The expectant mother peered anxiously at the ultrasound monitor for signs of life.
Just 24 hours earlier, she lost her left breast to cancer. She could only pray that she didn’t lose her baby, too.
Six months after exchanging their wedding vows, Michelle Lang-Schock and her husband, Harry Schock, are facing more challenges than many couples face in a lifetime.
Together, they’re fighting to save her life while anticipating the birth of their child in May.
“I think God gave me this baby,” she said, “so I could concentrate on something positive instead of sulking in the negative.”
Michelle, or “Missey” as many of her friends and family members call her, was going through a divorce after a 12-year marriage in February 2010 when mutual friends introduced her to Harry, who also was divorced.
The two grew close, spending time together and with their children — three for her and two for him. He stayed by her side and patiently comforted her for months when she mourned the death of her ex-husband, the father of her two youngest children, in a house fire.
On May 5 of this year, they exchanged wedding vows while surrounded by family and friends in Urbana, where most of Michelle’s family lives. The couple then spent six blissful days honeymooning in Florida before returning to their home in Wadsworth, which they share with his daughter, Alaina, 17; and two of her children, Max, 9; and Isabella, “Bella,” 6. His son, Trevor, 8, also visits.
The honeymoon didn’t last long.
By the end of the month, Harry lost his job as a restaurant manager, joining Michelle in the ranks of the unemployed. After years in the restaurant industry, he decided to pursue a new career and go to truck driving school.
When Michelle started to grow increasingly tired, she figured it was from all the stress.
That stress only increased in August, when she found a lump in her right breast.
Unexpected family addition
She instantly panicked. The branches of her family tree were weighed down by cancer, including several relatives with breast cancer.
Because the couple were unemployed and didn’t have health insurance, Michelle qualified for a free mammogram through the Breast and Cervical Cancer Project (BCCP), also known as the “Pink Ribbon Project.”
The state-sponsored program provides free mammograms and cervical cancer screenings to qualified uninsured women. If cancer is discovered, BCCP helps enroll the women in Medicaid to make sure all their needed care is immediately covered.
Before giving Michelle a free mammogram to rule out cancer in her right breast, the ultrasound technician at Akron General went through all the typical questions.
“Is there any chance you’re pregnant?”
She’s 41 and he’s 52. With five children ages 6 to 20 between them, adding a baby to their blended family wasn’t something the couple intended.
“Well, there’s always a chance,” she chuckled, dismissing the thought.
The newlyweds were relieved when the mammogram and an ultrasound determined the lump Michelle had felt was simply a fatty tumor, not a cancerous mass. Nevertheless, a nurse case manager from BCCP recommended she still follow up with a doctor just to be safe, given her family history.
The day before her appointment with Dr. Lee Anne Sprance, medical director of the Breast Care Program at Summa Barberton Hospital, Michelle continued to feel tired and forgetful.
A trip to the drug store and $9 later, a home pregnancy test revealed Michelle and Harry were expecting a surprise addition to their family.
Facing a cancer diagnosis
Still getting used to the idea of being pregnant, Michelle wasn’t too concerned when she went to her appointment with the breast specialist.
“While you’re here,” the doctor said, “let me look at your breasts.”
During the exam, she told Michelle to lift her arms over her head.
Sprance agreed the lump in Michelle’s right breast wasn’t a problem. But she paused as she examined the other breast.
“There’s something here.”
The “something” Sprance saw was a small, barely noticeable dimpling under Michelle’s nipple, which only was visible after she lifted her arms.
A subsequent ultrasound and biopsy in the days that followed confirmed the diagnosis: Michelle has breast cancer, which spread to at least one of her lymph nodes.
Had the cancer not been detected, it likely would have continued to silently grow and spread, fueled by the hormones of her pregnancy, until it was too late.
The couple agreed they would fight to beat the cancer while preserving the life of their unborn child.
Harry made one exception.
“If it comes down to losing you to keep the baby,” he told her, “I want you.”
That evening after learning she has cancer, Michelle and Harry had a family meeting and broke the news to their children.
Max fell on the floor and burst into tears.
“I already lost my daddy,” he sobbed. “I can’t lose you, too.”
“I’m not dying,” Michelle reassured him.
Her oldest son, Jacob, 20, embraced her.
“I’m not crying,” he said, “because I know you’re going to be OK.”
Cancer rare in pregnancy
A breast cancer diagnosis while expecting is rare, occurring in a range estimated at one in every 1,000 to one in every 10,000 pregnancies, according to the American Cancer Society.
In Michelle’s case, both her pregnancy and cancer treatments are being covered by Medicaid, a joint state and federal program for low-income residents.
