Bans on abortion are complicating access to drugs for cancer, arthritis, ulcers, other diseases

Some chronically ill women, because of legal bans on abortion, are facing questions about critical medications that could be used to end a pregnancy.

That conclusion is drawn in a story by Katie Shepherd and Frances Stead Sellers in yesterday's editions of The Washington Post.

"The sudden imposition of anti-abortion laws [after the reversal of Roe v. Wade] has left patients, doctors and pharmacists wading through a minefield of treatments and legal and ethical dilemmas related to women's health care — even in situations…that have nothing to do with pregnancy," Shepherd and Sellers write.

Medicines that treat conditions from cancer to autoimmune disease to ulcers, the piece notes, "can also end a pregnancy or cause birth defects and, as a result, "doctors and pharmacists in more than a dozen states with strict abortion restrictions must suddenly navigate whether and when to order such drugs because they could be held criminally liable and lose their licenses for prescribing some of them to pregnant women."

Even if they could show their patients suffer from conditions such as rheumatoid arthritis, the Post story goes on, "some doctors worry they could be prosecuted for prescribing such drugs to a patient with an unintended pregnancy."

Such patients, Shepherd and Sellers continue, "are also at greater risk because they can no longer seek abortions in their home states should they accidentally become pregnant while taking such drugs — no matter how grievous the injuries to the developing fetus."

Dr. Traci Poole

The article quotes Dr. Traci Poole, faculty member at Belmont University College of Pharmacy in Nashville and a practicing pharmacist, as asking, "If you are of childbearing age, are you going to be denied medications that could potentially interfere with a pregnancy?"

The story also says that physicians and pharmacists acknowledge "being blindsided by the speed of changes to state laws," and say they're making change to their practices to protect themselves against liability.

CVS and Walgreens and other major drugstore chains are instructing employees to delay filling prescriptions until they can validate their use to ensure they'll not be used to terminate pregnancies.

The Shepherd-Sellers article also quotes Jack Resneck Jr., president of the American Medical Association, who told federal lawmakers last month that doctors "have been placed in an impossible situation — trying to meet their ethical duties to place patient health and well-being first, while attempting to comply with vague, restrictive, complex, and conflicting state laws that interfere in the practice of medicine and jeopardize the health of patients."

More information about laws and their unintended consequences is available in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

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.

Oncologists told about chances of recurrence

Pregnancy after breast cancer is now believed safe, lead author of European study says

Breast cancer survivors who want to have children may be sighing with relief.

According to a recent story by Marilynn Marchione of the Associated Press, a study of 1,207 women in Europe shows those who became pregnant after their diagnoses "were no more likely to have their cancer come back than those who did not have a baby."

This was true, the story added, "even if their cancers were the type fueled by hormones, which surge during pregnancy and theoretically might spur a recurrence."

Results of the study were discussed at an American Society of Clinical Oncology conference in Chicago.

Dr. Matteo Lambertini

The study's lead author, Dr. Matteo Lambertini of the Jules Bordet Institute in Brussels, Belgium, was quoted as saying the test results show that "pregnancy after breast cancer can be considered safe."

Dr. Richard Schilsky, chief medical officer for ASCO, agreed.

Marchione quoted him as saying the results indicate, "fairly convincingly," that women needn't worry. 

More and more women are being diagnosed with breast cancer in their childbearing years, perhaps an outgrowth of "the average age of moms…rising in the United States," the AP story says.

In fact, it notes, "about 11 percent of new breast cancer cases in the U.S. are in women under 45."

The story also reported that a big study now underway "in the U.S. and other countries is taking this research one step further, testing whether it's safe for breast cancer survivors who want to get pregnant to temporarily suspend taking the hormone-blocking drugs like tamoxifen usually recommended for five years after initial treatment."

More details about studies relating to the disease can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.