Same Ol' Question - Pregnancy and Melanoma

Posted By
Nemesis
8/15/2017 1:55pm
View other posts by
Activity
Replies: 6

T1b here, 9 months post WLE and SNB. My melanoma was discovered during my post partum period (6 months after giving birth). I am not sure if a second child is off the table for me at this point. I want to wait for two years before trying to conceive, but I have read studies that say melanoma is worsened by pregnancy, therefore I am not sure if I should even risk it.

What would you do in my shoes?

Sorry you have this dilemma. I think from what I have read, and studies seem to be conflicting, I would not let a 1b dx stop me, but might depend on what my onc advised. I'm wearing mom of 3 grown children, 1 year post 2c shoes fwiw. 

Your personal tolerance for risk and uncertainty (and Dad's) will weigh heavily I expect. 

Thank you. I don't have an oncologist, just a dermapathologist and she sais to go ahead, but I don't know.

I totally understand the hesitance. For myself, I have not had kids yet, I am 30 and have stage 4. I am hoping to be done with this melanoma stuff in the next year or two, I plan on waiting a couple of years at least after being NED before trying to become pregnant. But the only thing that would stop me from trying to have a child would be to never be NED or to succumb to melanoma itself. If I were in your shoes, personally, I would wait about a year from now and then try for another.. because life is short and kids are a beautiful part of it.

Jenn - stage IV - Ipi/Nivo (Yervoy/Opdivo); now on Nivo maintenance

What you do depends on your personal risk tolerance.  I will share some of my story and my family's decision. When my husband and I decided to have children, we initially thought we'd have two. At the time, I was 6+ years post-Stage 1 melanoma, WLE and SLNB clear.  I was an early stage at diagnosis and being years earlier, melanoma didn't even cross my mind. My dermatologist, who I was seeing every six months, mentioned skin changes during pregnancy, so I watched my skin but didn't really consider that my prior cancer could spread. My child was born in May 2016, over 7 years since diagnosis. There were some complications, but long story short, I found out the day after that lymph node was very enlarged and needed to be biopsied. It was very deep and could not be felt superficially. It wouldn't have been discovered but for having a CT scan. I was officially diagnosed with Stage 3c two months later. No other primary was found, so we assume it was a metastases of my 2009 tumor. I'm not sure if the pregnancy and the metastasis are related, but it's too much of a coincidence for me to ignore. My good friend, who is an oncologist, said that studies are inconclusive so he would not have advised against pregnancy necessarily.

I started immunotherapy when my baby was less than three months old. I had some negative reactions, so we relocated for a few months to be closer to my oncologist at MD Anderson.  It was smoother than I expected but still rough to do with an infant. It's still difficult traveling back every 3 months for scans because you can't be within 3 feet of the baby for 8-24 hours after the scans. I've had a few scares of progressing further, but so far am doing well. My husband and I decided against the risk of another pregnancy. If we decide to expand our family, we will look into adopting. 

My situation is rare, and I don't want to scare you by it. I met a woman in Houston who was Stage 2 at diagnosis and went on to have two children without any issues. So you never know ... just not worth the risk for us. 

MD Anderson has fertility oncologists. You might see if your local doctor has one who can give you more statistics and information to consider before you take the next step. I'm also happy to provide more information if you need anything. Good luck with your journey. 

Hi Nemesis,

My story is similar to RHG's. I was stage 1b (found it when my daughter was 9 months old). SNB/PET were clear. I asked each doc - OB, derm, oncologist - if I could have another. (It took us 3 years to have our daughter so we were worried it'd take awhile again.) At 20 weeks along, I found a lump in my groin. I had a complete node dissection at 23 weeks pregnant as well as scans without contrast. We induced at 37 weeks and  when my son was a week old, my PET indicated I had mets on my liver, spine, and lots of subcutaneous spots throughout my body. My docs at Mayo put me on traditional chemotherapy. I failed it and they told me to "go home and be with my family." That's when I switched my care to MD Anderson. My husband, two year old, two month old, and I moved from North Dakota to Texas for me to enter a clinical trial (which is now an FDA-approved standard of care treatment). Nine months later I was cancer free and continue to be NED. 

My doctor at MDA believes my pregnancy made my melanoma kind of a "super melanoma." I agree. I feel fortunate to be on this earth and a part of my children's lives. I did have my tubes tied this spring. It was a tough decision as I always imagined having four children, but I know it was the right decision. 

So, what's my advice? I'm not sure. It may be smart to say, "wait." However, I don't think I would have adhered to that. It's so personal. Weigh your odds and go with your heart/gut.

Best of luck,

Ashley

I think my pregnancy amplified my melanoma. My melanoma on my back grew significantly during my pregnancy (at the time I just thought that's what moles did during pregnancy) and I was diagnosed 3a, 2 months post partum. I am four months out from that, and as of now I do not want to risk another pregnancy. With yours being stage 1, you are likely cured, so like the others I would go with your gut on it.