When Sarah Joanis found out she was pregnant, she was so thrilled -- and surprised -- that she took 12 home pregnancy tests in a row and photographed the positive results.
Three months later, however, Sarah, a former Michigander, and her husband, Kevin, who now live in Plainfield, Ill., received another shock: Her ovarian cancer had returned. She was 29 years old.
One of every 1,000 pregnant women in the United States has cancer, a stark convergence of life and death. For these women, treatment is possible. But it comes with terrifying decisions for the family.
Do you start chemotherapy, which could harm the fetus? Or do you delay treatment, potentially risking the woman's life?
Cancer and pregnancy "throws families into the worst scenario possible," said Dr. Gideon Koren, director of the Hospital for Sick Children's Motherisk Program at the University of Toronto. "I can't think of many other situations in life so devastating and difficult."
Sarah desperately wanted her baby. Kevin wanted to grow old with his wife even more. Ultimately, after many heart-wrenching conversations, they agreed Sarah and their baby would go through her chemo and ovarian surgery together.
It was a harrowing journey, but the couple now have another, happier worry: caring for Natalie Elizabeth Joanis, their daughter, who recently celebrated her first birthday.
Statistically, Sarah was an unlikely candidate for epithelial ovarian cancer. She was 26 and working as an electrical engineer for Ford in Detroit when she was diagnosed with a disease that typically targets women older than 55.
But on Super Bowl Sunday 2006, Sarah woke up with sharp abdominal pain that turned out to be a tumor. Doctors were able to remove the growth, along with her left fallopian tube. Because Sarah was young and wanted children -- and everything else looked good -- she didn't undergo chemo, which could have damaged her fertility.
The scare gave Sarah a new outlook on life and for the next two years she seized her moments. She finished her MBA at the University of Chicago by commuting from Michigan on weekends, married her soul mate and moved back to the Chicago area, where she had grown up.