'My pregnancy gave me a rare cancer at 39'

Naomi Smart and her husband Maik were overjoyed to welcome baby Annie along with excited big sister Heidi, aged three.

Naomi had heavy bleeding after an emergency C-section operation, and she became concerned the bleeding stopped but started again six weeks after the birth.

The 39-year-old was also suffering severe fatigue, but said she felt fobbed off when she went to her doctor. “My GP said, ‘It’s nothing,'” she said. “You’re tired because you’ve got a newborn. You’re bleeding because it’s your cycle starting again.

“But I was exclusively breastfeeding, which I’d also done with my first baby and my period hadn’t come back so quick and so heavy then.”

Naomi’s symptoms weren’t just “nothing”. The veterinary nurse soon began getting extremely painful thunderclap headaches, which made her vomit.

Medics initially suspected she may have had a retained placenta – when some or all of the temporary organ stays in the womb – and then they thought she had a blood clot on the brain.

But a scan revealed Naomi had multiple metastatic tumours – which is when cancer has spread to a different part of the body than where it started. She was devastated to learn it had spread to her brain, lungs, kidneys and spleen.

“They said with me being young, female and a non-smoker, it didn’t make sense that I had primary lung cancer,” said Naomi, who works for Guide Dogs for the Blind.

After tests, she was told she had choriocarcinoma, a rare and aggressive cancer that develops from cells that were part of the placenta during pregnancy. It happens in about one in every 50,000 pregnancies, according to Cancer Research UK.

“I’d never heard if it before,” said Naomi. “And sometimes when I’d gone into A&E neither had some of the medics.”

Treatment needed urgently

Chorio refers to the word chorion, which is the outer covering of the foetus, while carcinoma means cancer that starts in cells that make up the skin or the tissue lining organs.

While it is more common after a molar pregnancy (when a foetus doesn’t form properly in the womb), it can also happen after a full term pregnancy, miscarriage, ectopic pregnancy or abortion.

The disease can develop some months or even years after pregnancy.

As well as irregular vaginal bleeding and pelvic pain, symptoms can include seizures and headaches if it spreads to the brain, and pain in the abdomen if it grows in the kidneys or liver.

“I was also getting confused,” said Naomi, from Appley Bridge in Lancashire. “I had scanned and paid for my shopping at the supermarket and left it behind, and stopped at a green light in the car.”

The disease can be difficult to diagnose because it is so rare. Naomi’s choriocarcinoma was confirmed after doctors discovered her human chorionic gonadotropin (hCG) levels were off the charts.

These levels are raised in pregnancy but after delivery should drop rapidly, returning to normal levels by the third week postpartum. “Mine were 46,000 when they should have been zero,” she said.

“I was warned that the disease can grow quickly and can spread within a few days, so I needed treatment urgently.”

Shortly after being told about the brain tumours, Naomi’s headaches became very intense and she was rushed for life-saving surgery to deal with a bleed on the brain. A few days later, she had a second operation to stablise more tumours at risk of bleeding.

Naomi then endured five months of chemotherapy, which ended in February.

Challenges juggling life

Going through cancer is difficult at any stage of your life, but particularly hard with a newborn and a toddler. The surgeries have left Naomi with a brain injury that has caused loss of function down one side of the body and partial loss of vision.

“I had to stop breastfeeding Annie when I had surgery, and it was hard to break that bond,” she said. “Heidi is at that age where she is testing boundaries, and I’m always quite calm in my parenting but feeling so fatigued, I didnt have the patience. But I’m trying to go easy on myself for that.

“Heidi is old enough to realise when I was ill and throwing up. We haven’t mentioned the C word, she is too young. We’ve just told her that mummy is unwell with headaches. She tells me she is being quiet to help my headaches.”

Maik, who also works for Guide Dogs for the Blind, had to stop work to look after the children. Naomi’s friend has set up a GoFundMe to help with the family’s expenses while she is recovering.

Most cases of choriocarcinoma can be cured, and, as with most cancers, treating it early has the most successful results.

“I’ve responded well to treatment. My tumours have shrunk, they’re still there but inactive. I was told that if it is going to come back, it will probably be in the first 12 months so we have an anxious wait to see. I was told I have a 95 per cent chance of survival, so I’m hopeful.

“I want to tell people to keep pushing and questioning if they feel there’s something not right.”

Do you have a real life story? Email claudia.tanner@inews.co.uk.