth in June this year. Radiation therapy would begin after the baby was born, as well as breast surgery.
Idah’s oncologist had sent her for a genetics test earlier to find out if she carried the BRCA1 (BReast CAncer gene one) and BRCA2. The results would determine if she needed a lumpectomy (to remove the lump) or mastectomy (which removes the entire breast).
“There was a possibility of a mastectomy depending if I carried the BRCA genes. But the results came back negative, so I qualified for a lumpectomy,” Idah explained. That also meant that she would get to conserve most of her breast tissue.
Her body was responding well to chemotherapy as well. In the three months since she had started treatment, the 4cm lump had reduced significantly. By April, two months before she was due to give birth, she could no longer feel it.
A PREMATURE BIRTH
But while her breast cancer treatment was going well, her pregnancy took a worrying turn.
Idah delivered baby Noah prematurely in mid April, at 30 weeks, due to placenta abruption. The condition occurs when the placenta separates itself too early from the uterus, causing bleeding and danger to the foetus.
Even then, Idah said dealing with breast cancer is a “rollercoaster” of emotions. While some days are easy, she also lives with the worry that the cancer will come back.
“When you hear stories about cancer survivors, it’s always very positive, encouraging and inspirational. But behind those feelings, there are days that can get quite emotional.”
It’s not always ups, there are downs as well, she added.
Coming to terms with the diagnosis, accepting it, moving forward and dealing with each issue and treatment you have to undertake – all while keeping a positive outlook – is important, Idah said.
To do that, you need to find the positive in the tiniest of things, such as your family, husband or children.
In January this year, she reached out to the Breast Cancer Foundation (BCF) in the hopes of finding other women who had gone through the same experience.
When she was about to undergo radiation therapy, she relied on BCF’s Young Women’s Support Group for information and tips that might help her.
Idah recommends that women, especially younger ones, carry out daily breast self-examination – early detection would not only save lives but their breasts as well.
That’s also the reason why Idah chose to make her Instagram account public. She’s hoping to let others know that they are not alone in their despair and that “there’s always hope”.
“A follower shared with me that she was pregnant and found out that she had a suspicious lump,” Idah shared.
After finding out that it was indeed breast cancer, she told Idah how thankful she was to have come across Idah’s story. It kept her going, and kept her believing she would pull through.
“No matter how dark the place you are at is, or how lost you are, there’s always hope,” said Idah.
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