Molar pregnancy is the miscarriage that threatened to give me cancer

I'd never heard of getting pregnant with tumours until it happened to me, writes Natalie Stechyson on the HuffPo. Read on: 

When people ask me when I plan to have another child — as they tend to do once you've already birthed your first and proven yourself a breeder — I usually joke that I'm barely surviving the one I have.

I have a toddler in the throes of discovering his, um, independence, so it's not exactly an exaggeration. Plus most of my friends, family and co-workers know that my two-year-old son — bless him — didn't sleep unless he was held for the first seven months of his life, has brought home every possible contagious illness since he started daycare (plus lice, which I caught from him), and that when he was born he exploded out of my vagina like the Kool-Aid Man busting through a brick wall.

So, most people who know me nod understandably. But when I roll my eyes and joke that I'm barely surviving motherhood as it is, there's actually a little more truth to that than I've let on.

The author and her son, two days after her second D&C surgery in a month.
She is every so slightly tired but toddlers gotta toddler.

I have one child, but I've been pregnant three times in the last four years. I bled for five straight weeks before I finally miscarried my first attempt at having a baby. My second pregnancy gave me my son. My third, a molar pregnancy that was surgically removed from my body — twice! — this past spring, threatened to give me cancer.

See? Not exaggerating. Although the toddler temper tantrums are really sucking my life force, too.

Molar pregnancies are a rare 'genetic accident'
In a nutshell, a molar pregnancy is when you become pregnant with tumours that aren't necessarily cancerous, but they act like cancer and in rare cases they actually metastasize like cancer. The treatment is similar to cancer, too: surgery, and some women need chemotherapy or even (in rare cases) hysterectomies. It's a type of gestational trophoblastic disease that occurs when the tissue that would become a fetus instead becomes an abnormal growth in the uterus called a hydatidiform mole.

"A partial molar pregnancy is a genetic accident." - The Cleveland Clinic

Molar pregnancies only occur in about one in 1,000 pregnancies, and it all comes down to how the male and female DNA come together during baby-making.

In the case of partial molar pregnancy (PMP), which is specifically what I had (and am still being monitored for, since two surgeries still don't guarantee the mole won't grow back), what usually happens is two sperm fertilize one egg, resulting in the egg receiving a double set of the father's DNA (Why yes, I DO blame my husband and his over-eager sperm, thanks for asking).

The tumours that grow in a partial molar pregnancy are described as grape-like.

"A partial molar pregnancy is a genetic accident," the Cleveland Clinic explains.

"Instead {of a typical embryo} a cluster of grape-like cysts (known as a hydatidiform mole) grows in the uterus."

With PMP, there's a small chance the molar tissue will spread and become malignant, but the cure rate is excellent (that is what I remind myself over and over while hyperventilating, stress-eating ice cream sandwiches, and picturing my son growing up as a pauper/orphan — why my husband has also died in these scenarios, I'm not sure).

Some molar pregnancies are caught early by blood tests (one marker can be unusually high levels of the pregnancy hormone known as hCG) or by ultrasounds, but others like mine are only diagnosed after having a miscarriage.

No excitement. No heartbeat.
The urge to have a second baby hit me hard last February, the same month I was taken out by another bout of daycare stomach virus (hear me out) and had to abruptly stop breastfeeding my son because I literally could not stop puking. When I finally stumbled out from the bathroom a few days later, shaky but able to keep down liquids, my 18-month-old was fully weaned.

A few days later, when I could no longer admit that his baby curls were anything but an impressive mullet, I took him for his first haircut.

I cried for three days over his new short hair (hormones may have had something to do with it), grieved our nightly ritual of nursing him to sleep with the intensity of having lost a family member, but then finally emerged from my cloud of sadness a new woman. I was free! My body was mine! So naturally, I wanted another baby as soon as possible. I was pregnant by March.

The author, a few weeks pregnant, stifling the overwhelming urge
to barf so she can read to her son.

What's stolen from anyone who has had a miscarriage is the excitement over a new pregnancy. We know that a positive test does not mean a baby is on the way. We know all too well the statistics that one in four pregnancies ends in a loss.

Because of my previous history of miscarriage before I'd had my son, I had an ultrasound when I was just eight weeks pregnant to make sure everything was going smoothly. I went in to my appointment with a sense of dread (and not just because I was about to be probed in the vaheen). For me — despite having one healthy baby — ultrasounds consist of turning my head so I can't see the screen and waiting for the blank-faced technician to say "I'm sorry, but ..."

With my first pregnancy, I started bleeding heavily when I was only five weeks along due to a pregnancy complication called subchorionic hematoma. I had weekly ultrasounds to search for signs of life, all the while hemorrhaging clots the size of golf balls. My doctor decided there was no heartbeat after three more weeks of "I'm sorry, but ..." ultrasounds. It took two weeks of painful medication (and two more ultrasounds) to pass the fetus.

I don't like ultrasounds.

For those who have experienced miscarriages, ultrasounds aren't exactly exciting.

I'm now an expert in reading the technician's reactions and knowing if I'll be leaving with a photo for the fridge or walk out of the clinic deleting all the pregnancy apps off my phone. With this newest pregnancy, I looked at the technician's blank face as she searched for a heartbeat, and I knew.

"I'm sorry, but ..."

I deleted the apps that I'd been using to track my cycles so quickly, I don't even remember my due date. November something.

I'd never allowed myself to imagine anything but bad news, so I didn't even feel all that upset that my baby was just a fleck of genetic gunk, looking nothing like the gummy bear my son had resembled at his eight-week ultrasound.

