Focusing On Patients

Special delivery
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Typically, a delivery is scheduled between 33 and 35 weeks, when the baby's lungs have finished growing. A normal pregnancy, Dalrymple notes, is about 40 weeks, so while the delivery is earlier than nature intended, it doesn't harm the baby.

"The balancing factors are caring for the mother while protecting her baby. The bottom line is not to jeopardize care to the mother, although we do adjust treatment for pregnancy," says Dalrymple. "Normally, we perform X-rays of the pelvis to see if the cancer has spread, but you don't expose a pregnant woman to radiation."

Performing a Caesarean section followed by a hysterectomy is a delicate procedure that requires clockwork precision by a gynecologic oncologist, peri- natologist, neonatologist and anesthesiologist. All gather in an operating room. A Caesarean section is performed. Once the baby is delivered, he or she is whisked away to the nursery while the oncology team takes over. They take a biopsy to see if the cancer has spread. If it has not, standard treatment is to remove the cervix, uterus, lymph nodes and some pelvic ligaments.

A radical hysterectomy for cancer is more involved than a simple hysterectomy because, as with all cancer surgeries, doctors must remove a layer of cells around the cancer - known as the margin - to make sure they get it all. It's even more complicated with pregnant women, who are at higher risk for blood loss during surgery. The resulting operation is a painstaking, three-hour process as opposed to the 40 minutes usually needed for a simple hysterectomy.

Renita Hampton, her husband Eithyl, daughter Dimonique Hampton and (behind slide) son Brady enjoy a family outing.