Becoming a Mother When You Have an Incurable Disease
As a woman living with metastatic breast cancer, Patti faced a seemingly impossible decision: live in fear or live for right now. She chose today. What would you do?by Rachel Zohn Health Writer
Six years ago, at age 31, Patti was diagnosed with an aggressive form of breast cancer. Three years after that, the cancer came back. At just 34, she faced a metastatic disease that has a five-year survival rate of about 34%.
But Patti knows statistics don’t tell her story. And she doesn’t live in fear. So when her sister Kristin offered to be a surrogate for Patti and her husband, she knew what she wanted to do. She would become a mother.
Eight weeks ago, she did.
“I’ve had people tell me that I shouldn’t do this with everything I have going on,” Patti says, who’s now 37. “I understand their concerns. I might have thought the same thing 10 years ago. But this is my life. I always thought I’d have kids. I had this opportunity, and I took it.”
Stories like this–of a woman with metastatic breast cancer having a child through surrogacy–are exceedingly rare, says Pallav Mehta, M.D., an oncologist specializing in breast cancer at M.D. Anderson Cancer Care Center at Cooper in New Jersey, who has treated Patti for more than six years. In his 15 years of practicing and of the thousands of patients he has seen, Patti is the only patient with metastatic breast cancer who has found a way to become a mother.
While it’s possible for some women with earlier forms of breast cancer to get pregnant after treatment, it’s not an option for those whose cancer has spread. “Metastatic cancer isn’t curable,” Dr. Mehta says. “That doesn’t mean a woman can’t live a long time, but you also can’t take her off treatment for a year, which is about what it would take to have a baby. If you did that, she could die.”
Planning for a Future
As an oncology nurse, Kristin knew exactly what her sister would face when she was first diagnosed at 31. Chemotherapy will put most women into a state of chemically induced menopause, meaning they will stop having a monthly period while they are undergoing treatment. What’s more, some chemo drugs may permanently impact ovarian function or hormone levels, increasing the odds of infertility later, according to the American Cancer Society.
Just days after she had a double mastectomy and before she began chemotherapy, Kristin took Patti to an appointment with a fertility doctor to begin the process of freezing and preserving her eggs. It was a “just in case” insurance policy–a way to keep Patti’s options open, Kristin explains.
It would have been easy for Patti, who was still single at the time, to miss the window to harvest her eggs. “I don’t know if I would have gone through that whole process on my own, I was so drugged up and beat up after the surgery,” Patti said. Plus, the procedure is expensive; most insurance companies don’t cover the process or the on-going fees associated with cryopreservation. But thanks to Kristin and their mom, Patti didn’t have to worry about any of the planning. The sisters are close—they’re part of a set of quadruplets (they have another sister and brother), and they have a younger brother too. Patti’s family would be there for her no matter what.
Three Years of Stability, Then a Recurrence
A few weeks later, Patti had 16 eggs frozen and began seven months of chemotherapy and radiation. She continued to take drugs that were intended to prevent her cancer from returning, and she had regular scans to make sure new tumors hadn’t developed.
By the time she was 34, Patti had resumed her job as a high-school English teacher—and she had just started dating someone new, a quiet, kind man who was slowly winning her over. Life was good.
Then she discovered a lump in her neck. A biopsy and a scan revealed that the cancer had spread to the lymph nodes in her neck and the peritoneum, or the lining of the abdominal cavity. Patti decided not to share the news the right away. The whole family was soon headed to Walt Disney World, and she didn’t see the point of letting cancer ruin the vacation.
When Patti finally sat Kristin down to tell her, she simply pulled back her hair to reveal the biopsy scar on her neck, knowing her oncology-nurse sister would know what it meant. No one ever used the word metastatic, Kristin says.
Soon after, Kristin went with Patti to an appointment with Dr. Mehta. Kristin listened intently as he explained the next steps for Patti. As they were getting ready to leave, Kristin overheard Dr. Mehta tell Patti, “Keep living your life, and always have something to live for.”
Those words stuck with Kristin. It was the kind of thing Dr. Mehta always said and one of the reason’s Patti liked coming to see him. But for Kristin, those words were a spark that would soon light the future.
“It was something I would think about all the time,” says Kristin. “If you’re alive and you don’t do the things that you want to do, then it’s like cancer has already taken your life,” Kristin said. “Why shouldn’t Patti get to be happy, just because she got a crappy diagnosis?”
