There is no reduced fare during pregnancy. Cancer can strike at any time and you should be prepared for it. The only question is whether it is necessary to decide on serious treatment with the use of chemotherapy or to let the cancer develop in the interests of the unborn child. This is the story of pregnancy - suffering from lymphoma - Marta.

Pregnant cancermakes you face a difficult choice to treat or not to cure? - About the fact thatpregnant lymphomaI found out about the disease in the 26th week of pregnancy, when my supraclavicular lymph node suddenly increased - says Marta Świerczyńska. "Of course, it never occurred to me that this could be such a serious matter." Especially that before getting pregnant I had problems with recurring colds, night sweats, everything was itchy, my temperature was often elevated and lymph nodes were just enlarged. I used to visit doctors, but none of them could really tell what was wrong with me. Usually they concluded that it was an extremely stubborn infection. Finally, after another treatment with strong antibiotics, everything calmed down. I was feeling well, so we decided to try again for the baby we wanted so much. Since I lost my first pregnancy, now my closest doctor was my gynecologist, Dr. Henryk Olszewski. And that's what I showed him about the swelling that appeared around the collarbone.

Diagnosis: pregnant lymphoma, cancer of the lymph nodes

- Looking from the perspective of these three years, I can confidently say that it is him, my gynecologist, that we owe our lives to both of us, says Marta. - The doctor looked at me carefully. Then, of course, I didn't notice that after examining me, he first turned pale and then red. He immediately referred me to hospital for examination. And he was with me all the time, also during the knot biopsy. And I still didn't realize what was happening. Even when he told me to go to the Warsaw Cancer Center to get the results. He said that only there they can help me, because I have grains. Back then, that name meant nothing to me. It was only in Warsaw that I found out that it was lymphoma, a cancer of the lymph nodes. Doctor Wojciechowska-Lampka, under whose care I came, did not hide anything from me, put the coffee on the bench. And I irrationally thought: how can I?have cancer if I'm pregnant?

According to an expertJanusz Meder, MD, PhD, head of the COI Lymphatic System Cancer Clinic in Warsaw, President of the Polish Oncology Union

In almost every case of Hodgkin's lymphoma (Hodgkin's lymphoma) diagnosed during pregnancy, there is a possibility of antitumor treatment of the patient and bringing her to delivery on time. In diagnostic procedures, it is necessary to limit the use of methods related to ionizing radiation. It is allowed to perform specific tests. You can order a biopsy of suspicious lymph nodes, blood count, blood chemistry tests, general urinalysis, ultrasound of peripheral and abdominal lymph nodes, or chest X-ray (one photo). If possible, treatment should be postponed until the second trimester of pregnancy. However, if the disease shows high dynamics in the first trimester, and the patient does not consent to termination of pregnancy, chemotherapy can be administered by administering vinblasin (it does not damage the fetus) or - if the disease is located only above the level of the diaphragm - radiotherapy to limited fields with a low total dose ( 25 Gy) with simultaneous dose monitoring to the fundus of the uterus and the fetus. The permitted minimum dose of radiation to the fetus is never exceeded. In the third trimester, the most frequently adopted attitude is until the termination of pregnancy (34-37 weeks). In the second trimester of pregnancy, it is possible to implement multi-drug chemotherapy that has no adverse effects on the fetus. The Lymphatic System Cancer Clinic at the Oncology Center in Warsaw has been specializing in the treatment of lymphoma patients in pregnant women since its inception. Many years of own observations and observations from global oncology centers indicate the safe conduct of this type of therapy. Our observation includes over 60 women who underwent treatment during pregnancy, and their babies were free from defects and damage. These patients' children developed normally as did other he althy women. Some of these children are adults today who have started their own families.

