Molar Pregnancy Survivor Shares Her Rare Cancer Story

CURE Ambassador Program | <b>Michelle Velez</b>

It wasn’t just a miscarriage, it was a rare type of cancer called choriocarcinoma.

Did you know you can get cancer from a pregnancy? I had no idea, but at the age of 38 it happened to me. I was a longtime local news anchor living in Las Vegas with my husband and our two young kids. At first, I was a little worried about being too old to have another baby. After 35, women are considered advanced maternal age, which I always took to mean “grandma” status. It was a joke we would laugh about often, but my doctor assured us plenty of women have perfectly healthy pregnancies after the age of 40. Genetic issues were mostly the concern, but never did I once worry about cancer. I would later think about this, but quickly learn that age had nothing to do with my cancer diagnosis. Just plain dumb luck is what happened to me.

It started out as a generic, very common miscarriage. A “blighted ovum” is what it’s called, affecting about one in four pregnancies. At the moment, all I wanted was to be able to try again, so I asked if I could miscarry naturally to avoid unnecessary trauma. At that point, there was no reason to suspect anything abnormal, so I went home to let nature take its course. Over the next three weeks, instead of a miscarriage, I started to experience severe pregnancy symptoms: extreme nausea, food aversions and fatigue. I was so confused. I was supposed to be having a miscarriage, so why was I feelingmore pregnant?Then the bleeding started. At first it was light, but as the days went by it became more severe. Eventually I was passing clots the size of my hand, followed by traumatic gushes of blood. I was prepared for bleeding because I was expecting a miscarriage, but this didn’t seem right.

Turns out I did not have a miscarriage; I had a molar pregnancy – a condition that affects one in a thousand pregnancies – where tissue from the placenta rapidly produces and invades the uterus. The condition produces excessive levels of HCG (the pregnancy hormone) which in my case, skyrocketed to more than 850,000. A healthy pregnancy at 10 weeks’ gestation, which is where I was at, would produce levels around 25,000 to 30,000. Mine was almost a million. That’s why I was so sick. My doctor told me it was equivalent to being pregnant with six babies at once.

In most cases, a dilation and curettage (D&C) procedure to clear out the uterus is enough to correct the issue, but in some very rare cases the invasive tissues can persist. When that happens, a type of chemotherapy medication called methotrexate is the next step in the treatment process. This scares a lot of women because of the association between chemo and cancer, but most of these cases are NOT cancer. The chances of it becoming malignant are less than 1%. Everyone told me I would be fine.

We did the surgical procedure to evacuate the uterus and then monitored my HCG levels. The first week they dropped dramatically which was an excellent sign, but that was short lived. Over the next two weeks, my HCG levels doubled, and the bleeding became so bad that I could no longer leave the house. My doctor referred me to an oncologist because it was clear I needed the next step in treatment. I met with the oncologist, who told me that at the present moment, no cancer was detected in the tissues removed from my uterus. She said the next day, I’d be going for a CT scan. My HCG levels were rising rapidly which meant the tissue was growing somewhere on the body. We knew it was in the uterus from the bleeding, but as a precaution, we needed to check the rest of my organs. The day of my scan I was so sick I couldn’t drive. My best friend took me to the appointment because my husband had to work. Getting through it took every last ounce of strength I had and that night I finally broke down. In a desperate attempt to calm my mind, I searched molar pregnancy on social media in hopes of finding other women who had gone through it. What I found were pictures of women, with no hair, going through chemotherapy. That was the moment the panic set in.

The next morning, I was awoken by a call from my doctor’s office asking me to come in to discuss my scan. Bad news. They never call you in to talk in person when it's good news. On the long drive to the office, I spoke to my mom, husband and best friend. All of them tried to remain positive, but I knew. Initially, I was there alone, but my friend rushed down and met me at the office. We sat in the room just talking calmly, until the doctor finally walked in. She sat on the bed, handed me a piece of paper and told me it was the results of my scan. I had masses on my uterus, liver, spleen and all over my lungs. The tissue in my uterus had developed into a rare cancer called choriocarcinoma and metastasized. It was stage 4.

Since my cancer diagnosis, I have heard so many stories of the moment people found out and how they reacted. So many say they were stunned and speechless; for me it was uncontrollable crying. My body just crumbled, and my friend braced herself to take my weight. My mom was there on FaceTime and I only recall hearing her say “WAIT… WHAT?” My husband was called out of work and met us there. The doctor continued to explain the diagnosis and treatment, but I barely heard her. I just couldn’t stop crying. What about my kids? They are toddlers, they need me. I can’t leave my kids. How can a pregnancy lead to this? Stage 4? I'm going to die. The next several hours were a blur of information overload – and I never stopped crying once.

My doctor told me I had a very severe case of gestational trophoblastic disease (the medical name for the condition leading to my diagnosis) but the good news was that this type of cancer is extremely sensitive to chemo and is usually treatable with great success. The prognosis is about as good as it gets, a 91% chance of survival.

“Michelle,” my doctor said, “that’s like an A in the cancer prognosis world.” It was meant to be comforting, but all I heard is that 9% don’t survive. Considering I was in the 1% who got the rare diagnosis, statistics were not helpful.

The next morning, I had the port placed into my chest, and then I was admitted into the hospital where I needed several blood transfusions to replenish the blood I had lost. My blood hemoglobin was too low to begin treatment, and I needed to start immediately. It was also making me too sick to function, so we made the difficult decision to send the kids out of state with their grandparents. Two days later, I went straight from the hospital to the infusion center where I was hooked up through my still-tender port, and pumped to the gills with five different chemo drugs.

Over the next five months, I endured 16 rounds of chemo, six hospital stays, eight blood transfusions and two D&C procedures. I also lost most of my hair and ended up shaving my head. It was a long difficult road, but the treatment worked. Eight months after my diagnosis I was officially declared cancer free. For the next five years I will need regular blood tests to monitor the HCG levels, but that’s a small price to pay for my life.

I do not know why this happened to me, but I do believe there is a purpose now. One of the most frustrating things about my diagnosis is the lack of knowledge about it. The majority of the time, I find myself educating people about what happened to me because nobody has ever heard of molar pregnancies and the cancer they can cause. Even in the medical world, a lot of mistakes are made because most doctors and nurses just simply never see one in their career. So many nurses said the same thing to me “Molar pregnancy was a blip on my board exams”.

It’s rare, but yet it can affect any woman of child-bearing age. It has nothing to do with genetics, family inheritance, or age – you just need to have female reproductive organs. Why don’t we know about this? Women need to know about this. I believe part of the answer for my “WHY ME”, is to share this story and shed light on this virtually unknown type of cancer. Storytelling is what I do, and for the first time in my life, I'm telling my own story. My hope is to educate people - and more importantly - be a guide for other women who will undoubtedly come after me.

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