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What is a choriocarcinoma? My healthy pregnancy has given me cancer



My son was just 12 weeks old when the first pregnancy test returned positive.

The second one was successful too. And the third. And the blood test.

"I really do not think I'm pregnant," I told my doctor. I had chosen him for his relaxed atmosphere and humor, which I loved during my work and delivery. He shouted "Bag o 'steel!" When he broke my water . This time I felt less amused.

The reason why I was in the office doing a pregnancy test was to get birth control again. 1

2 weeks after birth, my body still felt stretched and crushed. The thought of immediately growing another baby in it made me give up my womb.

I've always been a person who lives life to the fullest. I work hard during the week, exhausting my husband Chuck by packing our weekends of adventure. I am a long distance runner, a traveler, an outdoor woman.

For these and other reasons, it took me years to get the idea of ​​being a mother. I knew I could be good at it if I ever had a chance to try it out. But I could clearly see two ways ahead of me: with child and without. None seemed to be fuller or emptier than the other.

But when I get into the idea of ​​something, I'm all there. As soon as Chuck and I decided to give the parenthood a shot, I never looked back. I'm building another adventure friend I told myself. I booked tickets to Iceland for my maternity leave and added a jogging stroller and a baby backpack to our registration.

Thorin was born in July 2017. I dragged him to the mountains and to the coast of Oregon. He shrieked as I dipped his toes into the glacial waters of an Alpine lake for the first time, and he chuckled as I laid him down by the lakeshore to wiggle his tiny toes in the dirt.

I felt strong. I felt confident. I was Adventure Mom.

I'm looking forward to the week I performed this postpartum pregnancy test: I was getting ready to start a new job. Chuck was preparing to be a full time father. I really did not have time to figure out why my body mysteriously believed it to be pregnant. And I really really had no time to actually get pregnant again.

At the appointment, my doctor thought I was pregnant. He told me, however, that there were several other possible explanations for a positive pregnancy test apart from actual pregnancy. He mentioned, for example, that it could be a piece of placenta left behind in the uterus, which would cause my system to have a residual hormone of human chorionic gonadotropin (hCG) that the body produces during pregnancy. He said these other reasons are unlikely.

I spent the week getting ultrasounds, chest x-rays, and blood tests that were irritated by the inconvenience. I did not get nervous until my doctor phoned his mobile phone late on a Friday night.

He suspected that he knew what was going on. He told me he would say a word, but he asked me not to google it: choriocarcinoma.

Of course I googled it right away when I got out of the phone.

Courtesy of the author

Knigge and Thorin on Mount Rainier in September 2017.

Choriocarcinoma is a tumor-related cancerous tumor that develops in the uterus.

It is a gestational trophoblastic disease (GTD), a group of rare tumors that develop in the womb of the uterus, in the cells that would normally become the placenta. According to the American Cancer Society, there are only about 2 to 7 out of 100,000 pregnancies in the United States.

Choriocarcinoma most commonly develops after a miscarriage or molar pregnancy (an unusually fertilized egg that develops into a tumor rather than a fetus). But in about a quarter of cases, choriocarcinoma may follow a healthy pregnancy and childbirth, says ACS, and it causes hCG levels to rise, hence my positive pregnancy test

"This Is Not Common" Nehal Masood an oncologist at the MultiCare Regional Cancer Center in Tacoma, Washington, and one of the doctors who treated me during my diagnosis when I addressed him to write this essay.

In a typical pregnancy, fertilized cells in the uterus develop into fetus and placenta. However, some pregnancies are complicated if these cells do not form as they should. In my case, Dr. Masood, the part of the placenta anchored to the uterine wall, developed abnormally and led to cancerous cells embedded in the uterine lining.

Dr. Masood added that this happened completely by chance and that people had successful consecutive pregnancies after choriocarcinoma treatment.

I could not help believing 19659031]

Any other measure had been my pregnancy through the book. At the first attempt we became pregnant, exactly as we had planned. I had no morning sickness (19459004) and no food defense – even on the Tsukiji fish market in Tokyo when I was just seven weeks old. I could continue running and doing yoga (19459069) (without the inversions) until the end. Even my delivery was relatively easy, albeit ten days late.

In retrospect, my only symptom after birth, which could have been pointed to the tumor, would have had bleeding. Vaginal bleeding is a well-known symptom of gestational trophoblast disease – but it is also a known side effect that people in the postpartum period have to deal with, and I was having a baby. I had no reason to assume that it was something else.

