To Conceive or Not To Conceive?

That's the million dollar question.

I saw my new oncologist at Seattle Cancer Care Alliance yesterday. I am transferring my care there for several reasons, none of which is that I don't like my current oncologist at Madigan. I love him. I love the nursing team there. I'm sad to leave. However, 70 miles each way is just too far to drive for daily radiation and the follow on care that I'll need.

I was lucky enough to get referred to one of the best breast reconstruction surgeons in the nation, and he works out of UW, so it just makes sense to transfer all of my care to SCCA. It also doesn't hurt that US News ranked SCCA/UW as the sixth best cancer hospital in all of the US, and that my new oncologist specializes in breast cancer.

Since my surgery is rapidly approaching, I have started to feel anxious about what my follow-on care will consist of. Part of that concern is what our timeline looks like as far as starting a family.

Easy stuff first: because of my BRCA-1 and triple negative status, I will see my oncologist for a clinical exam and have my blood tested for tumor markers every three months for the next two years (and every six months for years 3-5). I will alternate breast MRIs and CT scans every six months for the first two years, and then annually after that. I will also have to be monitored carefully for ovarian cancer, to include blood tests and pelvic ultrasounds every six months until I have my ovaries removed. The two years post surgery are crucial, as it is my most vulnerable window for recurrence.

As far as starting a family, that's where things get complicated. Our safest option is to have my ovaries removed now (which reduces my risk of recurrence as well as eliminates my risk of ovarian cancer) and adopt. Another option is to wait two years (to get past the highest risk of recurrence) and hope that the Lupron I've been taking has done its job protecting my ovaries during chemo, and we can get pregnant. My doctor says that my chances of that happening is pretty high (somewhere in the 85-ish% range). She also included a huge caveat to this option: should my cancer recur during pregnancy, we have to be prepared to terminate the pregnancy to start immediate treatment to save my life. We asked about fertility treatments now to preserve embryos and look at a surrogate when we're ready to have children, but that option is off the table because egg retrieval is extremely hormone intensive.

So now we have to make a decision...reduce my risk to the lowest possible extent and never have a biological child, or try for a baby and pray that I make it through the pregnancy cancer free. As if it wouldn't be awful enough to receive a second cancer diagnosis, it would be absolutely devastating to be faced with having to terminate our pregnancy, especially getting pregnant knowing of that risk. I just don't know if I could do it...

Cancer blows.

If you're the praying kind, please pray for us. If you're not, we could use all of the good thoughts you can throw our way.