Two dates will forever be etched into Michelle Cohen’s memory: April 2, 2018, when her son Franklin was born, and July 11, 2018, when she learned she was in remission from cancer.
Getting pregnant is one of life's gratifying moments. Ms. Cohen’s joy over her pregnancy soon turned to anxiety when she learned she had ovarian cancer.
Yet Ms. Cohen and her son, Franklin, now lead a fulfilling life, thanks to comprehensive care by the multidisciplinary specialists at the new Center for Pregnancy, Cancer and Reproduction of Northwell Health Cancer Institute.
“Motherhood is amazing!” Ms. Cohen said. “Until you live it, you don’t know what it means. It’s just amazing to have him here with me.”
Months and several attempts had passed before Ms. Cohen became pregnant in August 2017. She and her husband, Josh, were en route to a family reunion when they heard the big news.
Everything went smoothly until late December, when she began to endure pain in her lower left side. Suspicious sonogram results led her to be admitted to North Shore University Hospital (NSUH), where doctors identified a large mass near her left ovary.
She was soon released and instructed to monitor her pain, which returned two weeks later. Ms. Cohen’s ob/gyn, Wendy Fried, MD, sent her to NSUH. The mass had doubled in size and tripled in volume.
It needed to be removed. She had ovarian cancer.
“In a way, he saved my life,” Ms. Cohen said, holding a smiling Franklin. “If I didn’t have the sonogram, we would not know I had ovarian cancer.”
Cancer strikes one in 1,000 pregnant women. Ms. Cohen was 26 weeks pregnant when she learned of her diagnosis, which spurred a series of meetings and discussions about not just her care, but Franklin’s as well.
On January 15, 2018, Lisa Dos Santos, MD, a gynecological surgeon at NSUH, removed the malignant ovary — the first of three surgeries she performed on Ms. Cohen.
“Michelle’s first surgery was technically challenging because of the cancer diagnosis and the size of the mass,” Dr. Dos Santos said. “Because it was end of the second trimester, we knew it [would be] difficult to access during surgery. Minimally invasive surgery was not feasible.
“Franklin was monitored before, during and after the procedure. Neonatology [specialists were] on hand to make sure he was OK. We were able to successfully remove the tumor and pathology confirmed ovarian cancer.”
After her mass was removed, Ms. Cohen was placed on bed rest and under the care of Veena John, MD, medical oncologist, and Northwell maternal/fetal specialists.
“I had so many thoughts and fears. ‘Is it safe for the baby if I get chemotherapy?’”' Ms. Cohen said. “’Do I need to start chemotherapy right away?’ Would I lose my hair?”
Northwell’s pharmacy team confirmed that Ms. Cohen could receive chemo. She underwent two cycles of intravenous paclitaxel and carboplatin.
“Before I even met Michelle, we had multiple meetings to formulate a plan and identify the best approach,” Dr. John said. “All of this went smoothly. As you can see, treating cancer while pregnant is extremely complex. Northwell has the one-stop-shop to make sure it happens safely.”
When Ms. Cohen began to lose her hair, she and Mr. Cohen had their heads shaved together. At the barber shop, they noticed a familiar face seated beside Ms. Cohen.
“It was the rabbi who married us,” she said. “We were stunned. We hadn’t seen him in four years and we took this as a positive sign.”
Three weeks after Ms. Cohen’s second chemo cycle, Franklin was born at 7 lbs., 12 oz. The labor and delivery team included maternal/fetal specialists, anesthesiologists, neonatalologists, obstetricians and Dr. Dos Santos, who performed a cesarean section (C-section).
“He was healthy. And we were overjoyed he had a full head of black hair, which reassured us that chemo did not affect him,” Ms. Cohen said. “Everyone always tells you how amazing it is the day your child is born, but until it happened, I didn’t quite understand. The instant love is amazing. Now, I can’t imagine my life without him.”
Ms. Cohen received four more rounds of chemo. In July, Dr. Dos Santos reduced the risk of recurrence by performing a radical hysterectomy.
“This family’s story highlights the important need for the Center for Cancer, Pregnancy and Reproduction,” said Richard Barakat, MD, Northwell’s senior vice president for cancer services and physician-in-chief and director of cancer at the Cancer Institute. “We want to make it a seamless process, where our nurse navigators can put you in touch with all of the right people to get the best care possible. We don’t believe any other cancer provider in New York can provide all of these services.”
Ms. Cohen returned to teaching full-time in September. She and Franklin are happy and healthy, and beginning to find the routine that’s essential during the first year of parenthood.
“We found our rhythm,” she said. “Fortunately, he likes to sleep at night. So it makes it easy. To come home from work and see him smile, he just wants to play.”