This Pakistani expat in UAE fought rare cancer while pregnant

Four weeks after the treatment was started, she gave birth to a healthy baby boy.

Nida was nearing the end of her seventh month of pregnancy with her second baby when she felt a lump in her right breast.
"This was December 2018, and I felt the lump growing along with a nagging feeling of unease," said 28-year-old Nida Tanvir.
Though she did not pay any attention initially, Tanvir finally went for a biopsy when she felt that the lump was growing rapidly. "Two days later, I had an appointment with my gynaecologist, but I was told to meet the oncologist instead," said the Pakistani.
Her biopsy confirmed that Nida had diffuse large B cell lymphoma. Not only are primary breast lymphomas - a kind of blood cancer - very rare, they can also be very aggressive, which means that treatment cannot wait until delivery.
"Doctors assured me that the lymphoma was curable, but the problem was that I was pregnant and the treatment could not wait for another two to three months," she said.
Tanvir said it was a confusing time. "If the baby was delivered early, it would need support in the Nicu (Neonatal Intensive Care Unit) and premature babies can develop complications, too," she said. 
Dr Faraz Khan, consultant oncologist/haematologist at American Hospital, said: "Not all chemotherapies are safe for use during pregnancy, and that is why we had to chalk out a treatment plan for her."
He said PETCT is the standard staging scan in aggressive lymphomas. "But that would expose her to radiation in pregnancy, which is not accepted, and, secondly, how can she be treated when the treatment for lymphomas is with chemotherapy?"  The situation was challenging as there were no standard guidelines on how to manage such cases.
"We did a full body MRI and bone marrow biopsy, and it confirmed that the lymphoma was limited to the breast and was only on stage one," explained Dr Khan.
Her case was also presented at the Mayo Lympohoma e-tumor board and the treatment was started.
"We treated her with standard chemotherapy, and she received the first two cycles during pregnancy," he said.
Tanvir said the pain was bearable during the first chemo cycle, but the second one was a different story.
"In the second cycle, I started feeling fatigued and hair started to fall off," she explained.
By the 37th week of pregnancy, doctors found that her baby's kidney had dilated. "It was not due to the chemo, but a condition that was there before," said Tanvir.
Four weeks after the treatment was started, she gave birth to a healthy baby boy. Her elder one is three years old.
By the third cycle, Tanvir's cancer ?was gone. Then, she received six full chemo cycles and two additional cycles for protection.
Now, after completing all the treatment, her PETCT scan result is normal - and she is cancer-free.
"We are optimistic that she will do well and hopefully is cured, but close follow-ups will continue for the next few years," said Dr Khan.
"I underwent a lot of trauma, but things are looking up now," said Tanvir.
asmaalizain@khaleejtimes.com