Navigating a Cancer Diagnosis While Pregnant as a Nurse

Oncology Nursing News is launching From the Floor, a new blog series featuring first-person perspectives from oncology nurses, advanced practice providers (APPs), and physician assistants (PAs).

The series is intended to highlight the day-to-day realities of working in oncology through personal stories and reflections. Topics may include meaningful patient experiences, challenges in practice, lessons learned, career insights, or other experiences that have shaped their work.

Here’s where my story begins. I was 34, married for eight months, and six-months pregnant with my daughter. I had discovered a lump in my neck a few months earlier while I was driving home from work. I was alarmed, but thought it was a swollen lymph node that was harmless. By the time I addressed it with my obstetrician, she asked me to return to my ENT doctor that had removed my tonsils a few years earlier. My neck was becoming “webbed,” and I bad been experiencing some increased work of breathing.

I wasn’t really alarmed at the time. I felt more annoyed than anything.

I had been working 12-hour shifts at night and I was tired. Of course, being almost seven months pregnant, I felt huge — my stomach was getting bigger and I was uncomfortable, this is normal during pregnancy. I worked on a busy med/surg unit and I was on my feet most of my shift. The last night I worked was horrible. I was taking care of an older gentleman and his daughter was upset about something I cannot recall. She walked out into the hallway and proceeded to yell at me. I’m standing there, listening to her, thinking to myself, “I am pregnant and I have cancer. Why are you yelling at me?” I walked down the hall to the front desk and asked my charge nurse to come handle the situation. I finished out my shift, but called out sick that night. I just couldn’t physically do it any longer. I was tired and I didn’t feel well.

I scheduled my visit to see the ENT doctor. I explained that I had found a lump in my neck and that I felt like I was having a hard time breathing. He sat down behind me and performed a physical exam, where he was feeling my neck for lumps. He quickly swung his chair around and looked at me with concern. He told me I needed a cat scan “yesterday.”

I needed to talk with my obstetrician to ensure it was safe for me to have the scan, due to radiation exposure. I spoke with her on the phone and she told me that I could wear a lead apron to protect my baby while I was undergoing the scan. Once the scan was completed, I was relieved it was over, looking forward to “normal” results.

As I was driving out of the parking lot of the hospital, my ENT doctor was walking across the street from his office. I drove over to let him know I was done and I’d wait for the results. He told me, “You need to go back to the office, right away.” I knew then there was something wrong. I parked my car and went into the office. He sat me down and said, “You have lymphoma.” I said, “You mean, like Hodgkin?” He said, “Let’s hope so.”I was blown away and in shock.

This happened at the end of June in 2004.

In a matter of two weeks, I’d seen a perinatologist and I’d established care with an oncologist.

I had to see the perinatologist to have extra testing done to ensure that my daughter was growing at a normal pace, prior to making any treatment decisions. I had to establish care with an oncologist because I needed to start treatment.

On July 5, 2004, I had a biopsy, which confirmed the diagnosis of Hodgkin lymphoma and I had a mediport placed in my chest so that I could begin chemotherapy.

Undergoing those two procedures was very challenging. I had a large mediastinal mass that could potentially compromise my airway, so I had to stay awake during the biopsy and port insertion. I received some medicine (fentanyl) to decrease the pain and some local anesthetic, but I still felt pain and I was very anxious.

I just wanted me and my unborn child to be OK.

I underwent my first chemotherapy treatment on July 6, 2004. It was a Tuesday.

It was a long day — about eight hours.

First-time chemotherapy requires pre-medications and vigilance to ensure the patient doesn’t have an adverse reaction. My situation was a little more complicated because I was pregnant. I didn’t experience any untoward side effects. In fact, I felt good. No issues. I was at the mall three days later, walking around as if nothing was wrong.

I had a total of four treatments before my daughter was born.

I had a routine schedule: chemotherapy every other Tuesday, obstetrician twice a week for a biophysical profile (that’s where they perform an ultrasound to look at the fetus, checking for abnormalities in breathing, etc.) and a non-stress test, where they monitor the fetal heart rate and response to movement to determine if the fetus is getting enough oxygen.

I always looked forward to the ultrasounds so that I could see her move and breathe.

One particular visit was on a Wednesday, the day after chemotherapy. I was very tearful and not feeling well. The sonographer began moving the probe across my stomach. I remember her saying, “Look, mom. Her diaphragm is moving up and down. She’s breathing on her own!” I began to cry tears of joy. I was so happy to know that she was OK.

