Fer­til­ity mir­a­cle: “I thought I’d never be a mum”

The Australian Women's Weekly - - Contents - Genevieve Gan­non.

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.

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