Fertility miracle: “I thought I’d never be a mum”
The drugs used to treat breast cancer can be life-savers, but they have devastating effects on women’s ovaries. Yet there is a drug which is giving hope to women who want a baby after chemo, writes
Everything was falling into place for Natasha Eaton in January 2008. She was building a photography business and dating a wonderful man. The then 32-year-old had always wanted to be a mother and while disappointed it hadn’t happened for her yet, she was feeling excited about the future. She was on the phone one afternoon when she noticed a lump in her breast.
“I panicked and jumped in the car and went over to my aunt’s, and got her to check it,” says Natasha. A biopsy revealed she had stage three breast cancer. It was a Friday afternoon when she met with a surgeon and he told her that he wanted her to start chemotherapy on the Monday. As she staggered out to the car park, reeling from the diagnosis, one thought dominated her mind: she may never get to have a baby.
“I had a massive meltdown,” she says. “I thought, ‘This is not happening.’ I knew enough about chemotherapy to know I might not be able to have children.” Natasha had lost her mother to ovarian cancer in 1999 and was all too familiar with the side-effects of cancer treatment. The toxic drugs used in chemotherapy can shut down the patient’s ovaries. Breast cancer specialist Professor Kelly Phillips, who was the lead researcher on the Prevention of Early Menopause Study (POEMS) at Breast Cancer Trials, says early menopause is a common side-effect of the breast cancer treatment cyclophosphamide. “Virtually all women who are having treatment for breast cancer would receive that drug, which we know is toxic to ovaries,” she says.
For young women such as Natasha, cyclophosphamide can spell the end of their hopes of having a family, but all women who are given the drug are at increased risk of the health issues that come with early menopause, such as heart disease and memory and cognition problems. “Saving the ovaries is not just about saving fertility because the ovaries do other good things, too,” says Professor Phillips.
Natasha went back into the clinic and spoke to her oncologist, who suggested they remove the lump before starting chemo, to give them more time to discuss her fertility options. Luckily, the oncologist knew about the work Breast Cancer Trials (then the Breast Cancer Institute of Australia) was doing on a drug called goserelin, which, in effect, puts women’s ovaries into a state of hibernation for the duration of their chemotherapy.
The POEMS trial tested whether treating women with goserelin while they were undergoing chemotherapy allowed their ovaries to recover after treatment. When Natasha learned about the POEMS trial, she only had one question – “Where do I sign?”
“I wasn’t worried about surviving it. I was more worried about children,” she says. The international trial of 250-plus women found there was a 70 per cent reduction in the risk of early menopause in women who were given the goserelin compared with a comparable group who didn’t receive the treatment, says Professor Philips.
Natasha was one of those on goserelin. For six stressful months, all she could do was hope and wait. “It was horrendous. I went into robot mode,” she says. When she finished her chemotherapy in June 2008, her oncologist told her it would be two years before she would be able to contemplate getting pregnant. “I thought, ‘I’ve got to calm down. Stop worrying about it. It will happen.’” She knew her body had to recover. A few months later, she found out she was pregnant. She and her partner, John Cooper, had a son, Jack, now a thriving eight year old. “He was meant to be,” Natasha says. “It was a bad year, but we came out with a little boy on the way.”
Breast Cancer Trials wants goserelin to be available on the Pharmaceutical Benefits Scheme to all premenopausal women who need chemo. It’s listed on the PBS for women with hormone receptor positive early stage breast cancer, but those who are not eligible have to pay $330 a month. If it is added to the PBS, the cost will be $38.80 per month, or about $6 with a concession card. The Pharmaceutical Benefits Advisory Committee has recommended it be available to all premenopausal breast cancer patients. Now it’s up to the government.
“It was a bad year, but we came out with a little boy on the way.”
Natasha Eaton and her son Jack Cooper, now eight. “He was meant to be,” she says.