How a regular ultrasound to check on her pregnancy revealed a big health issue
Allison Misconin was told that the ovarian cyst spotted early in her pregnancy was normal — but during her 20-week ultrasound, her doctor labeled the mass as "suspicious." She was told her next stop should be an oncologist's office.
The 28-year-old, who was already versed in the world of cancer treatment from her work as an oncology social worker at the Cleveland Clinic, immediately thought of her unborn baby. Her yet-to-be-born son was developing well and moving regularly, and fear for his safety was "the only thing going through my head," she told CBS News.
"I don't want to say I didn't care, but I didn't care how it would affect me. I was only concerned with the health and safety of my baby," Misconin said.
For treatment, she turned to the Cleveland Clinic, where she already worked providing resources and support to cancer patients. During her first appointment with Dr. Robert Debernardo, the head of the department of gynecologic oncology at the Cleveland Clinic, he outlined a plan to surgically remove the mass so it could be biopsied.
Hearing about a surgery at that stage of her pregnancy "terrified" her, but just days later, she was in the operating room, ready to have the mass removed in a minimally invasive laparoscopic surgery. While the experience was scary, she said, it may have saved her life.
Treating ovarian cancer during pregnancy
DeBernardo said that it's generally best to conduct the "least amount of medical intervention possible" during a pregnancy, but in cases like Misconin's, surgery is necessary to deal with cancer before it can spread.
Once again, the timing of Misconin's pregnancy worked in her favor: DeBernardo said that typically, surgery isn't done during the first trimester because the fetus is too fragile, but doing the procedure too late in pregnancy can also complicate matters. It's best to do the procedure between 14 and 20 weeks, he said. Misconin was at the end of that window when the mass was determined to be suspicious, he said, but the procedure could still be done laparoscopically, which results in a smaller incision and shorter recovery time.
"It was sort of serendipitous that we found this," DeBernardo said.
The mass was successfully removed, and confirmed to be cancerous. The ovary that the mass was on was also removed, along with its corresponding fallopian tube. Misconin was then induced at 37 weeks, giving birth to a healthy baby boy named Thomas.
"(The day Thomas was born) was the happiest day of my life," Misconin said. "During this pregnancy, I was obviously so happy, and then that happiness really got taken away after this diagnosis, and it got traded in with anxiety and fear. So when I actually had my son, all of those anxieties and fears just kind of washed away."
A second surgery found no other traces of cancer in her body, which meant the surgery had removed the mass before it could metastasize and spread. Misconin said learning she was cancer-free was the "second-greatest day of her life."
Early detection of ovarian cancer
Dr. Deanna Gerber, a gynecologic oncologist at NYU Langone who was not involved in Misconin's care, said that the finding of the mass was akin to a "guardian angel looking out" for her.
"It was really early stage. That is extremely rare, and she got very lucky," Gerber said.
Typically, the disease is found in a more advanced stage, Gerber said, which makes treating it much more difficult. There is no screening test for ovarian cancer, and early warning signs of the condition include vague, common symptoms like abdominal discomfort or bloating. DeBernardo said that for someone like Misconin, it's even easier to write those symptoms off as part of pregnancy.
"There's nothing that really alerts women with an ovarian cancer to to say 'I need to go get checked out,' because there's nothing different," Gerber said.
Between 70 and 80% of ovarian cancer patients are at stage III or IV of the illness by the time they are diagnosed, the MD Anderson Cancer Center says online. For most ovarian cancer patients, this also means the cancer has already metastasized and spread to other parts of the body by the time it's detected, DeBernardo said. At that point, survival rates are poor, according to the American Cancer Society: Only between 30 and 44% of those patients live more than five years.
Pregnancy after ovarian cancer
Beyond having a healthy child and being cancer-free, Misconin wanted to prioritize preserving her fertility and leaving the door open for more children later on. She and DeBernardo spoke about it early in her treatment journey, and during the surgery, he was able to confirm that the cancer had not spread to the other side of her reproductive organs and leave them untouched.
Learning that she could still have children after the cancer and surgery brought a "tremendous sense of relief," Misconin said.
There are no risks with becoming pregnant again after being diagnosed with ovarian cancer during pregnancy, DeBernardo and Gerber both said. DeBernardo said that Misconin would be carefully monitored during future pregnancies, and that her care team would continue to keep a close eye on her remaining ovary to ensure no new cancers emerge.
Misconin said she's eager to carry on with her life and continue to grow her family.
"An ovarian cancer diagnosis can be very scary," she said. "A lot of people just automatically think there's no treatment and there's no hope. And I want people to know you can have an ovarian cancer diagnosis, and live a fulfilling life after that."
