Pregnancy later in life and cancer?

[question everything]

First, this is not to second guess the Edwards. I respect both of them. I contributed to and voted for him in 2004 before he dropped out, and will probably do the same again.

Whether or not Elizabeth chooses to continue with her life or withdraw and spend every minute with her kids is her decision. (Can spending every minute with the kids deteriorate to "do as I say because some years down the road you would wish that I were here to tell you what to do?")

But I think that Elizabeth may provide some information about the risks of getting pregnant at a later age (48) when peri-menapause starts with all the hormonal imbalance. Some breast cancer cells are stimulated by estrogen, when removal of the estrogen-producing ovaries is often one of the treatments. (I don't know about Elizabeth and it is none of my business). But for women considering getting pregnant at such a late age, I think that this is a question that needs to be addressed: whether throwing such a wrench at the delicate hormonal balance may stimulate the growth of estrogen-dependent cancer cells.

No, I am not second guessing their decisions to have two more children - again, none of my business - but Elizabeth does want to offer a legacy of continuing with her life, of not cowering in a corner or withdrawing.

After Betty Ford told the world about her breast cancer, many women rushed to have mammograms to detect any early signs of cancer, perhaps saving many lives.

Thus, perhaps, part of Elizabeth Edwards' legacy would be for women over 40 who consider getting pregnant, to include this risk factor, too.

OK, start flaming.

[valerief]

1. Betty Ford's last baby was at age 39. She was an alcoholic. nt

[CTyankee]

2. Actually, I thought the same thing and wondered about it. But I am not

a medical person so it was just idle speculation on my part. It seems to make sense tho.

Does anyone have statistics on the onset of breast cancer after late pregnancies?

[depakid]

3. I haven't seen any data on that

but I have seen studies that show that early pregnancy seems to be a protective factor against breast cancer.

[stellanoir]

4. Though I have enormous respect for Elizabeth and any woman with the stamina to have and raise

little ones later in life, given how endocrinology is one of the bigger mysteries in medicine, I wondered about the fertility hormone's influence as well.

No flames from me.

Far better to sending healing vibes to her I figure.

[likesmountains 52]

5. There are too many risk factors for breast cancer to make any

generalizations..and there is also evidence that mammograms aren't the miracle early detection exam that they were believed to be..And I believe that if a woman really wants to have a baby the fear of a future breast tumor won't make her have a change of heart..

[havocmom]

18. Yep. Too many cancers missed by mammograms

and I know women who had children young who got breast cancer later in life. Can't pin it on any one thing.

[Contrary1]

32. Not just "missed"

I found the lump myself, just 6 months after getting the all clear postcard in the mail.
After picking up the films, I discovered that the suspicious area was noticed. In fact,
the tumor was circled, with an arrow drawn to it, along with a question mark. No mention
of it was ever written up.

At the time, I thought that the technician who took the films, seemed a bit out of sorts.
If she had been more attentive, she would have not only noticed the very obvious lesion,
but would have taken even more films.

Education is the key. Women should insist upon seeing the mammography films, ask questions
and get copies of the report.

[question everything]

34. Sorry to hear that. Hope that you did catch it on time

and that your prognoses are excellent.

[Contrary1]

37. Thank you for your good thoughts...

I am almost 10 years out. It was a rough couple years, and I live with it every
day. But, cancer taught me that we are all our own best advocates. I now ask
questions, demand to see lab results, still do lots of research, etc...

I shudder to think of what the outcome may have been, if I had not found it myself.

I applaud all those who share their struggle publicly. Only good can come from that.



Take care. :hi:

[question everything]

30. True. But for the ones not aware of such a risk

if exists, thanks to Elizabeth Edwards they will have more tools for informed decisions.

[Avalux]

6. No flames, but if you're gonna throw out that hypothesis, back it up.

There's no scientific data that showing a link between a second, third, etc. pregnancy later in life and breast cancer. You are mixing up the stated risk factor of having a first child after the age of 35, which MAY give one an increased risk, but we really just don't know; it's like saying abortion causes breast cancer.