I was more upset about what I knew came next: another apologetic ultrasound a week later "to be sure," more blood tests, a quick appointment with an OB-GYN who agreed that a surgical procedure called a D&C (dilation and curettage) was the best course of action this time, and then the procedure itself, which thanks to a strong drug cocktail was only slightly horrifying and mentally scarring.

A selfie that the author - coming out of the drug-induced fog of her first
D&C - texted to her husband from the recovery room to let him
know she was OK. This photo did not help soothe him.

What I didn't expect was the OB-GYN who removed what I thought was a fetus from my womb to call me with the pathology report and say "I'm sorry, but ..." a month after I thought all the bad news was behind me.

But I quickly learned that some miscarriages take a little longer to end.

Molar pregnancies are confusing for everyone
Most people have never heard of a molar pregnancy unless they've had one, know someone who's had one, or happen to be a medical professional well-versed in the crap-shoot that is pregnancy. So things can be pretty confusing. From that first ominous phone call, my diagnosis has been a swirl of questions without straightforward answers, and even my OB-GYN has at times seemed flustered by my genetic accident.

Then there was the resident who falsely told me my chance of having a second molar pregnancy was around one in 20 (it's actually more like one per cent). The anesthesiologist who asked me how many weeks pregnant I was moments before he put me under for my second surgery (is "negative five weeks" an answer? I was negative five weeks). The technician who winked and asked me if I was hoping for a positive result — which is what one would want in a typical pregnancy — when she drew my blood to test my hCG (sure, if I'm hoping to get womb cancer, lady).

Often I find it easier to just keep silent.

Molar pregnancies feel like a never-ending miscarriage
It's October now — a month many countries use to mark pregnancy and infant loss — and when I'm feeling particularly dramatic I think about how I've been having a miscarriage for the past seven months, with two months of blood tests left to go until I'm considered cleared. Nine months total to miscarry. The irony isn't lost on me.

There was the original D&C surgery to end my pregnancy in April. The pathology report. Blood tests that revealed my pregnancy hormone level — which should have been registering at zero — was instead registering at 13,000. Another ultrasound by another blank-faced technician. A second D&C in May, this time under general anesthetic, an emergency procedure to remove the four-centimetre mass growing in my uterus.

The author waiting to be prepped for her second D&C. Her surgery was the day before the Royal Wedding, and she's still bummed she had to miss work and never got to write about the Mulroney twins.

Then weekly blood tests for six weeks to make sure my pregnancy hormone was finally dropping, and monthly blood tests for six months after hitting negative (in Canada, that's considered a level of less than five).

Only when those six months are up will I be done with this.

Molar pregnancies take a mental toll
Molar pregnancies are more than the loss of an expected baby and the risk of developing cancer. They're psychological torture. Every cramp feels like the tissue growing back. Every ache in my breasts feels like my hormone rising to dangerous levels. Every week and then every month is just a countdown to my next blood test, the only indicator I have of whether the last D&C did the trick.

Molar pregnancies are your body thinking it is still pregnant long after that hope has been literally scraped away. They are a miscarriage where every sign that your body is no longer pregnant is a relief: heavy periods, crashing hormones, and the end of that first-trimester nausea are causes for celebration. With my first miscarriage, those were all causes of grief.

A molar pregnancy is not knowing how to tell others what's happening to you because you barely understand yourself; it is to joke you should buy a lottery ticket since the one in 1,000 odds seem to be with you; it is to finally buy the damn ticket in a fit of whimsy and not actually win the lottery (shockingly).

A molar pregnancy is also to eat a million sympathy cupcakes sent by lovely co-workers while you're off work. A molar pregnancy is also to gain a million pounds.

Desperate for information and seeking others who could relate to my plight, I joined an online support group for molar pregnancies of all types (and there are types much worse than mine). It was the only group I could find, and there are only 2,200 members worldwide. It's been helpful and heartwarming (Who else will cheer for me when I write "I'm at <5, bitches!!!!"? Who else will surround me with love when I have late-night panic attacks?), and also horrific.

My two vigorous womb surgeries seem like nothing in comparison to what some of the women in my group are going through.

Yet I still consistently re-live the panic-filled days before my second surgery where I was so scared I might die that I started having out-of-body experiences; I still have dreams about giving birth to dead babies.

Soon, I'll be able to try for a second child
In December, I will officially be allowed to try to get pregnant again. Whether or not I will want to is another matter. The chances of having another molar pregnancy are extremely low, but so were the chances of having one in the first place. The odds of me having another miscarriage, however, are still what they always were for everyone: one in four.

Whether I have a baby, a loss, or even another molar pregnancy all comes down to chance, and I don't exactly feel like the numbers have been on my side.

I'd always imagined I'd have two children. I can even see it so clearly: two little boys tumbling into my arms and gripping my hair with grubby fingers and saying "Mama, Mama, Mama!"

The author and her son playing a game of "oven mitts," which obviously requires helmets.

But as December approaches, I wonder more and more if a single, beautiful child is better than the anxiety, the blood loss, the ultrasound technician saying "I'm sorry, but ...," the doctor assuring me "it's one of the most cureable cancers," the woman at the lab remarking how bruised my veins are, the pain of hurriedly ripping the bandages off my sore arm before my toddler can see them and get scared about another "Mama booboo," the memory of him crying when I was too tired, sore, or depressed to chase him around the house wearing oven mitts (a current favourite game we like to call "oven mitts").

I talk often about my son at my medical appointments. During one of my many recent blood tests, the technician (who clearly didn't know why I was there) asked me when I planned to give him a brother or sister. I looked at the blood flowing out of my still-bruised arm into yet another tube, about to be sent away for yet another test, and decided it would be easier not to explain.

"I'm barely surviving the one I have," I said with an exaggerated eye roll.