Of Bravery, Birth and Beauty

When most women think of pregnancy, they think of joy and the miracle of birth. While an expectant mother knows there may be days she’ll feel fatigued or anxious, it’s very unlikely the thought of cancer will enter her mind. So it was for 30-year-old Sarai Vaca when she became pregnant with her third child. Her previous pregnancies had gone smoothly, and she was now the proud mom of seven-year-old Ezra and two-year-old Amaya. She and her husband, Omar, had every reason to be looking toward the future with anticipation and hope.

Sarai found out she was pregnant in June of 2022. Just two weeks later, her life changed dramatically. It started when she felt a small mass on her left breast, about the size of a marble. When her doctor recommended she get it checked, Sarai went to Providence St. Joseph Hospital for a mammogram and an ultrasound. Those screenings revealed another area on the same breast that caused some concern. When the results came back a few days later, Sarai learned that both samples were cancerous.

Cindy Tran, MD, her hematologist-oncologist, points out that being diagnosed with cancer during a pregnancy is extremely rare, and the important message is to not be afraid to seek care. “If you catch the cancer early, it is still treatable and often curable with the right expertise. The St. Joseph Center for Cancer Prevention and Treatment has nationally recognized physicians and an award-winning cancer program with incredibly caring staff,” says the doctor.

The diagnosis was understandably frightening for this active young woman, who is also a second-grade teacher. She wasn’t sure what her path forward would look like, but Sarai forged ahead with optimism, determination and strength. The doctors told her she had two choices: a mastectomy or a lumpectomy. “The reason I chose a mastectomy is because the chances that I would have to receive chemo and radiation were very low, whereas with lumpectomy the cancer could still be in the margins. I wanted to decrease my odds,” she says.

STRESS AND THE UNKNOWN

Despite her logical decision, another challenge was just around the corner. “Right after my surgery, the doctor told me they took out seven lymph nodes. She said if those were negative, I wouldn’t need chemo or radiation,” Sarai explains. But a few days later, she learned that one lymph node was positive and the cancer had already spread to her armpit. She started a two-month course of chemotherapy.

As one would expect, the fear of the unknown was starting to stress Sarai. In mid-October she had what she now describes as a panic attack, saying, “There was so much going on. I kind of lost it. I was worried the chemo might affect the baby.” It was time for her to start leaning more on the compassionate caregivers all around her. Sarai confided her fears to her nurse navigator, Angela Acevedo. “Angela is amazing,” she says. “She told me I’d have to give it a chance and see how my body would respond. Her advice put me at ease. I really appreciated having someone like Angela there.” The two still keep in touch to this day.

TREATING THE WHOLE PERSON—BODY, MIND AND SPIRIT

Angela is one of many cancer navigators who cared for Sarai throughout her journey. A priority with them all was to treat not just the body but also her emotional and spiritual well-being. From the beginning, Sarai was especially grateful for Dr. Tran. “She came in the first day and said, ‘My goal here is to keep you and the baby safe.’ Once I heard that, I thought, ‘This is just what I want in my care. I want a doctor who is as interested in my baby’s health as my health,’ ” she recalls.
Dr. Tran praises Sarai’s constant determination to do whatever was needed to keep her baby safe while fighting the cancer. “Whenever I have a rough day, it is nothing compared to what my cancer patients have endured. I am always humbled by their journey,” says the doctor.

Sarai’s OB-GYN, Allan Akerman, MD, also couldn’t have been more encouraging. Every time she saw him, she recalls, he praised her positive attitude and stressed how much that was helping her cope. In fact, Sarai was so upbeat that when she told her co-workers she was taking a leave of absence, they were shocked to learn she was pregnant and battling breast cancer at the same time. “They told me they never would have known, because I was coming in every day with a smile on my face.”

The list of Sarai’s incredible caregivers is a long one. In addition to the doctors and her nurse navigator, there was her team of chemo nurses and a social worker. She describes them all as so loving that they made her feel like a rock star. “The last time I saw them was really emotional. I didn’t love the chemo, but I loved being with them. Sometimes it didn’t feel like I was there for treatment. It was more like I was just socializing with my friends. My husband would always tell them, ‘She loves coming here.’”

Sarai delivered Olivia Grace on February 10. She felt a huge sense of relief knowing her daughter had finally arrived, safe and healthy. Dr. Tran and the entire cancer center team are thrilled that mother and baby continue to thrive.

For a grateful mom, baby Olivia is a living symbol of the joy that began Sarai’s journey. “I feel very blessed to be surrounded by so much love.”