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Trying to conceive
Hello-
Wondering if any one with superficial, non-invasive bladder cancer has gotten pregant?
I had a low grade, non-invasive tumor removed by TURB 1/25/08. This was my first tumor found by ultrasound incidentally. I had the ultrasound as a follow up to a miscarriage (at 6 weeks) that had been followed by 4 weeks of spotting.
We have been trying to conceive for almost two years. We have a 3 1/2 year old. I am 34 years old.
When I asked my urologist about trying to conceive and what the recommendations are for someone my age with this type of tumor, he said he basically didn’t know. That there aren’t that many women my age getting bladder cancer and even fewer that are trying to conceive or that are pregnant. He was concerned that if I was pregnant and needed TURB for a recurrence that would be an issue. His suggestion was to wait until we have the results from my next cystoscopy in three months before trying again. He also said that bladder tumors are not hormone-sensitive.
I looked on PubMed for research articles dealing with this and came away with a couple studies saying cystoscopy during pregnancy was okay. Nothing on TURB, anesthesia options, leaving a tumor until after delivery if one is found during a pregnancy, etc.
Has anyone dealt with this or asked their doctors about this? Any research into this that anyone knows about? Does anyone even do research on bladder cancer and women of child-bearing age???
I’ll contact my ob/gync as a next step to get his opinion on the matter. Just curious if any of you have references or resources I can consult or any other advice.
Thanks in advance,
Lynn -
7 Replies
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Hi Ladies,
I have been pondering this progesterone and healthy bladder thought…I had a complete hystectomy and oophraectomy 2.5 years before I was dx’d with bladder cancer. My bladder seemed fine then – I had fibroids so bad my uterus was the size of being 3 months pregnant, the ovaries were taken as I am also a breast cancer survivor. I wonder if the loss of hormones could have added to the bladder cancer arising. Any thoughts?
By the way, years ago I was on progesterone therapy as my hormones were so off the norm and caused numerous problems. Anyone else have a previous theapy too?
God Bless, Holly -
I honestly don’t have the reference but I did read somewhere that progesterone is important to healthy membrane. My own experience supports it. A doctor said that also when I mentioned the health of my bladder during pregnancy. Maybe doing a google search would pull up something. Sorry I can’t be more explicit.
I too was concerned about getting and not staying pregnant. I did progesterone suppositories for a while and I think switched to cream and/or some form of capsule or tablet. I did get pregnant and stayed pregnant with my today 9-yr old. I remember not wanting to stop taking the progesterone even after my doc told me I had enough progesterone into the 2nd or 3rd month of pregnancy.
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Hello again-
Thank you so much for your responses! I appreciate you sharing your experiences and pointing me to Tom and Alana’s story. I am amazed at what all of you have been through!
I do feel incredibly fortunate about finding this tumor incidentally. Who knows when I would have started having hematuria or some other type of symptoms? Months, years from now?
As for both things (miscarriage and diagnosis) happening so close together, I’ve wondered how I would be dealing with each situation had they happened alone. Now that I’m through dealing with my first tumor and now in the period of waiting for my next cystoscopy, I find I have space in my head and heart to deal with my miscarriage. Yeah, it sucks.
But I remain optimistic about having another child. And maybe no tumors. I can dream, right? Hearing other people’s stories about dealing with bladder cancer and conceiving/pregnancy certainly helps. I’m trying really hard to keep things in perspective. I imagine as time passes I’ll be spending less energy thinking about this.
Wendy R- I’d be interested to hear more about your theories on the relation between progesterone and healthy urothelium membrane. Part of my trouble with conceiving has been low progesterone levels that cause me to ovulate late in my cycle. It is funny to even think this may all be related. Once again, I am struck with our amazing our bodies are and how little we really understand them.
Wendy S- Yes, I guess I was curious what the standard course of action would be if I were pregnant, continued getting scoped every three months and then they found a tumor. Leave it there until after giving birth? Remove it? I guess they could biopsy the tumor to determine grade and then make the decision to remove it immediately or wait.
