June 7, 2017

Cancer Diagnosis Yields Big Surprise for New Mom

Read the Spanish version of this story here.

June 7, 2017 | If the circumstances surrounding Angel Castillo’s birth are any indication, his life will be full of surprises.

It was during a routine gynecological exam in January 2016 when Angel’s mom, Carmen Martinez, got some very unexpected news: She had cervical cancer. As a new mom to her then-6-month-old son, Santiago, Martinez feared the worst.

“I thought, what if I die and leave my baby,” she said.

Carmen Martinez (front) holds her son, Angel, while surrounded by her family and a few of the UAMS staff members who supported her during her pregnancy and cancer treatment. Pictured from left to right are Martinez’s husband and son, Luis and Santiago Castillo; Infusion Clinic 1 clinical services manager Brian Dinsmore, R.N.; ANGELS program clinical interpreter Diana Johnson; Cyndi Root, R.N.; and chaplain Beverly Milford.

Martinez was quickly scheduled for a consultation with UAMS gynecologic oncologist Alexander “Sandy” Burnett, M.D., who recommended she undergo a radical trachelectomy. This surgical procedure would remove the cancer but leave her uterus intact, allowing Martinez to have more children in the future if she chose. Burnett is a professor in the Department of Obstetrics and Gynecology in the UAMS College of Medicine.

A native Spanish speaker, Martinez used medical interpreters from the ANGELS program during her visits to UAMS. ANGELS (Antenatal and Neonatal Guidelines, Education and Learning System) is a program of the UAMS Center for Distance Health aimed at helping woman at high risk for complicated pregnancies receive the best possible care.

On the appointed day, Martinez and her husband, Luis Castillo, arrived at the UAMS hospital where she began being prepped for surgery. It wasn’t long, however, when she was told the procedure had to be postponed due to another unexpected surprise. A routine urine test had revealed she was pregnant.

“When they told me I was pregnant, I couldn’t believe it. Dr. Burnett sent me home to think about what I wanted to do next. I felt a little joy about the new baby, but also a lot of fear,” she said.

Together, Martinez and Castillo decided to continue with the pregnancy under the watchful eye of Burnett at the UAMS Winthrop P. Rockefeller Cancer Institute and Dawn Hughes, M.D., a fellow in the UAMS Maternal-Fetal Medicine Fellowship program.

During her medical residency at UAMS, Hughes trained under Burnett, who is board-certified in gynecologic oncology. Martinez’s case allowed the two to work closely again, this time to develop a personalized treatment plan for their patient.

According to a 2013 study published in the journal Therapeutic Advances in Medical Oncology, rates of cervical cancer during pregnancy vary from 0.1 to 12 per 10,000 pregnancies. While rare, it is reportedly the most commonly diagnosed gynecological cancer during pregnancy.

“Dr. Burnett and I spoke early on and decided to delay treatment for the cancer as long as possible. However, when a follow-up exam revealed that the lesion on her cervix was larger than expected, we determined the best course of action was to begin chemotherapy at 20 weeks into her pregnancy,” said Hughes.

A total of six chemo treatments took place in the UAMS Cancer Institute’s Infusion Clinic 1 under Burnett’s guidance, while Hughes performed multiple ultrasounds to monitor the baby’s growth.

“Mrs. Martinez was understandably nervous and always wanted to put the baby’s well-being ahead of her own. We assured her that most of our pregnant patients who undergo chemotherapy do incredibly well, and fortunately she and her baby were no exceptions,” Hughes said.

On Nov. 16, 2016, 5-lb., 14-oz. Angel made his debut via a scheduled C-section, which was immediately followed by a hysterectomy. The experience brought Martinez full circle to the day she found out she was pregnant. “It was a relief to see he was strong and healthy,” she said of her new son.

Martinez’s time at UAMS touched not only her own family, but also those around her. “There was something very special about Mrs. Martinez. She was my first pregnant patient, and on top of that, there was a language barrier to overcome,” said Cyndi Root, R.N., a nurse in the Cancer Institute’s Infusion Clinic 1, who quickly developed a bond with Martinez. “We love all of our patients. They are our family,” she said.

To honor Angel’s birth, the nurses of Infusion Clinic 1 decided that a special gift was in order. They purchased blue yarn, which UAMS chaplain Beverly Milford had blessed by her church, St. James United Methodist Church. Then, volunteers in the Cancer Institute’s Sit & Knit group created a one-of-a-kind baby blanket, which was presented to the family about four months after Angel’s birth.

For now, Martinez is relieved to have two healthy sons and no sign of cancer. “If the cancer doesn’t return for five years, they will declare me cancer free. Angel will be 5 years old then, and that will be a happy day,” she said.