Cancer and You - Volume Two (and other random thoughts)

So today was my annual appointment with my OBGYN.

Sidebar - Why didn't someone remind me just how much I despise the OBGYN's office????  I had forgotten just how terrible it was to be the only non-pregnant woman in the waiting room (unless you count the woman who was way past childbearing age who was there with her preggers daughter).  I mean, seriously?  Couldn't they segregate the place - you know, have a pregnant waiting room and a non-pregnant waiting room?  The pregnant waiting room can be filled with magazines regarding babies and pregnancy and the likes.  The non-pregnant waiting room will have People and Entertainment Weekly.  Ahhh, bliss.

So, as I am sitting in my lovely paper gown that opens in the front with the oh-so-fashionable paper drape over my lap in the exam room that must be as cold as the Arctic Circle, doc enters room and wants to converse with me before my exam.  Now I don't know about you all, but I have a problem conversing with my doc I see once a year when I am not hiding behind layers of actual fabric.  He asked how things were going, I giggled nervously and told him we were officially infertile.  (No shit, Sherlock.  Don't you think he already knew this LAST year when you saw him after the 2 failed fresh cycles?  Did you really think he thought you stuck yourself with all those needles just for shiggles?)  Then I filled him in on our Adoption plans that were now superseded by the Donor Embryo cycle in October.

He added the additional STD cultures to my PAP with no arguments.  He suggested adding the HPV virus testing to the PAP as well (sure, what is another test at this point???) and sold me on the benefits of knowing your risk for cancer is much lower and not having to have a PAP but every 3 years if you are negative for HPV.  (Really?  3 years before I have to put my feet in stirrups again if this FET doesn't work?  And you think you need to SELL me on this?  Where do I sign???)

Sidebar #2 (or 5 if you count the other random thoughts in italics already in this post) - Maybe the non-segregated waiting rooms were actually part of his plan to convince me to have the HPV test added to my cultures)

Anywho...

So, I followed up the HPV cancer conversation with my burning questions regarding ovarian cancer.

Basically, he indicated that my risk is indeed greater due to all of the risk factors I had read about on google. (Delightful.)  He explained that hyper stimulating your ovaries is probably what causes the majority of this increased risk - not necessarily the meds themselves.

The good news was that he didn't think the risk was great enough to schedule me for surgery to remove my ovaries (Ahem, they really aren't doing me any good, doc.  Remember at the beginning of this appointment when I told you I am officially infertile???  Well, it isn't because of my hubby's swimmers...If you were asking me for my uterus, we might have a problem.  But Dr. C is prescribing replacement hormones for anything those bitches would be providing, so if you want to rip them out, by all means...No wait, you are right.  No need to get all jumpy there.  After all, everyone gets pregnant after they adopt or give up, so perhaps I should hold on to them for a little longer.) 

His suggestion?  Birth Control.  (Perhaps I stuttered earlier.  I know I was having a hard time speaking clearly since I was naked.  Or perhaps you didn't hear that part of the conversation because you could see through my stylish paper suit and my rockin' hot body was distracting you.  Regardless, I really want kids...Birth Control will really F*#K with that "OOPS" baby after we just relax.)  He indicated that being on birth control early in life may have offset some of the risk I have taken on by all of our efforts to expand our family.  He also suggested that perhaps I should spend about 5 years in my 40s on BC to lower my risk some more.  (Glad I didn't have to explain to you the fact that I wasn't ready to hang up my hat on my child bearing years just quite yet.)

So, all in all AND in all seriousness, it wasn't all bad news.  I am glad I asked about the increased risk and I will definitely plan on adding some sort of BC to my life after we finally become parents.  (Maybe even the kind that keeps Aunt Flow from visiting.  I think that bitch and I have spent plenty of time together.)

A Double Dose of Cancer

I debated internally whether or not to share this information with all of you - because I didn't want to alarm any of you.  But, because I love all of you dearly and I felt I needed to post.

I am not a doctor, nor did I stay at a Holiday Inn Express last night, so if this information speaks to you, you should consult your physician.


Cancer #1 - Your Baby/Child
IMO - this is nothing to freak out about.  I wanted to share the info so that you could judge for yourself.  Or, so that if someone who loves you happens to mention this fact to you in passing, you will have already read the information.  Knowledge is the key, right?

