Allison Misconin learned that ovarian cyst spotted early in her pregnancy was normal – but at her 20-week ultrasound, her doctor called the mass “suspicious”. He was told his next stop should be an oncologist’s office.
The 28-year-old, who already knew the world of cancer treatment from her job as an oncology social worker at the Cleveland Clinic, immediately thought of her unborn baby. Her son, who was not yet born, was developing well and moving regularly, and fear for his safety was “the only thing on my mind,” she told CBS News.
“I don’t want to say I didn’t care, but I didn’t care how it would affect me. I was only concerned about the health and safety of my baby,” Misconin said.
For treatment, she turned to the Cleveland Clinic, where she was already working providing resources and support to cancer patients. At his first appointment with Dr. Robert Debernardo, chief of gynecologic oncology at the Cleveland Clinic, he outlined a plan to surgically remove the mass so it could be biopsied.
Hearing about surgery at this point in her pregnancy “terrified” her, but days later she was in the operating room, ready to have the mass removed in laparoscopic surgery minimally invasive. Although the experience was frightening, she said, it may have saved her life.
Allison Misconin
Treating ovarian cancer during pregnancy
DeBernardo said it’s usually best to do “as little medical intervention as possible” during a pregnancy, but in cases like Misconin’s, surgery is necessary to treat the cancer before it spreads.
Once again, the timing of Misconin’s pregnancy worked in her favor: DeBernardo said that typically surgery isn’t done during the first trimester because the fetus is too fragile, but that the Intervention too late in pregnancy can also complicate things. It’s best to do the procedure between 14 and 20 weeks, he said. Misconin was at the end of that window when the mass was deemed suspicious, he said, but the procedure could still be done laparoscopically, which results in a smaller incision and a shorter recovery time.
“It was kind of by accident that we found this,” DeBernardo said.
The mass was successfully removed and confirmed to be cancerous. The ovary on which the mass was located was also removed, along with the corresponding fallopian tube. Misconin was then induced at 37 weeks, giving birth to a healthy baby boy named Thomas.
“(The day Thomas was born) was the happiest day of my life,” Misconin said. “During that pregnancy, I was obviously very happy, and then that happiness really disappeared after that diagnosis, and it was replaced by anxiety and fear. So when I had my son, all these anxieties and fears were somehow replaced by anxiety and fear carried away.
Allison Misconin
A second surgery revealed no further evidence of cancer in his body, meaning the operation removed the mass before it could metastasize and spread. Misconin said learning she was cancer-free was the “second happiest day of her life.”
Early detection of ovarian cancer
Dr. Deanna Gerber, a gynecologic oncologist at NYU Langone who was not involved in Misconin’s care, said the discovery of the mass was akin to a “guardian angel watching over” her.
“It was really at an early stage. It’s extremely rare and she was very lucky,” Gerber said.
Generally, the the disease is detected at a more advanced stageGerber said, which makes treatment much more difficult. There is no screening test for ovarian cancer, and warning signs of the disease include vague, common symptoms like abdominal discomfort or bloating. DeBernardo said that for someone like Misconin, it’s even easier to eliminate these symptoms in the pregnancy setting.
“There’s nothing that really makes women with ovarian cancer say, ‘I need to go get checked out,’ because there’s nothing different,” Gerber said.
Between 70 and 80 percent of ovarian cancer patients are in stage III or IV of the disease when they are diagnosed, the MD Anderson Cancer Center reports online. For most ovarian cancer patients, this also means that the cancer has already metastasized and spread to other parts of the body by the time it is detected, DeBernardo said. At this point, survival rates are low, according to the American Cancer Society: only between 30 and 44 percent of these patients live more than five years.
Pregnancy after ovarian cancer
Beyond having a healthy child and being cancer-free, Misconin wanted to prioritize preserve your fertility and leave the door open for other children later. She and DeBernardo talked about it early in his treatment journey, and during surgery, he was able to confirm that the cancer had not spread to the other side of his reproductive organs and affected them.
Learning that she could still have children after cancer and surgery brought her a “huge sense of relief,” Misconin said.
There is no risk in getting pregnant again after being diagnosed with ovarian cancer during pregnancy, DeBernardo and Gerber said. DeBernardo said Misconin would be closely monitored for future pregnanciesand that her care team would continue to closely monitor her remaining ovary to ensure no new cancers appeared.
Misconin said she looks forward to moving on with her life and continuing to grow her family.
“A diagnosis of ovarian cancer can be very scary,” she said. “A lot of people automatically think there’s no treatment and there’s no hope. And I want people to know that you can be diagnosed with ovarian cancer and experience a lifetime of fulfilled life after that.”
Allison Misconin
