Over the weekend, I mustered a lot of courage to do a Facebook Live chat with Mei Sze about cancer and fertility. It’s a difficult topic to talk about in public because infertility insecurity has been my biggest issue since my cancer diagnosis four years ago. At that point in time, I didn’t know if I wanted to have my own children yet but very quickly after learned that it’s one experience I’d be most curious about if I end up kicking the bucket at 25 from cancer.
The full 39-minute long interview is available on Choo Mei Sze Facebook Page; also embedded below.
But if you’re not one to watch such a long video and still want to get the gist of the topic discussed, here’s a concise written version.
It’s actually my written response that I prepared prior to the interview to prevent me from going all emotional or too long-winded — something I tend to do almost all the time. The gist is all there, and is definitely more concise. Note that I skip through stories about my cancer diagnosis and jump straight into the topic of cancer treatment and (in)fertility insecurity.
What was your biggest worry about having cancer?
The first was financial. The first person I contacted immediately after getting out of doctor’s office was my insurance agent.
Honestly, every other issue that I faced, I only learned as I went along the cancer journey. It’s like “on-the-job learning”. That includes learning that cancer treatment may or may not affect fertility!!
I already had a million things to sort out and think about from diagnosis until my surgery one week later. I didn’t know infertility risk was something that I had to think about as well!
The way the topic was brought up was also very impromptu. On the day of diagnosis, I already pre-admitted myself for the surgery that was taking place one week from then. After I broke the news to my mom, she had a lot to catch up on and she just wanted to meet the surgeon that was going to cut me open. So we walked in to the surgeon’s clinic just to have this “meet-and-greet” session.
My then-bf was with me and the surgeon casually asked, “Are you married?”, “Are you planning to get married?”, “Do you plan to have kids?”. And went on to pre-empt me that cancer treatment may or may not affect fertility. And that he’d usually advise his young patients to go through fertility preservation first but he was not giving me that option because he really needed to operate me within a week, sooner if possible.
I was caught off guard.
I was 25. I just committed myself to a new job. I was in a relationship of less than two years. We were taking things slow and haven’t even talked about marriage or family planning. I haven’t even seriously considered if I want to have children. But when a cancer diagnosis was thrown at me, the question quickly changed from “Do I want to have children?” to “Can I even have children if I want to (and if I live)?”.
Is the journey difficult to have had cancer and then get pregnant?
Cancer itself is a very difficult journey. In this day and age, infertility issue is very common and it’s very difficult also. So having to try to balance between preserving my life and my fertility was very stressful.
I thought about this a lot and personally for me, it’s challenging because of a few factors:
Firstly, family planning is not only my business, but my partner’s and our families’ concerns, especially in the Asian context. So suddenly, cancer treatment is not just about saving my life but also about whether or not I’m taking away their dream of starting a biological family.
Secondly, cancer and infertility are not within my control but cancer treatment and fertility preservation are.
I knew that by allowing my surgeon to cut me open, I’m allowing him to do whatever he can to remove the tumour, part of colon and anything else inflicted by the tumour, including reproductive organs. I chose to proceed with the surgery within 1 week instead of going through fertility preservation first and delay the surgery by 1 month.
I also knew that by allowing my oncologist to administer 12 cycles of chemotherapy drug into my body, it could affect my fertility to a certain extend. I chose to proceed with the chemotherapy even though at that point in time, there was already no evidence of cancer.
On top of that, I knew that by signing up for a 3-year clinical trial, I would be on drug for 3 years, during which if I were to fall pregnant, I’d be dropped out of the clinical trial that (who knows) could have lowered my risk of cancer recurrence. I chose to commit to the clinical trial for at least 2 years, before trying to conceive.
These are the decisions that I made and so I was burdened by the risks I took in regard to my fertility.
Last but not least, at age 25 before I ever tried to conceive, I didn’t even know my infertility risk — if I was very fertile, normal fertile, not so fertile or even infertile when I had to make decisions affecting my fertility rate. I didn’t know if the risks I was taking were too much or too little.
Unfortunately, cancer and fertility is such a sensitive, difficult yet common issue that many young cancer survivors, especially female ones, are going through but may not get enough awareness.
Has there been complications after finding out you are pregnant?
Yes. And I’d just focus on complication as a result of cancer treatment.
Up until quite recently, I was suffering from an adhesion colic pain for 4.5 weeks because of the open surgery I had on my abdomen. Scarring from such major surgery is very common and I’ve been very fortunate that I never had that complications in the past 4 years…until pregnancy.
Every day and sometimes every minute, I was struggling to move and walk, especially after meals, because of the pain.
The good news was adhesion colic doesn’t endanger the pregnancy in any way if it stays as localized pain. I just had to deal with the pain, with or without painkiller – my choice. The scary news was it could progress to bowel obstruction that will require emergency open surgery during the pregnancy.
I’m just so thankful the adhesion colic resolved by itself mysteriously and hope that it does not return ever again.
How does it feel to be seeing your dream come to life?
Relief beyond belief.
It felt like I finally got an answer to the bets I made since four years ago. It felt like I finally got a positive test results for an exam I sat for four years ago.
I finally learned that my body is capable of creating a new life. Now, I just hope and pray that it is capable of sustaining this new life until full term as well.
What is your advice for those who have had cancer and want to have a family too?
Talk to your doctor about fertility preservation BEFORE cancer treatments. Based on what I hear from other cancer survivors, not every doctor has this conversation with their patients.
But if you have already started treatment without this conversation, understand your infertility risk and try to take control of what you can, like considering fertility treatment, and then have faith! Within our circle of young cancer survivors, we have seen successful cases of natural conception and assisted conception =)
And at the end of the day, assess and understand your priorities, then make it known to people who matter. If natural conception is your priority, start trying as soon as you can. If fertility treatment is your option, save a lot of money? LOL. If non-biological family is your choice, you do you. People will have opinions either way so just stick to what matters to you.
I hope that with this sharing, my story can create awareness about cancer treatment and infertility risk, as well as be a beacon of hope to colorectal cancer survivors who went through similar cancer treatment and have the same concerns.