Friday, March 30, 2007
CANCER JOURNAL - BREAST CANCER, SIDE EFFECTS AND BIRTH DEFECTS RESULTING FROM CHEMO
My chemo started yesterday. It left me feeling more tired than when it began, and headed for bed two hours earlier than normal last night; but I was wide awake at 4 this morning, and so that effect seems to have worn off. Other than that, there was surprisingly little impact from the drugs. I've been warned that the side-effects tend to kick in 72 hours after treatment, so Sunday may be unpleasant.
My chemo drugs are Adriamycin (doxorubicin HCL) and Cyclophosphamide. Both drug sheets given to me by my oncologist's office carry the "Special precaution" that "Contraceptive measures are recommended during therapy with this medication." "Missed menstrual periods" are listed as a side effect for both drugs.
The breastcancer.org website addresses the issue of pregnancy and chemo:
Depending on the stage of the cancer, some pregnant women with breast cancer may need chemotherapy. Doctors do not generally give women chemotherapy during the first trimester (first three months) of pregnancy because it could harm the organs of the fetus that are developing during that time.
A women diagnosed with breast cancer during her first trimester may opt to delay starting chemotherapy until she starts her second trimester. But one small study suggested that a chemotherapy treatment delay of 3 to 6 months could increase the risk of the cancer spreading outside the breast by 5% to 10%. Whether or not you decide to delay treatment depends on the type of cancer you have, how urgently your doctor thinks you need to begin chemotherapy, and how important it is for you to continue your pregnancy.
Several studies have shown that FAC chemotherapy (fluorouracil, Adriamycin, and cyclophosphamide) given during the second or third trimesters of pregnancy is surprisingly safe. Rarely does such treatment appear to cause miscarriages, premature birth, stillborns, or birth defects. Remember, though, that this combination might have a negative effect on your future fertility—your ability to get pregnant again after treatment is over.
That impact on the mother's future ability to have children would necessarily have to be considered before starting chemo. Naturally if a baby has already been conceived, decisions would take that into account. But if the woman of child-bearing years is not yet pregnant at the time of diagnosis, the decisions about contraception are vitally important both for her potential baby conceived during chemotherapy and for her future potential babies.
The ninth month is critical for white blood cell count:
If possible, women should not get chemotherapy about a month before delivery to avoid it causing low levels of white blood cells for them or their babies at birth. A French study found that of 17 women who had chemotherapy for breast cancer within a month before delivery, one had a newborn with low white blood cell counts.
Tamoxifen, which I am not taking, is considered unsafe:
Tamoxifen is considered unsafe to take during pregnancy. So if you're trying to get pregnant, or you think you might be pregnant, you should not be taking tamoxifen. Work with your doctor to figure out how long you can be on tamoxifen to get the most critical benefit while not losing the opportunity to get pregnant.
In order to have a healthy baby while taking this drug, a woman must have good control over conception. The pro-life position here speaks for effective birth control.
I have read that some women are on Tamoxifen as a maintenance drug to prevent recurrence. The impact on childbirth could be devastating.
Will chemotherapy make you infertile is also covered by breastcancer.org. Since it would require pasting the entire text here to do it justice, I will simply suggest that you click the link and read it there.
