Chapters Transcript Video Patient Receives Cancer Treatment While Pregnant One walk you never want to take as an oncologist is down the corridor of the obstetrics ward. But miracles like Amanda's case encouraged me to keep pushing in situations where it doesn't seem possible. It was 2021, so I was pregnant. I was 36 at the time, so I was considered advanced maternal age, so we did the genetic testing. She had a positive cell-free DNA screening, which is a routine pregnancy test. Hers was flagged as being abnormal. UCSF did a follow-up test and the baby was deemed completely fine, but they wanted to continue to look into the situation because obviously it was like the problem was in me. That screen is often positive in patients who'd had a history of cancer and Amanda had had a history of melanoma. And so she saw her dermatologist who was like, yeah, probably, let's just do this pan MRI and that MRI showed some concerning lesions in the liver and then one small spot in the colon. It was because of that incredibly astute radiologist who picked up a shadow in the colon that we landed with pursuing a diagnostic evaluation for colon cancer with a colonoscopy. And that confirmed colon cancer. I knew at that point we were probably dealing with the big C, but I had no idea. In what capacity? Um, When what would be my oncologist's fellow walked into the room and said, you know, you might want to get your husband on the phone. I didn't know I was getting a diagnosis then. It was stage 4 diagnosis. It was my husband's birthday. He came rushing to the hospital, a high risk OB nurse. Took me out to the garden and just held me. I mean, this was still pandemic and she just held me. And I will never forget that. By the time I came in, she had very quickly shifted in a very short period of time into what are we going to do about it. At that point, a huge multidisciplinary team meeting was convened. That is one of the moments when I've seen UCSF at its best, where one of these potentially tragic cases pulls us all together and reminds us why we're here. My husband John was googling Doctor Van Loon, and he was pretty blown away by Doctor Van Loon's credentials. And it's like, oh my gosh, this doctor's dealt with other pregnant women that have cancer because it turns out there are other pregnant women that have colon cancer. Fortunately, in Amanda's situation, she had a fetus that we knew was already viable. So at that point, the conversation really shifts to how do we take care of Amanda? And she and I sat together and she looked at me and she said, this baby needs a mother. What I needed was for people to believe in me. To tell me that I was strong, that this was going to be my biggest race yet as a runner. I kind of made this mindset shift of, I'm not going to be asking what if questions like, this is where we're at, you know, we're gonna go with it. She initiated chemotherapy very quickly after that. The comfort with chemotherapy in pregnancy is relatively new, which is why it's so important to come to a place who has experience in these cases. They were strapping monitors on the baby several times a day so they could check my. Baby throughout the whole process. They were gonna let me go to about 37 weeks. They had to make the plan to induce me because the baby was breached. Didn't make it to the scheduled induction because my water broke. So we drove to the hospital and, you know, C-sections are quick and that was just like, it was so exciting to have Levi. It was amazing. As soon as she delivered, we shifted into action. Fortunately, she had had pretty significant shrinkage of the tumors in the liver as a result of those 1st 3 cycles. We let her recover from her delivery and she continued chemotherapy for a total of 7 cycles. And then we had a surgery date which was really exciting and it was exciting because they could do it in one procedure, get it out of the colon and the liver at the same time. It's incredibly important as an oncologist to be able to work with surgeons of the caliber as Doctor Maker and Doctor Varma. Doctor Varma just walked in the room who are proficient and expert in performing cancer surgeries. After surgery, I got a clear pathology report, which was huge. They got it. Her journey went as smoothly as we possibly could have hoped for. She was a rock in the journey and she trusted her team. And in the end, her outcome was far better than any of us ever expected. It's one of those weird things where pregnancy maybe saved her life because, because she was pregnant, she had this genetic testing, so she got this workup. I'm lucky I could look at it like I'm. Unlucky for having gotten this in the first place, but to be a stage 4 patient with no evidence of disease, It's huge. I credit UCSF with so much. In a crisis that human spirit is truly remarkable, and I think Amanda's an example of that. Levi is too. He's so much fun. People told us when he was a baby that he was so chill. I like to think that he knew that mom was going through something and he was just gonna be kind of chill and give mom a break. I started training for a marathon a week after finishing treatment and ran my 6th marathon just over 4 months after finishing treatment. Which might have been too fast, too soon, but it was a really good distraction. This is a big spin. I'm just so happy for her that she's come through on the other side. Now, Levi's growing up with a mom and Amanda's cherishing every moment. Published Created by
