Tuesday, July 26, 2022

Women with cancer diagnoses — and docs — face tough choices because top court discarded Roe

Following the U.S. Supreme Court's eliminating abortion rights validated half a century ago in the Roe v Wade decision, pregnant women with cancer diagnoses may face wrenching choices.

Doctors as well are now facing difficult decisions.

That's the conclusion of a recent story by Gina Kolata in The New York Times, which headlines the piece with: "Urgent questions arise about how care of pregnant women with cancer will change in states where women are unable to terminate pregnancies."

Kolata's piece notes that "if the life of a fetus is paramount, a pregnancy can mean a woman cannot get effective treatment of her cancer. One in a thousand women who get pregnant each year is diagnosed with cancer, meaning thousands of women are facing a serious and possibly fatal disease while they are expecting a baby."

Dr. Clifford Hudis
The article quotes Dr. Clifford Hudis, chief executive officer at the American Society of Clinical Oncology, to the effect that "if a doctor can't give a drug without fear of damaging a fetus, is that going to compromise outcomes? It's a whole new world."

The Times story explains that cancer drugs are dangerous for fetuses in the first trimester, and while older chemotherapy drugs are safe in the second and third trimesters, "the safety of the newer and more effective drugs is unknown and doctors are reluctant to give them to pregnant women."

Some 40 percent of women who are pregnant and have cancer have breast cancer, but many other cancers occur in pregnant women: blood cancers, cervical and ovarian cancer, gastrointestinal cancer, melanoma, brain cancer, thyroid cancer and pancreatic cancer.

Moreover, the story says, "women with some types of cancer, like acute leukemia, often can't continue with a pregnancy if the cancer is diagnosed in the first trimester. They need to be treated immediately, within days, and the necessary drugs are toxic to a fetus."

Dr. Eric Winer, director of the Yale Cancer Center, is also quoted: "In my view, the only medically accepted option is termination of the pregnancy so that lifesaving treatment can be administered to the mother."

Some oncologists, Kolata's story continues, "say they are not sure what is allowed if a women lives in a state like Michigan, which has a law that criminalized most abortions but permits them to save the life of a mother."

Dr. N. Lynn Henry
In that regard, still another physician, N. Lynn Henry, an oncologist at the University of Michigan, says that "we can't prove that the drugs caused a problem for the baby, and we can't prove that withholding the drugs would have a negative outcome."

In other words, the story goes on to attribute to unnamed doctors, "complications from pregnancy — a miscarriage, a premature birth, birth defects or death — can occur whether or not a woman with cancer takes the drugs. If she is not treated and her cancer gallops into a malignancy that kills her, that too might have happened even if she had been given he cancer drugs."

A law professor and bioethicist at Harvard, I. Glenn Cohen, projects — according to the story— that "we are putting physicians in a terrible position. I don't think signing up to be a physician should mean signing up to do jail time."

Additional information about chemotherapy can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

No comments:

Post a Comment