Her high-risk obstetrician, Dr. John W. Stewart Jr., has faced the challenge of caring for a pregnant woman with cancer a handful of times during his 20-year career.
“You’re always having to weigh maternal benefit versus fetal risk,” he said. “You’re treating two patients, not just one. Obviously, if bad things happen to moms, then it affects the babies.”
His recommendation: Be as aggressive as safely possible with the cancer treatment.
“We need to take care of the mom first,” he said. “We don’t necessarily delay treatment. We’re not trying to deliver orphans. We want that mom to be able to take care of that baby.”
Surgery couldn’t wait
Michelle’s doctors consulted to determine the best way to preserve both lives.
Sprance wanted to keep the surgery and anesthesia to a minimum. So Michelle’s plans to have her right breast and ovaries removed to prevent another cancer diagnosis were put on hold until after her baby’s birth.
But delaying the mastectomy for the left breast wasn’t a viable option. In those months, the cancer could grow, with devastating consequences.
As long as Michelle got enough oxygen throughout the two-hour procedure, Stewart had assured them, the baby should be fine. But knowing Michelle would need to see for herself, he offered to perform an ultrasound after surgery so she could know her baby’s heart was still beating.
As she waited in the pre-op area at Barberton Hospital in late October, surrounded by family and close friends, Michelle clutched a small stuffed cat named Ringo that her son Max gave her to keep her company. He took an identical one to school with him that day.
Before she left for surgery, her pastor joined her in prayer.
“It’s going to be fine,” she said confidently to the anxious group.
Relief in a heartbeat
The surgery went as planned, but the recovery was rough.
Because of her pregnancy, Michelle couldn’t receive all the typical mix of anti-nausea drugs to counter the effects of the anesthesia.
After a mostly sleepless night at Barberton Hospital, she was discharged to rest at home for a few hours before Harry, her mother and her aunt brought her to Stewart’s office in Akron for an ultrasound.
With Harry standing by her side, Michelle took a deep breath as the sonographer eased the transmitter over her barely swollen belly.
“There’s a heartbeat!” she cried out, pumping her fist into the air. “Thank God!”
“She just took a little nap yesterday,” Michelle joked to Harry.
Though they didn’t know the gender yet so early in the pregnancy, Michelle already was referring to their baby as a girl, while Harry called the baby a boy. Other times, he compromised and called the baby “shim,” short for “she/him.”
“I’m good now that I know the baby’s there,” Michelle said with a smile.
Radiation not required
Harry took care of the cooking and cleaning while Michelle recovered. But the stress on her body, combined with the typical bouts of morning sickness, took their toll, causing her to lose 11 pounds in a week.
Michelle and Harry returned to Barberton Hospital the week after her surgery so Sprance could inspect her incision and share pathology results.
The news, overall, was good. Only three of the 18 lymph nodes removed during her surgery had cancer cells.
“It’s under four, which means no radiation,” Sprance told them. “I’m really happy.”
The short time between diagnosis and surgery proved critical. If one more lymph node had cancer, Michelle would have needed radiation, which would have waited until after her baby’s birth.
“Good,” Michelle nodded. “Just chemo.”
The tumor was a little larger than originally estimated — 2.2 centimeters instead of 1.8. The slight difference moved her from stage IIA to IIB.
“I still can’t believe I have cancer,” Michelle said, tears welling in her eyes.
“I know,” Sprance said, placing a comforting hand on her patient’s shoulder. “But we’re getting it taken care of.”
Four weeks to wait
Women typically need to wait about four weeks after a mastectomy to begin chemotherapy. The body needs time to heal before being bombarded with drugs that target fast-growing cells.
When Michelle starts her chemo treatments next week on schedule at Barberton Hospital, she will be 14 weeks pregnant — far enough into her second trimester that the baby growing inside her will already have developed organs.
By waiting until the second trimester to start chemotherapy, the potential problems for the developing fetus are minimal, Stewart said. “Most of the cancer therapies don’t significantly affect growth.”
Every three weeks until about a month before her scheduled due date, Michelle will receive two chemotherapy drugs through a port in her arm. She’ll rely on family and friends to help her through the treatments when Harry’s new job as a truck driver takes him out on the road.
The chemo will cause her to lose her hair but — if all goes as planned — not her baby.
“Every time I get sad,” she said, “I concentrate on my pregnancy.
“Being pregnant, it gives me a reason I have to fight, because I’m fighting for two lives.”
Cheryl Powell can be reached at 330-996-3902 or firstname.lastname@example.org. Follow Powell on Twitter at twitter.com/abjcherylpowell.