One and Done by Cancer, NOT Choice

By Lauren Rabinovitz

Infertility creates a tornado of grief, loss, and anger, and a deep wondering of “why me.” Secondary infertility (the inability to conceive after having no challenges conceiving a baby) can feel a little different. In addition to all those feelings, there is an added layer of worth,--of whether these intense feelings are deserved when one already has a child--which can amplify these profound emotions. Women with secondary infertility can struggle finding support because “you should be grateful that you already have a child.” That is not especially comforting for someone who desires more than one child. I mean, when you want that second piece of cake, obviously you already enjoyed the first and still very much want the second. So now let’s layer on a cancer diagnosis as the reason for secondary infertility, and one has entered a unique place in hell.

I was diagnosed with hormone positive breast cancer two weeks after a miscariage and three years after having my first child. Having a second child was always a little up in the air for me. I had a high risk pregnancy with my first and severe postpartum anxiety, so the idea of starting up again did make me pause. However, my husband and I made the choice to try. And we were quickly successful--for a few weeks. When the bleeding started, I didn’t panic and I didn’t fall apart (okay, maybe a little bit) because I told myself we would just try again. I didn’t realize that this failed pregnancy likely caused a hormone surge that helped me find a giant lump in my breast not even two weeks later, a lump that I would soon learn contained breast cancer. At 36. In an instant, I went from being old to try and have a baby to really young to have cancer. My mindset shifted from “what will my daughter’s life be like without a sibling?” to “what will my daughter’s life be like without her mom?” 

I also began learning about complete loss of control. I am known for many things, but “go-with-the-flow” I am not. I hate surprises so much that I picked out my own engagement ring and gave my husband a time and location for the proposal (he’s a keeper, that one). I have grown to appreciate my anxiety because it has helped me have a lot of success. It also told me to follow my instincts when I felt the lump and run to urgent care in the middle of a global pandemic.

A cancer diagnosis comes with paralyzing fear and also, when you are lucky, a plan that is decided upon by brilliant medical minds.I am incredibly grateful for these experts and the field’s advances, but my plan put me on a train hurtling through time and space at lightning speed, and my ability to control anything became nonexistent. To be fair, breast cancer treatment does come with some unique options. Do I shave my head before my hair falls out, or wait? Should I remove one breast or two? Shall I take the medication for my side effect (diarrhea) that gives me another side effect (constipation)? Or, my very favorite, “What size breasts do you want?”

I quickly learned that my breast cancer was highly hormone positive (her2 positive as well), had already spread to lymph nodes, and was especially aggressive, so 48 hours after receiving my devastating diagnosis, I was sitting in a surgeon’s office being asked if I wanted to discuss fertility options. This “choice” felt similar to the choices I offer my daughter: “Would you like to put your shoes on yourself or would you like me to help you?” Either way, those shoes are going on your feet because we are going to be late. Getting pregnant again, in any way, quickly became another casualty of cancer for me. 

Flash forward about 10 months and I am still on the cancer fighting train and will be for some time. I spend most of my days living a life full of polarization, which looks like a thousand little thoughts that can be divided into gratitude for life and intense anger for my cancer. My daughter has been both a reason why getting through cancer treatment has been tough (well, in addition to the debilitating nausea, fatigue, and pain) and the reason I’m making it through intact. Did I really want to get out of bed and make her an egg during chemo? Not at all. Did she get me out of bed and keep me from giving in to the pain and exhaustion? Absolutely. Did she kiss my bald head and tell me I looked pretty like her hairless dolls? She sure did.

I have been incredibly fortunate to develop deep friendships with a tribe of phenomenal women in “Cancer Land,” some with children and some without. (Someone in one of my support groups said the best way to make new friends in your 30s is to be diagnosed with cancer.) Cancer doesn’t always make a woman infertile, but it very often does, or it can make having a baby after treatment very risky. Most women in the young adult cancer world fall into two categories: those who are never able to have children (which sucks big time) and those who become infertile after completing their families (which also sucks).

This in-between place I find myself in is painful. I don’t feel qualified to feel sad in comparison to those never able to experience carrying a biological child, and I find myself insanely jealous of those women without this additional layer of loss. It has taken me time to label this experience as simply that—a loss—and to learn that I need to grieve it.  

Grief is not a competition, and emotions are not mutually exclusive. I’m learning how to live a life of duality. I can feel happiness for a friend’s new baby and still feel sad for myself. I am not sad about the second child I will never have—my triangle family is beautiful and perfect—but I am sad about the loss of choice. I miss pre-cancer Lauren, but I’m growing to love this new version of myself. She’s still sarcastic and still has an unhealthy obsession with her dog, but cherishes moments just a little bit deeper and holds her daughter just a little bit tighter.

Lauren Rabinowitz was diagnosed with triple positive stage three breast cancer in July of 2020. She lives and works in Washington DC with her husband, daughter and dog.