At 34, following the birth of her third child, Bianca began experiencing abnormal heavy and persistent bleeding which turned out to be a rare postpartum cancer, impacting 1 in 50,000 pregnancies.
Following the birth of her third child in December 2021, Bianca became concerned about heavy and persistent bleeding which carried on into February 2022. “From my two previous pregnancies, I knew to expect some bleeding during the postpartum period, but this felt different, this was more than the previous two and I was also passing rather big blood clots”.
Conscious that she was now eight weeks postpartum, she knew her maternity hospital would only continue her care for a six-week period, but she rang them anyway to check if they could help. They referred her to the ED in her nearest hospital.
“It was incredibly stressful because at that time, my eldest was three and a half, my middle child was two and I had my eight-week-old, who I was still breastfeeding – I took him to the hospital with me, and my aunt came along to help. After waiting about an hour to be seen to, just to fill out my information and explain what my issue was, it was a further hour and a half by the time I was seen to medically. All the while, I was sitting in the waiting room, running to and from the bathroom to change out my pads every five/ten minutes, because they were so soaked with blood.”
Eventually, she was examined, and blood tests were done. While lying on a ward awaiting the results of some tests, she felt very weak and dizzy. She would later pass out from the loss of blood. “Once I stabilised, they gave me tranexamic acid to stem the bleeding and it seemed to work. They told me I needed a pelvic ultrasound, but that it could take some time due to waiting lists and delays. With the tablets they gave me, they told me that should stop the bleeding and I was discharged.”
“It worked for a week but when my prescription ran out, the bleeding started again so I went to my local GP to get a repeat prescription. He contacted the hospital and asked them to prioritise me for the pelvic ultrasound scan as he was concerned, we didn’t know the cause of this bleeding."
While this worked initially, it didn’t work for very long, explains Bianca. “It worked for a week but when my prescription ran out, the bleeding started again so I went to my local GP to get a repeat prescription. He contacted the hospital and asked them to prioritise me for the pelvic ultrasound scan as he was concerned, we didn’t know the cause of this bleeding.”
Bianca recalls a really scary event one Saturday morning. “I was on my own with three kids and I had passed a lot of blood that morning and really didn’t feel well. I was weak and just felt drained. I rang my husband who was at work, and he came home straight away. We rang the Shannon Doc because it was Saturday and explained we weren’t going into the Emergency Department again and asked them to line somebody up to receive us. They tried to refer us back to my maternity hospital even though we had been through all this and explained that the maternity hospital wouldn’t see us as it had gone beyond the six weeks. My husband decided he wasn’t going to drive me because he was quite worried about the journey and how I’d cope so he called an ambulance that took me straight into the hospital. In the ambulance on the way, I remember vomiting and then passing out because of how weak I was”.
Once at the hospital, Bianca was seen to by a Consultant Gynecologist, who took her up for the pelvic ultrasound straight away. “They found a tiny growth on my uterus that had to be removed, but because I had lost so much blood, they needed to arrange for blood transfusions, three of them, to get my bloods up. When I got to a sufficient level, they operated on me and removed the growth. We didn’t know what it was, and the doctor was keen to get to the bottom of it, so she sent it off for analysis and it eventually had to be sent to the National Maternity Hospital in Holles Street.”
Within two weeks of that procedure, Bianca was bleeding heavily again, she explains. “I went back into hospital, my bloods were done again and my hCG levels were through the roof, even though I wasn’t pregnant. We did another pelvic ultrasound, and the growth was back again. At that point, it hadn’t been confirmed but the doctor said she thought we could be dealing with a very rare type of cancer, called Postpartum Choriocarcinoma, which she said impacts approximately 1 in 50,000 pregnancies. Two days later, we’re at the end of March now, we got the call from Holles Street, and it was confirmed that’s exactly what it was.”
This news rocked Bianca and her family, but as she puts it, at least now they knew what they were dealing with. “It was shocking to hear, but you just get on with it, you have to. I was referred down to Cork to a specialist for this type of cancer. When I first went down to him, we had to do MRIs and scans everywhere because this type of cancer can spread quickly. Thankfully, it hadn’t spread, we had caught it early enough.”
“Because of the risk of bleeding, they wanted to keep me in for my first week of chemotherapy treatment to keep me under observation, so I spent nine days down there and it was really hard being away from my family for that long. Thankfully, the first round went well, so they were able to shift my treatment to Limerick which cut down on my travel time.”
“I was obviously unlucky to find myself with this rare form of cancer, but I also look on the positive side and consider myself very lucky with how my treatment went. For the first ten weeks, I was on a low-level treatment that was fine, and it didn’t result in any hair loss, or sickness or loss of appetite really. They needed to up my treatment after ten weeks, which again, I found okay. I did lose my hair, but I didn’t care – it’ll grow back, but being able to spend time with my family, I could never get that back.”
“There’s a 4% chance it could come back and if it does come back, there’s a very high likelihood that will happen within two years."
Bianca finished her treatment in September 2022 and has to go for regular checks until February 2024. “There’s a 4% chance it could come back and if it does come back, there’s a very high likelihood that will happen within two years. As my hCG levels must be continually monitored, I have been advised not to get pregnant between now and February 2024, because if those levels go up, they won’t be able to tell if that’s the cancer returned, or just me being pregnant. So, we have to put off that decision about whether we want to try have another child.”
Reflecting on her cancer journey, Bianca says she only got to spend six-to-eight weeks of her maternity leave bonding with her newborn, before she was thrown into dealing with her own health and eventual cancer diagnosis. “It just baffles me really that your maternity leave can’t be deferred. For about 25 weeks of my maternity leave, I was in and out of hospitals trying to get to the bottom of what was going on with me, getting the diagnosis and then dealing with my treatment and all that entailed. Thankfully, my employer has been really understanding, and I’m currently on a career break spending time with my children, time that I lost out on throughout last year.”
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