[question everything]

31. Only hypothesis based on data that some cancer cells

are stimulated by estrogen. This is why recent drugs bind to estrogen receptors to block estrogen molecules.

And the data that at this age hormonal cycles start to get out of whack and, of course, that pregnancy changes the hormonal cycles, too.

Adding the known data I reached the hypothesis. Perhaps Elizabeth's case would cause researchers to look at data. I am sure there are plenty, it is only a matter of selecting specific criteria to study them.

As stated above, even if there is a link, this may not prevent women who have longed for a baby to abort once they are pregnant at late age, but it should be one more factor for them to consider, thanks to Elizabeth.

[no_hypocrisy]

7. There have been other medical warnings against having children

at ages later than 35 or 40, such as a higher risk for Down's Syndrome.

But with the proper medical advice, genetic testing and sonograms, a woman can make a well-reasoned decision at this point in time and with new medical discoveries, the chances of harm to either the mother or the fetus will be reduced. The odds are not 100 out of 100. I don't see this as a barrier to woman having children after a certain age if they can conceive.

[Generator]

8. I was just thinking about Wendy Wasserstein

There is a controversy whether fertility drugs and the like also raise cancer risks. But more than anything why oh why (oh non scientific I) does it have to be the people that are sweetest, funniest, most interesting-(Andy, Molly Ivins..and now EE) that this has to happen to? Why, oh why? OH YES..I won't say their names..I'm not that nasty..but why do the good seem to die faster and younger than the bad? When was the last time an evil right wing propagandist died young? Can you name any? Maybe this is the hell realm and the good realm is beyond. It certainly seems that way many days to me.

[kestrel91316]

9. Can you cite actual clinical data to back up your theory? It is

an interesting theory, but without actual clinical data it's just meaningless speculation.......

[Berry Cool]

10. Exactly. It's also utterly pointless speculation if it turns out that Elizabeth's cancer

is not the kind that is stimulated by estrogen at all. In that case, hormones truly have zip, zero, nada to do with her having this.

I'm so tired of the women who get breast cancer being blamed for bringing it on themselves. It's time we quit with the "You didn't watch your diet enough" and "You didn't watch your weight enough" and "You got too stressed out" and "You didn't have babies early enough in life" garbage and started looking at the possibility of this thing being environmentally caused and not always the result of some way a woman made some lifestyle decision that caused her to get the disease.

[question everything]

33. Did not imply that anyone who gets sick "brings it upon oneslef."

Not even smokers, since many of us know so many smokers who lived to a ripe old age.

Medicine has been called "the youngest science" for a reason. Most of it is based on theory and statistics and even what is once considered a "sure thing" is later being discounted: Hormone Replacement Therapy, antibiotics, stents..

But IF there is a risk factor, Elizabeth's legacy will be to bring it to light, to study it and perhaps to be ready for it when a peri menapausal woman IS becoming pregnant.

[undeterred]

11. Well geez.

I'm a 50 year old female who has never been pregnant and I've actually heard that I'm in a higher risk group for ovarian cancer than a woman who has been pregnant. Women are always punished for our choices, I guess.

[treestar]

13. Exactly, or that's the way the MSM would have it

Get pregnant later in life? you'll get cancer.
Get pregnant young? You'll get cancer.
Get pregnant many times? You'll get cancer.
Never get pregnant? You'll get cancer.
have a lot of sex? You'll get cancer.
Don't have sex? You'll get cancer.
Get married? The stress will give you cancer.
don't get married? The "loneliness" will give you cancer.
Take the pill? It'll give you cancer.
Don't take the pill? You'll get cancer.

Cancer is strange, the only real link is smoking with lung cancer.

Elizabeth got this through a combination of genes, diet, various and sundry life choices, drugs prescribed or just pure chance, or factors not understood. It's not her fault. It's life's fault. It's God's decision. It's Dubya's fault. hell, it's Clinton's fault.

