Facing sinonasal undifferentiated carcinoma during pregnancy

I was working as a physician assistant in California when my husband’s job moved us to Singapore. About a year after we got there, I started to experience pressure in my face, a watery eye, frequent sneezing and an occasional headache behind my right eye. I had these symptoms for two months before I decided to see a doctor. An ENT specialist scoped my nose, saw a mass and proceeded with a biopsy.

On Oct. 9, 2019, I was diagnosed with sinonasal undifferentiated carcinoma, a tumor that starts in the sinuses. My tumor had spread into the brain and was the size of a lime.

This was unexpected and unsettling news, but what made it even harder was that I was 18 weeks pregnant.

Keeping the baby and starting chemotherapy

Within a week, we returned home to California. Four days later, I was in an exam room with my OB/GYN when I had a seizure due to the swelling in my brain from the tumor.

After being rushed to the emergency room, I had another seizure. I was taken to the ICU, then admitted to the oncology unit. I decided to keep the pregnancy and started three rounds of chemotherapy during weeks 19 to 29 of my pregnancy. The tumor responded well to the chemotherapy, but I developed a cerebrospinal fluid leak due to a hole that the tumor left between my brain and sinuses.

Choosing proton therapy at MD Anderson

My doctor recommended that I go to MD Anderson for proton therapy. My first appointment was on Dec. 17, 2019. I met with head and neck oncologist Dr. Renata Ferrarotto, radiation oncologist Dr. Steven Frank and skull base tumor experts Dr. Franco DeMonte and Dr. Ehab Hanna. My husband and I decided to move to Houston in January 2020.

Dr. Ferrarotto spent a lot of time answering my questions with compassion. She was great at coordinating my care with my other physicians, including the OB/GYN who would deliver my baby.  All of my doctors did a phenomenal job working together to care for me and my son.

A healthy baby, then proton therapy

My care team decided to not start my proton therapy until after the baby was born. I did a fourth round of chemotherapy to give the baby three more weeks to develop.

My son, Bennion (“Benny”), was born on Jan. 14, 2020, through a scheduled caesarean delivery. We scheduled the delivery at 31 weeks to give him a good chance of doing well while also ensuring we didn’t have to push back my proton therapy too much. After spending a few weeks in NICU, Benny had no identifiable issues.

I started proton therapy 10 days after I delivered Benny. Every time I saw Dr. Frank, he asked about our son. I felt very taken care of.

I completed my 35 proton therapy treatments on March 13, 2020, which happened to be my 28th birthday. Dr. Frank bought me a birthday cake to celebrate these two milestones.

Social distancing during the COVID-19 pandemic

Just as I finished proton therapy, COVID-19 began spreading in our area. We flew to Utah to be with our family, which was the scariest part. But we self-isolated and enjoyed the time with our newborn baby.

I received strength from my baby in utero. He is my first child, and I was motivated to go through treatment to be his mom.

As I learned, I can handle a lot more than I thought, thanks to the incredible people who love, care for and support me – including Benny, who doesn’t yet know how he gave me strength at a time when I needed it most.

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