Thank you again,
Lynn -
Hi Lynn,
You aren’t the first woman we’ve met with this dilemma. Wendy R spoke of Tom and Alana’s experience, their story is on the website here:
http://blcwebcafe.org/stories/young_tas.aspIn a way you are lucky to have caught this tumor ‘incidentally’.
From what I’ve seen over the years, bladder cancer doesn’t interfere with pregnancy as long as the tumor is non-invasive. If it’s a low grade tumor it may even be ok to wait until the pregnancy is finished to remove it as the risk is very low but of course the exact characteristics of the tumor must be known before taking that approach.
I think Alana had to wait until her baby was born to complete treatments.
I’m sorry about your experience, it must have been a very hard blow, double whammy so to speak.
I wish you well.
Wendy S -
Hi Lynn,
A caring forum member alerted me to your question about pregnancy during bladder cancer. I was 36 when initially diagnosed in 1994. Low grade Ta. I became pregnant and had my son (now 9) in 1998 (4 years into bladder cancer). I didn’t ask first – it was just right. I found out I was pregnant the day I was to begin my first BCG instillation. Cancelled the BCG until after my son was born and until after I was done breast feeding. My bladder cancer history until that point (the first 3-4 years) was persistent recurrences almost every 3 – 6 months with TURBs each time. I am sure my uro was concerned about recurrences when he heard the news. The Amazing thing is that my bladder was the healthiest it had ever been during the entire pregnancy and during breast feeding. According to my uro, it looked completely healthy, pink, and normal. Things were taken care of. Never experienced that again. As soon as breastfeeding was done almost a year later, I began having recurrences again. Over the next several years until 2004, they progressed in grade to grade 3 plus CIS. Thus I opted for bladder removal with a neobladder. The rest?….well another chapter. So, to answer your question: yes. By the grace of God, I did have a wonderful, precious child in the midst of this mess who is the gift and the fuel beneath my fight to this day.I don’t know what would have happened if my bladder wasn’t temporarily healed during my pregnancy (I also believe there is something to progesterone and healthy urothelium membrane). There is another couple on the webcafe email list (Tom & Alana) who found out she had T1 bladder cancer during pregnancy a couple/few years ago. It was pretty intense. They were able to hold off on treatment for a few months until after the birth of their second little blessing. They are busy living their lives so don’t hear much from them at the moment but it’s my understanding she remains cancer free. Knowing Tom, I am sure he will be happy to share with you if you search the archives for his (Tom Steinmetz) posts a couple of years ago (http://listserv.acor.org/archives/bladder-cancer-cafe.html).
I know that not all urologists choose to do a TURB at the first sign of every low-grade recurrence. There are a few studies supporting this approach. Mentally, it would be a tough one for me to have had to follow but still something to keep in mind.
thinking about you,
Wendy R. -
Hi Susan-
Thanks for your repsonse. No, I hadn’t seen these articles. Thanks for looking. I’ll have to check them out.I talked to my ob/gync doctor today. He said I was his first patient to have bladder cancer. Gee, I feel so special. He didn’t have any hard and fast recommendations either but felt like waiting for the next scope (as suggested by my urologist) would be good.
He also reassured me that pregnant women have things happen like appendix ruptures and have to go to surgery. It can be done. He also said, “you can’t wait forever”. Not sure whether to feel comforted by that or not.
We will wait for the three month scope and then see what happens. In the meantime I’ll keep poking around for more info.
Thanks!
Lynn -
I found these two 1995 article citations using “Google Scholar.”
Laughlin KR, Ng B. Bladder Cancer during pregnancy. Br J Urol 1995, 76, 421-2
Laughlin, KR. The management of urological malignancies during pregnancy. Br J Urol 1995, 76, 639-44.
Are they the same ones you found?
Wishing you success in your quest for information and the larger goal that has motivated it. Susan (mssmr)
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