Raquel Lopez was 40 years old and pregnant with her fourth child when she learned she had colorectal cancer. She spoke to Health about what it was like to go through chemo while carrying her son to term.
About nine months prior to getting pregnant, in January 2016, I had started having some blood in my stool very, very sporadically. At my routine physical, I mentioned it to my primary care doctor. Being so young and with no family history of colorectal cancer, and since there was no pain or other symptoms, we just chocked it up to hemorrhoids and figured we would wait and see if more symptoms arose. Nothing happened.
Fast forward to October 2016. I was pregnant with my fourth child. I had had three very easy pregnancies, but this one was hard. I figured this was payback. I started bleeding a bit more, and things became a little more painful as the pregnancy progressed. Having been pregnant three times before, I knew these weren’t normal aches and pains.
I also started to get diarrhea. That worried me because it can lead to dehydration, which in turn can spark early labor. So I went back to my primary care doctor. He thought my symptoms were still probably within the normal spectrum of pregnancy, but I told him they weren't. “I’ve done this three times before, this is not normal,” I remember saying.
He sent me to a GI specialist right away, who was also concerned about the risk of dehydration. The specialist thought I could have ulcerative colitis and wanted to start me on treatment with steroids, but then decided to do a scan first to verify the diagnosis. Two days later, I was at Advocate Christ Medical Center for the test, which was like a truncated version of a colonoscopy. You could tell right away; the tumor was right there. I then had a full colonoscopy, and I was diagnosed with stage 2 colorectal cancer.
Because I thought it was just ulcerative colitis, I had gone to the scan by myself. My husband was at home with our three kids. Here I was at the hospital by myself being diagnosed with cancer. I was in disbelief. I remember thinking, Are you freaking kidding me? It felt surreal. I had no risk factors, no family history. Had I not seem the tumor on the scan, I would have thought it was a joke.
I was sent for lab work and got a lot of information—the wheels started turning immediately. A whole team was assembled. When I arrived home, my husband asked, “How did your scan go?” I motioned him upstairs with my eyes so I could talk to him without the kids hearing. I had to break it to him that this is what we were looking at now.
Because of the pregnancy, everything went super fast. I always say that had I not been pregnant, who knows how long it would have taken to diagnose me? Colorectal cancer symptoms—like abdominal pain or changes in bowel habits—can be similar to early signs of pregnancy, so it can be hard to diagnose. Even if you suspect cancer, some of the scans used to confirm it can’t be done in traditional ways when you’re pregnant. The abdomen has to be shielded for a lot of the scans, and you can’t use the contrast agent that’s usually used with CT scans.
When I had an ultrasound to look at the size and depth of the tumor within the muscle walls, part of my uterus was in the way. Doctors couldn’t be 100% sure how embedded the tumor was, because they couldn’t get a whole picture. I had to have a port installed for chemotherapy; surgery itself while pregnant requires special precautions. Every step of the way wasn’t typical; I had this other person to think of as well as myself.
A maternal-fetal medicine (MFM) team walked me through all the worst-case scenarios, like delivering at 30 weeks. The goal was to treat me with chemotherapy right away while prolonging the pregnancy as much as possible for more viability for the fetus. The five to seven days it took to figure out the exact plan were so hard.
I started on a low dose of chemotherapy with a lot of extra monitoring. I had five chemo sessions while I was pregnant. I was diagnosed at 28 weeks, and by 29 weeks I was doing chemo—that’s how fast it went from having the first scan done to having a whole treatment team in place.
Chemo sessions were very long for me. After I was done, the baby would be monitored for hours and had to pass several tests, like a stress test, before they would let us go. The whole thing would easily take 10 hours.
I did chemo from week 29 to week 34 and then recovered for a few weeks. I was induced at 37 weeks and gave birth to a healthy baby boy on June 26, 2017. He’s 8 months old now and crawling. As the fourth child, he’s very vocal and fights for attention! He has a superhero-sounding name: Maximus Crowe.
We say the crow is his spirit animal because a crow can live and thrive in a toxic environment, and that’s pretty much what he did through the chemo. The funny thing is my husband and teenage daughter had actually thought of that name prior to my diagnosis, very early on in my pregnancy. At the time I told them they were crazy; we were not naming a kid that! But after I was diagnosed, no other name fit him.
Then the real treatment began. Three weeks after delivery, I started full-on chemotherapy along with radiation. In early October 2017, I had surgery to remove the tumor. Monday is my last chemo session. I can see the light.
Pregnancy in and of itself is a lot to deal with. Cancer itself is a lot. You put both of them together, and it’s very overwhelming. You’re bringing this person into the world and wondering, Am I going to be around to take care of him?
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With three other kids at home, life was already very busy. We had to take a practical attitude. I had to be Mom first before being a cancer patient. I really had no time to feel sorry for myself. I was grateful I was diagnosed at a stage where it was treatable. Once we had a treatment plan, I knew we were going to get through it as a family.
I want other pregnant women to know that it never hurts to just say something about your symptoms. Tell someone things don’t feel right. Don’t chock it up to pregnancy symptoms. It’s easy to think you’re supposed to feel bad when you’re pregnant, but speak up if something doesn’t feel right or good.