I still felt strong and healthy before and after my diagnosis in October 2017, which made it even worse when I checked in for an appointment at the Regional Cancer Center and was told I was sick and sick.

The choriocarcinoma can spread to the lungs, brain and other organs, and it is harder to cure once it has spread. But luckily we got it early thanks to this pregnancy test, even if it was accidental. The cancer had not spread beyond my uterus, but time was of the essence. During the week between my first positive pregnancy test and follow-up with my new oncologist, the test results showed that my hCG levels increased 60 percent (and higher hCG levels mean that there are more tumor cells ) ,

Suddenly everything happened at once.

On my third day of work in my brand new job in an industry I had never worked in, I got the official diagnosis. It was hard enough to be back working with a 3-month-old girl without finding out how I wanted to incorporate chemo into my life.

At the same time, Chuck became the son of a full-time father to our son. In order to survive the next four months, we would both have to readjust our expectations for our home, for my performance at work, for my body, and for our relationship.

I just cried once: the day I had to … I completely weaned my son on a single afternoon in October. It would not be safe to nurse him with the chemotherapeutics that pumped through my body. But I moved. I was afraid that if I spent four months of my baby life thinking too much about how bad I felt about myself, I would not be able to get out again.

Compared with other cancers (breast cancer) (lung, large intestine, prostate), choriocarcinoma is "very treatable" with chemotherapy and may also be curable at an advanced stage, says dr. Masood. And because we got it when I was only considering level 1 because I was young and healthy (aside from the cancer) and was considered low risk, I was a candidate for single agent chemotherapy. I have a "good" type of cancer. And I had to treat it with a "good" kind of chemo. I agreed and knew that I would come out on the other side.

But even though I knew it could be so much worse, it was not easy.

So much of my identity is wrapped up I was strong and active and I could feel this version slipping off of me.

All I wanted was Adventure Mom – but my strong, reliable body that had carried me over the finish line of so many road races Summit of Mount St. Helens and through 41 weeks of pregnancy was not that strong anymore. I knew I was lucky – I had a strong support network and my prognosis was good – but when chemotherapy weakened my body, I felt I was losing the person I was.

I was exhausted. I was not sure how I came up with my new job. I was weak and evil and felt guilty because I had to rely on my husband to keep our lives together. And I tried to be a good mother, wife, sister, daughter and friend.

Most of all, I was afraid that one day I might look back and remember the first year of my son's blood-drawing and nausea at a hospital, so I forced myself, the good moments – no matter how small – to be remembered.

So I hit the brakes.

I was incredibly ill in the first half I did not eat for two weeks and only ate saltine, applesauce and mashed potatoes. But for the first two weeks, my son tried (and hated) solid food for the first time. I'll never forget his face – covered with peas and completely betrayed – because that's the memory I want to keep.

Instead of walking and hiking and planning adventures, I sat on the couch and read Dinosaur Dance and Gossie & Gertie . Instead of planning the night in the city, we ordered pizza and played board games with the family. I reset my expectations for myself. And for the first time, I really started to understand what it meant to live in the moment.

I also had to find a way to separate my experience of cancer from my experience as a new mother. I love the disrespectful parenting humor and thought I was weird when I first joked a riffing slogan, "You're lucky, you're cute, Kiddo – since you gave me cancer and everything." Then I paused and thought deeply about what it might do to a child to possibly grow up because I thought he had something to do with his mother's cancer. My husband and I swore we would never reconnect the two. I lived as two separate versions of myself: I did not want mother of 3 months and woman walking through chemo meets.

Knigge and her husband smile at Thorin on his first birthday (July 2018).

Ended lastChemotherapy roundEndFebruary2018

My cancer has disappeared, and should not come back . I was healthy and lucky that my body responded well to chemo and we caught and treated him early. But when the drugs drove the last disease out of my body, they left something else in their place.

Before the cancer, I was a person who struggled with everything I tried. I could not finish an adventure before I planned the next one and wanted to do and experience everything. I am still that person, for the most part. But I'm slower now, more conscious.

In the end, cancer has taught me more to be a wife and a mother than anything else in six years of marriage. It forced me to slow down and focus on just being with my son and husband.

I am now a better woman, a better mother. And a better person.

Halley Knigge is a mother, writer and adventurer living in Tacoma, Washington. It is free of cancer from 1 March 2018.

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