scorecardPregnant cancer patients may die because doctors fear treating them could now count as illegal abortion, experts say
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Pregnant cancer patients may die because doctors fear treating them could now count as illegal abortion, experts say

Marianne Guenot   

Pregnant cancer patients may die because doctors fear treating them could now count as illegal abortion, experts say
LifeScience3 min read
  • The reversal of Roe v. Wade has opened the door for much more restrictive abortion laws.
  • Some may end up stopping cancer care in cases where it could end a pregnancy, experts said.

The overturning of Roe v. Wade is likely to end in the deaths of cancer patients who become pregnant by preventing them from getting treatment, experts told Insider.

Doctors may fear giving some treatments if they could lead to ending the pregnancy, which could risk breaking the state laws banning abortion, even when someone needs it, the experts said.

Before the Supreme Court ruling, pregnant people and doctors could decide on treatment like this based only on medical factors and make their own judgments about the risk to a pregnancy.

More-restrictive laws could make doctors reluctant to give treatments even when the patient needs it to survive, for fear of being charged with illegally delivering an abortion, the experts said.

"This ruling calls into question giving treatment that may cause termination of pregnancy (even if intended to treat cancer)," Dr. Stephanie Blank, president of the Society of Gynecologic Oncology, told Insider.

Many cancer treatments will not affect the pregnancy. Surgery, for instance to remove tumors, is usually not a big risk, said Dr. Karen Knudsen, CEO of the American Cancer Society.

But chemotherapy and radiation therapy can, in some cases, affect a fetus and raise the risk of miscarriage, said Blank, who is also the director of Gynecologic Oncology for the Mount Sinai Health System.

Some cancers, like cervical cancer or gestational trophoblastic disease, are not possible to treat without ending a pregnancy, she said.

Providers are at risk if they are found guilty of unlawfully helping to terminate a pregnancy, Katie Keith, director of the Health Policy and the Law Initiative at the O'Neill Institute, told Insider.

"You're putting physicians in an impossible situation and they're not going to provide the care for fear of the liability," she said.

In some states, they could risk a fine or lose their medical license. In others, they could be imprisoned, she said.

"We're now in sort of this hellscape of a very state-by-state situation," Keith said.

States might also try to use the reversal of Roe v. Wade to criminalize pregnant people for pregnancies gone wrong, said Michelle Banker, Director of Reproductive Rights and Health Litigation at the National Women's Law Center in an interview with Insider.

"People suffering miscarriage may be forced to justify or prove that the miscarriage was not their fault," Banker said.

Knudsen, the American Cancer Society CEO, pointed to a case in the Dominican Republic to show what could be coming in the US.

Rosaura Almonte, known by the media as "Esperancita," was 16 when she was diagnosed with leukemia. Because she was seven weeks pregnant, courts denied her treatment for 20 days while they decided whether it was legal. She died shortly after.

Had she been given the treatment immediately, she would have had a much higher chance of survival, Knudsen said.

"I can't say this forcefully enough. There is a strong correlation between early intervention and better outcomes," said Knudsen.

She added that the ACS is not taking sides on last week's Roe ruling, but is "deeply concerned" about its effect on cancer patients.

The ruling has already had consequences in the US.

On Monday, the Women's Med Center in Dayton, Ohio, turned away a cancer patient seeking an abortion before her chemotherapy, said Val Haskell, who runs the center.

A "heartbeat" bill to ban abortion after six weeks came into effect on the day the Supreme Court ruling came down.

Haskell said the woman did not expected to get pregnant and discovered her pregnancy in June, midway through her cancer treatment.

Her doctors, Haskell said, immediately ended her treatment and medication. She was past the six-week Ohio threshold when the Supreme Court ruling came down, leaving her with no access to abortion within the state.

Haskell said the woman instead crossed state lines to Indiana for termination on June 30.

Knudsen said that pregnant people could find themselves excluded from newer cancer treatments as well, like immunotherapy. Pregnant people are generally excluded from clinical trials, so providing legal certainty that a fetus would be unharmed could prove impossible.