“Choose either your wife or your unborn baby.”
These words still haunt Marina Ch Ralte, a 41-year-old hailing from Mizoram’s Aizawl.
Back in 2021, when Marina was two months pregnant, she was diagnosed with cancer of the uterine cervix. Her doctor told her an abortion would be risky. And then uttered these words to her husband.
This was way easier said than done, literally. But Emanuel Lawnkima, Marina’s husband and a restaurant owner in Aizawl, knew that this wasn’t the end. And was he right.
Two years after she was diagnosed with cervical cancer, Marina is today cancer-free and mother to a healthy 1.5 year old baby.
This is her story.
Biopsies, Bleeding & A Broken Heart: Getting Diagnosed With Cancer
Marina and Emanuel, parents to a young boy, had been desperately trying for a second child. In January 2021, they unfortunately had a miscarriage.
In June 2021, when they got pregnant again with their rainbow baby, their happiness knew no bounds.
But just two months into the pregnancy, Marina (then a 39-year-old) started bleeding, continuously and excessively.
What she thought was a miscarriage turned into her worst nightmare. Two hospitals, multiple doctors, and a couple biopsies later…she was diagnosed with cancer of the uterine cervix.
But her home state did not have adequate healthcare services to help her out.
According to the Indian Council of Medical Research – National Centre for Disease Informatics and Research, there is only one medical college, one tertiary cancer care centre, and regional cancer centre in all of Mizoram.
Local doctors advised Marina to seek help from Dr PK Das at New Delhi’s Apollo Cancer Centre, since he had also successfully treated Rosie, another patient from Aizawl who was pregnant with twins while suffering from breast cancer.
Ab Dilli Door Nahi: Chemotherapy, Treatment & Beginning of Recovery
Marina sought help from doctors at the Apollo Cancer Centre when she was 16 weeks pregnant and diagnosed with a seven cm long tumour in her uterine cervix, which was at an advanced 2B stage.
Considering the complexity of her case, a team of medical oncologist, gynaecologist, surgical oncologist, foetal medicine specialist, and radiation oncologist was put on the case.
Cervical cancer cases in pregnant women are extremely rare. Studies show that 0.8-1.5 cases of cervical cancer are noted per 10,000 births.
According to the Asian Pacific Journal of Cancer Biology, only “1 to 3 percent women diagnosed with cervical cancer are pregnant or postpartum at the time of diagnosis.”
Dr PK Das, Senior Consultant, Medical Oncology, said, “Our priority was to safeguard both the mother’s health and the developing baby. We administered safe chemotherapy drugs after monitoring the baby’s growth.”
Usually in cervical cancer cases, patients are given radiation therapy and a surgery is conducted to remove the cancerous cells.
But since Marina was pregnant, both of these options weren’t possible as they could pose risk to the baby.
And an abortion wasn’t possible too since the tumour was blocking the opening of the cervix and it would have put the life of the expectant mother at risk as well.
So, the doctors opted for what was the only viable solution left with them.
Give intravenous chemotherapy to the patient so that the tumour shrinks.
Deliver the baby through a traditional lower segment caesarean section during the 37th week.
And perform surgery postpartum.
Marina underwent five cycles of chemotherapy while she was pregnant. She’d also go for regular foetal monitoring so that the doctors could closely track the baby’s development.
After Myra, now 1.5 years old, was born in March 2022, Marina continued with
Chemotherapy
Radiation therapy
Brachytherapy
In August 2022, Marina was cancer free. And now a year later, her cancer is currently in remission and she has adopted a healthier lifestyle, involving eating properly and exercising.
Major Challenges That The Medical Team Faced
But again, easier said than done. The medical team did face a bunch of challenges:
When Marina was being given radiation therapy after the delivery, her uterus size was changing postpartum. Depending on the size, doctors had to rework their plan every two weeks and personalise the “shield” to protect other organs from radiation.
Initially doctors thought that Marina might have to deliver by 28 weeks but she was able to carry the pregnancy to full term.
They also had to make sure that the baby’s growth was not being hampered by the medicines that Marina was taking.
Marina also contracted COVID-19 in the seventh month of pregnancy.
However, here, Dr Mano Bhadauria, Senior Consultant, Radiation Oncology, Apollo Cancer Centre, Indraprastha Apollo Hospital, New Delhi, also clarifies:
Chemotherapy does not affect the DNA of the baby during pregnancy, there are no side effects.
There should be no problem in breastfeeding the baby post-partum because external radiation is given to patients.
However, the baby’s growth has been monitored in the last year and half by doctors, just to ensure that no side effects affect her.
Through Thick & Thin Literally
However, despite all this, Marina kept going. “I wanted to be a fighter, not a patient,” she tells FIT.
“The toughest part was trying to not have a negative outlook towards the situation. What kept me going was knowing I was not alone and the positive attitude of my doctors.”Marina Ch Ralte to FIT
Throughout the recovery process, a clinical psychologist counselled her too.
And now, owing to the resolve she never left behind, she’s enjoying every bit of motherhood. Emanuel says, “Myra is a very active girl.”
He laughs as he adds, “Hyperactive, in fact.”
“Two years ago, when the doctor asked me to choose between my daughter and my wife, I would have chosen my wife. Now, that question is my nightmare.”
More & More Awareness The Only Way To Fight Cervical Cancer
Doctors that FIT spoke to emphasised that cervical cancer is preventable. The human papillomaviruses or HPV vaccine has 95 percent efficacy against the disease.
And yet, in 2022, according to a Lancet study, India accounted for 21 percent of the 6,04,127 cases of cervical cancer reported globally. Out of the 3,41,831 deaths, 23 percent occurred in India.
If you look closer at the data about India, it shows a grimmer picture.
6-29 percent cases of cancers in women were reported to be cervical cancer, according to a 2016 study, Burden of Cervical Cancer and Role of Screening in India.
The highest incidence of cervical cancer reported in India is in Mizoram and the lowest in Assam’s Dibrugarh district.
However still, in Mizoram, only 6.9 percent women annually undergo screening for cervical cancer, ICMR data says.
Even as India-made vaccines are becoming available, accessibility remains an issue to be countered.
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