Difficult decision in pregnancy: start lymphoma treatment or give up chemotherapy

- The doctor said that I had to choose whether I would start therapy or not - recalls Marta. She presented both scenarios of events to me without being blown away. She also explained that if I decide to start treatment now, the child will not be in danger that the chemotherapy will not affect his he alth. The one given to pregnant women is milder, specially selected so as not to harm the little man, and the placenta will stopharmful substances. She said I had seven days to think. I was driving home and my head was so confused. On the one hand, the opinion of a specialist that the baby will be safe, and on the other hand, a mother's fear for the baby. Are you sure he is safe? I was scared, I was so scared. But I decided to heal myself. What prevailed was that the lymphoma attacked not only the nodes but also the diaphragm. He could have strangled my unborn daughter! - The decision to start treatment was the most difficult decision in my life and I hope that I will never be faced with such a dramatic choice again - Marta does not hide her emotions. I picked it up and held on to it. I never discussed why this happened to me. For a moment I only wondered why now? Now, when our dreams have a chance to come true? But then I thought there was no point in pestering myself, looking for answers to such questions. It is a waste of time and, above all, the energy that is needed to fight the disease. After all, it wasn't just about me, the life of a child was at stake. When I told the doctor that I wanted to be treated, she immediately directed me for a drip. Until the birth, I had two chemicals. Overall, I was fine, neither vomiting nor even nausea. I was smiling at people, but there was constant anxiety inside.

Pregnant lymphoma: fear for the unborn baby

In the evening and yes, I was calmer because I felt the baby's movements. But in the morning, when my stomach was calm, there was fear. Fear for my daughter. Is she really alive? Is she okay? What I did not do to feel even the slightest kick … I massaged my stomach, rushed to the refrigerator, because apparently when mom eats something, the baby comes to life; I ate sweets because I heard that they also stimulate the baby to act. And the unimaginable relief when I felt that Amelka was changing her position. It cannot be described. And it didn't matter that because of these gastronomic reasons, I gained a dozen kilos. My gynecologist was with me all the time. After each chemotherapy, I checked in with him for all the tests. He was in constant contact with doctor Elżbieta Wojciechowska-Lampka, who conducted oncological treatment. He cared for me as if he were his own child. Anyway, I am in a way, because he was with my mother when I was born.

Happy pregnancy termination: natural delivery

He also welcomed Amelka. I gave birth to her in the 38th week by the forces of nature and only I know how relieved I was when it turned out that she had everything in its place and that she was he althy. Because it is one thing to see a child on an ultrasound screen, and another to really see it. The most difficult period, when fear for my daughter's he alth was dominant, finally endedfeeling. Because despite my full confidence in doctors, I was still haunted by the fear that I had made the right decision. Now I know you do. I started to heal in time and thanks to that we are both alive.

Treatment continuation: fight against lymphoma after childbirth

- "Get up for breakfast" - I heard these words from my husband every day - Marta smiles. - It made me nervous. After childbirth, there was no longer any reduction for pregnant women, I was treated like any other patient. And I also felt all the unpleasant effects of the chemicals. I had seven in total, the first month after giving birth. I had nausea, I was constantly tired, I would prefer to hide under the covers. And here: "Get up" and "Get up, you won't be lying like that all day." I was a little bit upset that despite my illness I have no peace. And he did it on purpose. And he was right. I would never forgive myself that I missed another smile from my child, a new face, a new gesture. I looked at her and knew I couldn't give up and let cancer win. The most difficult part was during radiotherapy, because I had to stay in the hospital for a month. Sure, I had weekend passes, but those five days without my loved ones were endless.

Happy ending: successful lymphoma treatment

Amelka is three years old, she goes to kindergarten, she is he althy and is making trouble. My treatment was successful. My husband and I never talked about the disease. I don't know if we didn't want to or couldn't. But he was with me all the time and I know I can always count on him. He also supports me now, when I joined "Owl Eyes", an association supporting lymphoma patients www.sowieoczy.pl. We try to pass on knowledge about this disease, because early diagnosis is a chance for full recovery.

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Pregnancy