My Mother In Law has watched several of her loved ones suffer from or die with cancer.  And, as some of you may remember, she recently battled the disease herself and is currently in remission.  But any time that she hears the word "Cancer" in a news headline, it is a huge cause of concern for her.  Understandably so, right?

Well, shortly after we found out we were at the top of the donor embryo list, she let me know that she had heard a story that indicated children born from IVF have a higher risk of cancer than children conceived naturally.  She admitted that she didn't know much about it, but urged me to look into it before making up our minds about moving forward with our donor embryos.  I did consult Dr. Google to see what he had to say.

Basically, the article indicates that there is a **slightly** higher risk for childhood cancer in children born through IVF.  It cites that the increase isn't due to the process, but is more like due to the advanced age of the mother's eggs and also due to the genetics the parents are passing along to the child.  The figures about percentage vary from article to article based on the way they calculate the percentage.  However, if you are interested in reading more about it, you can read the medpagetoday article or the article in Time online, or you can google it yourself.

To me, the best part from either of these articles was the last paragraph or the article in Time. 

Even if the study had confirmed IVF as a risk factor, experts say the level of increased risk is not enough to deter parents from undergoing the treatment. While IVF may bump up a tiny risk of childhood cancer, without it, many infertile couples may not have a baby at all.

It almost seems as if the person writing this article really understood the pain and suffering of infertile couples, doesn't it?

Cancer # 2 - YOU
After the bomb  my MIL dropped, I was sitting in the waiting room for 2 hours at a Dr's office (taking one of my staff members for stitches from an accident on the job) and there wasn't really anything but People Magazine in espanol or medical type magazines to read.  And believe me, peeps, looking at the pictures isn't as fun when you don't know the celebs or when you can't read the captions.  So, medical magazines won.  And what I read has caused me to come home and do some further googling.

Not only does your status as an infertile mean that your child could have a higher risk of cancer, it means you are possibly at a higher risk of ovarian cancer. 
From what I am reading, it would appear to me that we infertiles may have risk that increases exponentially - several of the bullet points spoke to me.

These articles cite the following items indicating increased risk:

• A woman who has had children has a lower risk of ovarian cancer than women who have no children. The risk gets even lower with each pregnancy.
• Using the fertility drug Clomid® for longer than one year may increase the risk for developing ovarian tumors, and the risk seemed to be highest in women who did not get pregnant while on this drug.
• Fertility drugs seem to increase the risk of the type of ovarian tumors known as "low malignant potential" (LMP tumors). If you are taking fertility drugs, you should discuss the potential risks with your doctor.

The first study that I read (in that medical mag) mentioned only Clomid.  However, it made me wonder if all of my days on Clomid or Femara or (oh heavens) Gonal F and Menopur was going to increase my risk of ovarian cancer even more - after all, if Clomid increased your risk, wouldn't all fertility drugs (especially these that made you ovaries resemble bubble wrap) increase your risk?  My Googling did bring to light this statement from cancer.org.

However, women who are infertile may be at higher risk (than fertile women) even if they do not use fertility drugs. This may be in part because they haven't had children or have not used birth control pills (which are protective). More research to clarify these relationships is now underway.

So, the increased risks may not be in association with the drug, but the disease of infertility.

Other good news I found?

• Using oral contraceptives (also known as birth control pills or "the pill') also lowers the risk of ovarian cancer.  So, ladies, all those months on the pill prior to finding out we were infertile weren't "wasted time and money".  They could be offering you some lower risks of ovarian cancer.  In addition, all those BCPs you popped for your IVF cycles did more than just get you ready for a transfer.
• Both aspirin and acetaminophen have been shown to reduce the risk of ovarian cancer. Once again, all those baby aspirin you took during your IVF cycles, good stuff.  And the acetaminophen you popped for those painful periods or to combat those lupron headaches?  More good stuff.
• A study of women who followed a low-fat diet for at least 4 years showed a lower risk of ovarian cancer. Now all those diets you have gone on to loose all of that infertility weight also offer you an added benefit - not only can you fit back into your skinny jeans, but you are combating ovarian cancer...

Okay, so those last 3 I may have been searching for a lighter side of things.  I don't like to just post doom and gloom stuff.  And dry wit is part of why you all love me.

But seriously, if you feel that you want to read more about your possible risks, you can read a couple of articles at Mayo Clinic or at cancer.org or you can talk to your doctor.
I know that when I go next week for my next round in the stirrups, I will be asking my OBGYN about it.