Meanwhile, Patti wasn’t dwelling on the negative either. A newly approved targeted drug seemed to be keeping her cancer stable, and she was moving forward with finding happiness and living her life. She became engaged to the man she had just started dating not long before her second diagnosis. Patti knew they loved each other–so why wait? The couple got married about five months later.
But there was still one thing missing.
Growing a Family
After Patti had been married about a year, the two sisters got to talking about surrogacy. Neither of them can remember exactly how the conversation started, but they both remember that Kristin was the one who offered to be Patti’s surrogate. Her reasoning? If one of her siblings needed a kidney, Kristin would give it. So why not give her sister a baby?
“I thought, if Patti could keep battling cancer all this time, I can be pregnant for nine months,” Kristin says. “I love her so much. She’s been the best aunt to my three girls. I wanted to return the favor and be a great aunt for her. I wanted to see her become a mom. And I guess, there was a part of me that thought, this way I’ll always have a piece of her.”
Over the years of dealing with breast cancer, Patti had lost several good friends to the disease. And as heartbreaking as that was, she was also upset to see people living with fear and becoming absorbed in the possibility that they would die soon. To Patti, that was no way to live. She realized she had kept those eggs frozen all this time for a reason. This was her chance to be a mom.
It wouldn’t be an easy journey for either sister. Becoming a surrogate requires extensive legal, medical, and even psychological preparation. Once they were finally ready to begin the IVF process, they discovered that only half of Patti’s 16 eggs survived once they were thawed. The remaining eight eggs were fertilized with her husband’s sperm, and five became viable embryos.
Kristin underwent IVF with two of those embryos. There was excitement and elation when they discovered Kristin was pregnant—and then despair when Kristin miscarried in the first trimester.
There were three embryos left. They decided to try again, but this would be their only chance. One embryo didn’t survive the thawing process. Another never took once it was transferred. But the third one stuck. Kristin willed the tiny developing fetus to hang tight. And it did.
“I liked to joke that it was her last egg in my basket,” Kristin said. “I was so scared throughout the pregnancy. I knew this was their last shot.”
Throughout her pregnancy, Kristin was careful to always remind herself that the baby she carried wasn’t her own. She played music that she knew Patti liked, including one of Patti’s favorites, Josh Groban’s Granted.
Meanwhile, Patti was going through significant complications. The cancer had caused lesions in her abdomen, which resulted in painful partial bowel obstructions. Patti was admitted to the hospital half a dozen times, feeling terribly ill and unable to eat solid food.
“I was so bloated, I felt like I was pregnant,” Patti says. “Kristin would be like, ‘Feel my belly.’ And I was like, ‘No, feel my belly!’ I could feel bubbles moving through my intestines. I thought, it’s almost like a baby kicking.”
During this time, Patti had to have a catheter inserted in her chest because a blood clot in her arm made it impossible to insert an IV there. But the port also made it difficult for her to shower or wash her hair. Kristin, who lives nearby, would come over to Patti’s house several times a week and help her.
These visits were also a chance for Patti to have some face-to-face time with Kristin’s growing belly. As Kristin blow-dried her hair, Patti would sometime place a hand on her sister, feeling the baby within.
“I remember the first time I was over helping her wash her hair,” Kristin says. She put her hand on my belly and started crying, and then I was crying. We just understood.”
A Life to Hold Onto
These days, Patti is like most new mothers, constantly tending to everything that comes with caring for a tiny person. She’s up in the middle of the night to feed him and she spends her days washing bottles and running loads of baby clothes through the laundry.
Unlike other new moms, she’s also juggling all the appointments and treatments she needs for her own care. But thankfully her family–including Auntie Kristin–and many friends have stepped up to help her and husband manage it all.
Patti’s breast-cancer support group even threw her a big baby shower several weeks ago, surprising her with a pile of gifts and so much love. It’s all made her appreciate how many people want to help her celebrate, how many people want to share in her joy. And these days, she has a lot of joy to give.
She feels her heart ache with it when she watches her son. When she sees his eyes light up or hears him coo. She sometimes thinks about his future, and what he’ll be like when he grows up. But mostly she focuses on each moment with him.
She knows that no matter what happens, her son will be surrounded by people who love him. And she knows a part of herself will always be with him.
“I see myself in him, especially in his eyes, the way he looks at me,” Patti says, her voice heavy with tears. “When I look at him, I know there’s a little piece of me in there. It’s a miracle that he’s here.”