Motherhood after colon cancer

UCI Health experts ensure that a young woman gives birth to a healthy baby despite cancer treatments that can harm fertility

December 16, 2013

At 33, Natalie Schiavone had finally met the man with whom she would share her life and raise a family. Five weeks before their August 2010 wedding, she learned the cause of the chronic constipation she’d been ignoring for more than a month: a malignant tumor in her colon.

Colon cancer is rare in people under 50. The stunned Long Beach City College English professor reacted to the news with anger and determination. The diagnosis, she decided, would not derail her wedding to Brian Burgess or their plans to have children.

“OK, let’s get this thing out,” the Huntington Beach resident said, all the while thinking, “I can’t believe I’ve waited almost 34 years for my wedding day and now it will always be tied to this.”

The day of Schiavone’s diagnosis, a Friday, her gastroenterologist called the best surgeon she knew.  The following Tuesday, UCI Health colorectal surgeon Dr. Michael J. Stamos, a nationally recognized colon cancer expert and chair of the Department of Surgery at UCI Health School of Medicine, cleared time in his surgery schedule  to meet the couple.

Natalie Burgess 350

After considering her biopsy results, Stamos said surgery was needed soon.  “Can we do it today?” Schiavone asked, explaining that she wanted to walk down the aisle in a matter of weeks.

Then Stamos mentioned that her ovaries might need to come out if the tumor had spread beyond the colon wall. Schiavone dissolved into tears, telling him she couldn’t bear losing her ability to conceive. He reassured the couple that he and the team at UC Irvine Medical Center would try to preserve her fertility.

Less than two weeks later, Schiavone was more than a little loopy as she was wheeled into the recovery room, but she recalls hearing Stamos and his colleagues say they were able to remove all of the golf ball-sized tumor, and that it hadn’t breached the colon wall. There were high-fives all around.

On July 29, four days after her surgery, Schiavone was released from the hospital – 23 days before her wedding. A few days later, she learned that some tumor cells had been found in nearby lymph nodes. Thanks to Stamos, she already had an appointment scheduled with Dr. Leonard Sender, a UCI Health oncologist who specializes in adolescent and young adult cancers.

Chemotherapy, Sender said, was required to kill any remaining cancer cells in her body; and because chemotherapy can affect fertility, he recommended that they consider harvesting healthy eggs from her ovaries beforehand.

The clock was ticking. She would need to begin hormone treatment right away to boost the number of eggs her ovaries would produce in her next menstrual cycle. Again, Natalie refused to postpone the wedding.

On Aug. 21, 2010, Schiavone’s uncle, a Roman Catholic priest who had married her parents 40 years earlier, presided over Natalie and Brian’s wedding Mass in the groom’s Diamond Bar parish church. Afterward, in a small anteroom, the newly minted Natalie Burgess hiked up her slinky satin wedding gown, jabbed herself in the lower abdomen with her first hormone shot then headed to the reception.

The couple also delayed their honeymoon to continue the injections and to harvest her eggs. In vitro fertilization at USC’s fertility program produced 18 healthy embryos, which were cryogenically preserved. Chemotherapy began in late September and continued until Feb. 16, 2011. Through it all, she kept teaching. Her students even wore face masks when they had a cold or runny nose, lest they affect her chemo-suppressed immune system.

At every follow-up visit, Burgess pestered Sender: “When can I start trying to get pregnant?”

In September 2011, confident that the chemo drugs were completely gone from her system, Sender gave the go-ahead. On Nov. 17, 2012, Isabella Grace Burgess was born – conceived, as Burgess puts it, “the good old-fashioned way,” without tapping their “hockey team on ice.”

Today, she is filled with gratitude – for her doctors, her husband and their daughter. “I look at her and think: Life is good. I tell Brian, ‘You know what, Mr. B? Our lives don’t suck. We’ve been blessed.”

She worries sometimes that the cancer may return. But as the extended Burgess and Schiavone clans gathered for Isabella’s first birthday party, Burgess vowed to be around for many more.

She is confident that her doctors – Sender, Stamos and the rest of her UCI Health medical team – will ensure that she celebrates Isabella’s fifth, 10th and 20th birthdays.

“I feel like these doctors are not going to let anything happen to me.”

— Kristina Lindgren, UCI Health Marketing & Communications