You can’t imagine the fear of knowing that you may be causing harm to your unborn child.

I believe God grants mothers special graces. I had faith that both Catherine and I would be OK. I was still afraid, but I had faith that all would be well.

On Friday, Aug. 20, I went into the office for a non-stress test. After about 20 minutes, the doctor came in and gave me some juice to drink-the baby was sleeping and not moving around, so they wanted me to drink something sugary to help stimulate her to produce some movement. After about 45 minutes, the doctor came back to me and said I was dehydrated and I needed to go to the hospital. My doctor didn’t seem overly concerned — she was calm and explained that she wanted me to go in for some IV fluids.

Since I was unaware of the true gravity of what was happening, my husband and I drove home, ate lunch, ran some other errands, and at about 5:30 pm, we drove up to the hospital.

It wasn’t long afterwards that I learned I would be having an emergency c-section.

I was shocked and scared.

I had to undergo a spinal, where they stick a needle into your back to numb you from the neck down so that you don’t feel any pain from the surgery.

I hated the way that made me feel.

I had a nurse assigned to me, to just be there for me, whatever I needed. I asked her to rub my feet so that I could know they were still there. I know that sounds silly, but it was reassuring.

There were some tense moments leading up to my daughter’s birth.

There was a neonatologist in the room that expressed his frustrations with not knowing my prior medical history (the cancer part) and what treatments I had undergone. I get it. He was concerned about the unborn child he was going to be responsible for.

My obstetrician yelled at him while she was working on delivering my daughter.

After that occurred, the room fell silent. No one was talking. You could hear a pin drop.

Catherine Diana Pinkos was born at 7:29 pm. She didn’t make a sound. She wasn’t breathing. The neonatologist had an intubation blade ready so that he could put a tube down her airway, but before doing that he quickly suctioned her airway and she let out a cry. Her lungs were good! I remember saying out loud, “Give ‘em hell, Catherine.”

I didn’t get to hold or see her for several hours. She was whisked away to the nursery and my husband went with her.

I was eventually taken to the recovery room and after an hour or so, I went up to my room, where I anxiously awaited meeting my baby girl.

She was in the nursery for about four hours. She had low blood sugar, which is common in premature infants.

Around midnight, she was finally brought to my room where I was waiting, along with my parents and my husband.

She was so tiny and beautiful.

I held her for a little bit and then passed her around to the others.

Eventually, my parents left for home and then it was just me, Joe, and Catherine. Our perfect little family.

I fell asleep and Joe stayed up most of the night, holding her.

Because I was receiving chemotherapy, I wasn’t able to produce breast milk, so she had to be bottle fed with formula. Joe fed her when she cried and rocked her back to sleep.

This is the part where it got worse for me. I began to feel sick after treatment four.

I started to lose my hair. My face was fat from steroids. I felt awful.

By treatment eight, I was ready to quit. My husband sat next to me while I was feeling sick.

He liked to use sports analogies so he told me to think about a hockey game. He said, “You’re in the third period and you’ve only got 15 more minutes to go — you can do this.”

Of course, I finished out my entire six-moth regimen and then I underwent five weeks of radiation.

I was motivated to go back to work. Joe and I had been looking at houses right before I got diagnosed. We were actually going to put in an offer on a house the day I had my CT scan.

I returned to work in April of 2005 and life seemed to be returning to normal.

I had a follow up CT scan in July of 2005 that revealed I’d had a recurrence. I was devastated. This is where things got really hard for me.

Vikki L. Pinkos, BSN, RN, CCRN, CNML, serves as Patient Care Manager, MMH 5, at Moffitt McKinley Hospital. A dedicated healthcare professional since age 19, Vikki began her nursing career in 2001, discovering her passion for bedside care after the loss of her grandparents to cancer inspired her to make a meaningful difference. Her perspective as a nurse took a profound personal turn in 2004 when, while seven months pregnant with her daughter, Catherine, she was diagnosed with Hodgkin Lymphoma and began a six-month chemotherapy regimen. Navigating an emergency c-section, treatment, and a subsequent disease recurrence leading toward an autologous stem cell transplant. Vikki brings a deeply empathetic understanding of patient resilience, fear, and hope to her leadership and her writing for Oncology Nursing News.