[undeterred]

14. And my 80 year old mother who refused to take ERT

and has never had a mammogram in her life (because she's heard they hurt) is apparently cancer free.

[Clark2008]

12. How late is late?

I'm 37 and, while I am swelling up the size of Mrs. Puff on Spongebob in my final trimester (with no other signs of preclampsia, I should add - BP's fine and no protein), my pregnancy has been relatively easy.

P.S. I should also add that my pregnancy was a surprise. I wasn't trying and certainly wasn't using ANY hormones. I can't even take the Pill.

[annabanana]

15. Clearly you're not TOO late!

My youngest was born when I was 39.. My family has a fierce history with B cancer.. but so far so good.

Mammograms are mandatory here.

[DemBones DemBones]

19. I don't think 37 is "late." My grandmother gave birth at 40, back in the Thirties.

Doctors today sometimes act as if pregnancies in women over 30 are something new. :shrug:

As I said, my grandmother had her last child when she was 40, back in the Thirties, about fourteen years after her seond child was born. My mother had her last at 35, in the Fifties. Her second was born when she was 30. Nobody called those "late" pregnancies, and they didn't have any problems, either.

Surprise babies are nice! Congratulations! :-)

[Clark2008]

20. My doctor didn't act as if it were new.

He did send me for nuchal translucency testing, but since that was hunky-dorey, he didn't send me for anything else.

[question everything]

35. I was talking about peri menapause that starts at different

age for different women with average age, I think, of 45-50. And this is when hormonal imbalance starts.

Elizabeth had her youngest children at 48 and 50.

[Lex]

16. Maybe the fertility drugs carry some risk too.

:shrug:

[tnlefty]

17. I wasn't aware that pregnancy later in life had any risk factors.

My youngest was born when I was 35, but nothing was ever mentioned about pregnancy later than that besides the possible birth defects that were elevated at 30 when I began. Damn.

The only thing that was mentioned was that breastfeeding without supplements for the first 6 months seemed to be protective against breast cancer for me along with the benefits to the neonates.

[DemBones DemBones]

26. It's the heavy doses of estrogen given to women

who are having difficulty conceiving, or have chosen to have IVF due to difficulty conceiving, that MAY increase a woman's risk of breast cancer. Usually, these women are over 30, as ELizabeth Edwards was when she had her two younger children. ( I think she was over 40, actually.) It's not the age during pregnancy that's the concern.

Oral contraceptives MAY increase the risk of breast cancer, hormone replacement therapy after menopause or hysterectomy MAY increase a woman's risk of breast cancer.

Women are supposed to be advised of the potential risks before taking any hormones. We all choose to take risks when we feel the benefits will outweigh the risks.

As a result of hormone treatments (and possibly IVF, I don't know for sure whether that's ever been stated) Elizabeth Edwards had two children that she wanted. Maybe her breast cancer was caused by the hormones, maybe it would have happened anyway. There are usually several variables involved in causing cancer.

I have a friend who went through multiple IVF attempts with only two miscarriages and an ectopic pregnancy to show for it; this was a good ten years before the Edwards children were born and my friend has not developed breast cancer. I have another friend who'll be 90 this spring and she's been taking estrogen for forty years, with no problems.


There is good evidence that breast feeding for six months without supplements (for you non-parents, that means no slipping the baby a bottle of formula, or feeding any cereal) DECREASES a woman's risk of breast cancer, besides being best for babies. Neonates get a huge benefit even if the mother only nurses for a few days, when she is producing colustrum prior to producing milk.

[moc]

28. Breast cancer has not been implicated in fertility drugs.

Just pulled up the citations. The evidence suggests that ovulation induction does not increase the risk of BC. It *may* increase the risk of ovarian cancer, but findings are mixed.

