Battling cancer while expecting a baby

Four years ago, Mrs Janna Tomassen, was given the best of news - she was pregnant after receiving In-vitro Fertilisation (IVF). Then, 24 weeks into her pregnancy, she heard the worst of news - she had Stage II breast cancer.

"I thought that the doctor was talking about someone else," recalled the 39-year-old Dutch-born housewife. "My number one worry was the baby and I blocked out the thought that a choice would have to be made between the baby or me."

But Janna recovered quickly from the news and concentrated on the battle plan mapped out by her doctor, Dr Khoo Kei Siong, Deputy Medical Director and Senior Consultant, Medical Oncology, at Parkway Cancer Centre (PCC).

Dr Khoo said: "Timing of the chemotherapy treatment was crucial to our success. Janna had to undergo three cycles of chemotherapy treatment during the key window period - between the second trimester to first part of the third trimester - during which potential impact on both the mother and the baby can be kept to a minimum, if at all."

He explained that there were no large randomised trials of pregnant women receiving chemotherapy, because of the small number of such patients to start with. But in his 20 years of practice, he had seen two other mothers through their pregnancies and cancer treatment, delivering healthy babies both times.

So, assured by her team of experienced doctors, Janna started on her chemotherapy. She experienced few side effects, other than tiredness and hair loss.

Looking back at that difficult period, Janna said: "Losing my hair was the most difficult part. When I looked at myself in the mirror, the hair loss suddenly made me realise that I am now ill, a patient."

It was also during this period that Janna and her husband, Mr Ronald Tomassen, 39, adopted their little girl, Muny, from Cambodia. Muny was four years old then when she joined the Tomassen family.

Ronald and Janna had reservations about proceeding with the adoption after learning that Janna had breast cancer. But all the doctors and the orphanage encouraged them to go ahead with their decision. "The doctors told us to go ahead and do whatever we planned to do as it will give me a lot of positive strength and provide a helpful distraction," Janna said.

Ten days after Muny arrived, Janna began her chemotherapy treatment. Being pregnant, sick and having to take care of a new toddler, she went through a roller coaster ride emotionally and physically.

Thankfully, Muny proved to be a wonderful distraction to Janna and brought a lot of joy and laughter to the family. Also, out of necessity, Janna had to bring Muny to school every day, and this gave her no time to stay at home and let her negative thoughts wander.

Dr Khoo Kei Siong, Deputy Medical Director, Parkway Cancer Centre

Asked how did she keep her spirits up and deal with that challenging period, Janna credited her wonderfully supportive husband, Ronald, for helping her to stay positive.

"Ronald would tell me to think of the good things and take things step by step, not to look too far and worry too much. He would also keep me company at home and watch Dutch TV programmes with me. Also, I would remind myself of the Dutch saying 'to think of the glass being half-full, instead of being half-empty'."

In addition, after every chemotherapy session, the first thing that Janna would do is to go for yoga lesson to relax herself.

Baby Kai was born a little premature - but healthy and of normal weight.

In 2007, Janna was diagnosed with breast cancer again, just when the family was about to relocate to Hong Kong. The big challenge was to continue with chemotherapy treatment in Hong Kong.

Fortunately, Dr Khoo assured Janna that this could be done smoothly and indeed, Janna continued with her treatment in Hong Kong and her cancer is now in total remission.

Dr Khoo said: "Breast cancer can happen during pregnancy, even though it is not common. But it can still be adequately treated, without compromising the outcome. There is some risk, but we should never give up hope."

This patient's story was first published on Parkway Cancer Centre's website.