A mother who found out that she was pregnant AND that she had high grade cancer, all within a matter of days, has paid tribute to experts at Liverpool Women's for saving her life and that of her baby with ground-breaking surgery.
Diane Mullineux of Wirral, went to theatre at Liverpool Women's when she was 11 weeks pregnant for the removal of a cancerous tumour from her cervix along with most of her cervix. This was followed by a laproscopic (keyhole) procedure to remove her lymph nodes.
Liverpool Women's is the first in the world to report carrying out these procedures at this stage of pregnancy, says Diane's surgeon, Mr Jonathan Herod, Consultant Gynaecological Surgeon/Oncologist.
Diane was warned that there was a risk of miscarriage during the operation. Also, that if the baby survived, Diane would have to have a radical hysterectomy as soon a it was safe for her baby to be delivered. But Diane was prepared to go through all that and more so long as her baby survived.
Her ordeal had begun last August when she and her partner, Nicky Dures, were celebrating the fact that she was pregnant. But then Diane received a call following a routine smear test carried out before she realised she was pregnant. The news was devastating. She had high grade cervical cancer.
"One minute we had been so happy at the thought of the baby. Then suddenly I was faced with a life-threatening condition," says hairdresser Diane. She was advised at a Wirral hospital that standard procedure was to have an immediate termination followed by a hysterectomy. It was pointed out that Diane already had two children, Billy, eight and three-year-old Sadie from a previous relationship. But this pregnancy was to be a first child with Nicky, her partner for two years. Desperate to keep the baby, Diane asked for a second opinion and was referred to Mr Herod at Liverpool Women's. He has pioneered fertility saving surgery for North West women with cervical cancer.
"He was like a breath of fresh air. He gave me hope," says Diane. "He said that even though I was pregnant, he could operate to remove the tumour and hopefully stop the cancer spreading. But there was a risk of miscarriage because they would be working so close to the womb."
Diane had life-saving surgery on September 19th last year and her lymp nodes removed to see if the cancer had spread. "That test came back clear but Mr Herod said there were still some worrying cells in my cervix. Because of that I would have to have a hysterectomy immediately after the birth.
"I knew the cancer might come back while I was having the baby. It was a very anxious time because I hardly had any cervix and might need a stitch to carry the baby. But I was scanned every two weeks and managed without. All I wanted was for the baby to survive."
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Diane got her wish on February 20th, 2014, two days after her 30th birthday, when the couple’s dark-haired daughter, Nancy Rose was delivered by caesarean at 33 weeks and five days at Liverpool Women’s. She weighed 4lbs 9oz.
"The theatre was full of people when I went in, says Diane. "There was the caesarean team, the neonatal team and the hysterectomy team."
Courageous Diane had an epidural so as to be awake for the birth. "I saw Nancy for a minute and then I was given a general anaesthetic for the hysterectomy. That night, even though I felt very tired, I asked to be taken to the neonatal unit in a wheelchair to see her. I felt overwhelmed when I saw her. We had been through so much together. I felt guilty that she had to be delivered early because of me. I wished she could have been born at the normal time."
Diane only found out later that Nancy had stopped breathing soon after birth and had to be rushed to special care and be put on a ventilator for some hours. She and Nancy spent some weeks on the new Transitional Care unit which meant that Diane could stay in the Women's with Nancy until her daughter was ready to go home instead of being discharged and having to visit her daily. "That was brilliant," says Diane.
"I am so grateful to Liverpool Women's. They gave me hope when I thought there wasn’t any. Without them we wouldn’t have Nancy now. I don’t think I was particularly brave but I couldn’t have done it without Nicky. He loves Nancy so much. She is going to be a real daddy's girl."
Said Nicky, 38: "Diane is an amazing woman to have gone through all this. She was so positive and calm all the time. Even on the day of her operations she was very relaxed about it all and smiling. I am very proud of her."
Diane's consultant, Mr Jonathan Herod, said he had previously treated two women under similar circumstances and both had excellent outcomes with healthy babies delivered and no evidence of any further problems related to the cancer.Those two cases were the first ever to be reported of such treatment while pregnant anywhere in the world. Diane was at a later stage than they were but as she wanted to keep her baby so much he offered her the opportunity to have the same treatment.
"She agreed and therefore underwent a Cone biopsy of the cervix and a laparoscopic (keyhole) operation to remove her lymph nodes. This was carried out when she was about 11 weeks pregnant. The lymph nodes were all negative but there was more disease in the cervix.
"We explained to Diane that there would be a risk of miscarriage and that some of the disease might still be in the cervix but after consideration it was decided that we would go forward with the pregnancy and deliver her by a caesarean section once it was safe for the baby and carry out a radical hysterectomy at the same time.
"We are delighted that there is no evidence of disease in tests done following her hysterectomy. Her baby is doing well and Diane is making an excellent recovery. She is a very brave and strong woman."