Also, keep in mind that fertility drugs are not synonymous with estrogen. The drugs that are given to hyperstimulate ovulation are FSH and LH (follicle stimulating hormone and leutinizing hormone), not estrogen. This includes drugs like pergonal (one of the older drugs, the one I was on) and newer drugs like follistim and gonal-f.

Finally, it's not clear EE received ovulation induction. She only would have if she had used her own eggs. At her age of conception, I wouldn't be surprised if she used donor eggs. If that's the case, it's the donor who is hyperstimmed, not the recipient.

[tnlefty]

29. I had difficulty, had surgery, but I was given progesterone

supplements for the post possible conception phase. We were scheduled for shots (I forget the name of the drug) and GIFT and we finally did it on our own and with the progesterone supplements I was a crazy woman and I was taken off of those within the first 2 weeks post conception.

I was always deemed a high risk pregnancy, but as I stated, no one ever mentioned an elevated risk if I chose to try it again when I would've been even older. The only thing that was mentioned was a reduced risk of breast cancer by breastfeeding, which I did with the younger 2, but didn't have the same support with the preemie (the first) after he left the hospital when I could pump and then when he was deemed OK, I was allowed to spend time with him in the neo-natal unit while he nursed and fell asleep because it was tiring, only to wake up and begin nursing again. I didn't have the support that I needed for the one who probably needed it the most!

I have to take exception to your use of the word "only" in relation to your friend's miscarriages. I had one when my oldest was 9 months old, and I delivered another son at 24 weeks and 5 days after being in the hospital for 6 days. These events were emotionally painful for me and my spouse, but it has only made me more pro-choice than I was before.

I would never even begin to criticize Mrs. Edwards for her choices, but I hope if there is an elevated risk to her health that physicians told her clearly about that risk.

[moc]

21. Pregnancy is a protective factor against breast cancer.

Not saying it's causal; just that parity is inversely associated with breast cancer. Some suggest that lactation is protective.

Never heard any data regarding late pregnancy and breast cancer. I don't think it would make a difference, though.

[Lex]

22. I think the risk factor may come with the fertility drugs

not the pregnancy itself.

[moc]

25. I used fertility drugs for my last pg (gave birth at 40) so I saw those

data when they came out. I don't recall the details just that I wasn't that impressed by the findings. (I'm a public health academic.)

ETA: I wouldn't be that sure the Elizabeth Edwards used fertility drugs. At her age, I would guess that it's more likely she had donor eggs. (I've never heard one way or the other; just guessing based on what I know of fertility tx in older moms.) If that's the case, she didn't have ovulation induction (the fert drugs implicated by that research I referred to.)

[wicket]

23. My grandmother had her last baby at 48

And she's still going strong at 86 (never had cancer either).

[NashVegas]

24. My Grandmother Had Her First Child at Age 18

And eventually had a double mastectomy.

There's no exact science.

[DemBones DemBones]

27. No exact medical science, at least.

Too many genetic and environmental variables.

[Tinksrival]

36. I read an interesting article yesterday that was linked through Huffpo

It was a slate article from Oct-2004.

medical examiner: Health and medicine explained.
Did Elizabeth Edwards Use Donor Eggs?All signs point to yes.

http://www.slate.com/id/2108863/

snip>>>>>>

Do the math, and it's not hard to figure out that Edwards gave birth to Emma Claire at age 48 and Jack at 50. And yet if Edwards used her own eggs, this is all but impossible—a woman's ovaries completely stop producing viable eggs by age 45 in all but a tiny percentage of women.

Snip>>>>>


Donor eggs, I guess you can add this to your ponderings.

[question everything]

38. Again, it is not my business how

the children were conceived. Only that pregnancy does involve hormonal changes. And if a 48 year old woman, now at least perimenapausal, is getting pregnant, this may increase her risk for breast cancer - the type that grows when exposed to estrogen.

And if Elizabeth's cancer is of that type, then perhaps her experience can add to the information presented to women of that age who consider pregnancies. This, too, can be her legacy.