Dr. Dirk Pikaart at UCHealth Memorial Hospital Central helped to save her life
It’s an unusually cold morning in June, a foggy day when it feels more like winter than spring. It makes no difference to Amber Appleton. She’s got her youngest children, Phynn and Everly Appleton, out at Fox Run Park in Black Forest.
Amber smiles as the children play, zig-zagging through a thicket of trees in a game of Hide and Seek with older brother Tanner and dad Greg. The game doesn’t last long before Phynn takes off in a full sprint for the nearby playground. With Spiderman qualities, he scurries up the ladder then cruises down a slide.
This is the kind of day that Amber lives for, one filled with the simple pleasure of watching her children frolic as if they had Red Bull for breakfast. (They didn’t.)
“I don’t expect anything extraordinary after this,’’ she said. “I just want to live and enjoy the simple things.’’
A little more than two years ago, Amber committed to taking the high road and giving back to others whenever she could. At eight months pregnant with Everly, now 2, a doctor discovered something he didn’t like and sent her to Dr. Dirk Pikaart, a gynecologic oncologist at UCHealth Memorial Hospital. Tests confirmed cervical cancer, which is often found when women seek care for pregnancy because a pap smear is included during a prenatal visit.
Then 35, Amber was in such shock when she received the diagnosis that she didn’t leave the doctor’s office for the next six hours. She had so many questions. No. 1, of course, was whether her baby would be born healthy. No. 2, would she live?
“When I sat down with them, it was if I was the only patient that day, and they weren’t going to leave the room until they could get a sense that I was ready to leave. They were great, their attentiveness and their attention to detail. It was very helpful,’’ she said.
With terrific support from her husband and her mother, Amber managed a tsunami of emotion. She focused on her health and that of her unborn child. She had one plan: “I’ve got to do everything possible to make sure that she gets into this world healthy and that I live so that I can take care of her. And so I did.
“We waited to seek out treatment until after she was born because I was so close. They were just going to keep a close eye and monitor me until she was born,’’ Amber said.
Pikaart said that many women delay treatment of cancer during a pregnancy to save their child.
“There’s a growing body of evidence that if done carefully with proper guidance from a gynecologic oncologist, the pregnancy can be saved with little risk to the mother and baby,’’ Pikaart said.
Four weeks after Amber was diagnosed with cervical cancer, Everly was born healthy. Amber, though, had taken a turn. The tumor, small only a month earlier, had grown to the outside of her cervix. She had a radical hysterectomy. A few weeks later, tests showed the cancer had spread to a lymph node.
“Cancers can grow at different rates so waiting involves close monitoring to make sure there is no significant progression while the baby matures to a safe gestational age to deliver. Many cancer treatments including surgery and chemotherapy can be administered to pregnant mothers with no harm to the baby if done properly at the right time during the pregnancy,’’ Pikaart said.
After delivering Everly, Amber felt that cancer dictated her life.
“I had to get into treatment, which was devastating to me because I couldn’t be a normal mother to her. I couldn’t nurture the same. I couldn’t breast feed because I had to quickly get on medications and do all kinds of testing,’’ she said.
Pikaart prescribed chemotherapy and radiation, a regimen that left her worn out. Her husband and mother scrambled to keep up with the everyday needs of the family. Though her energy was depleted, Amber vowed to fight. And she made a promise to herself. If she lived, she vowed to give back to those who had helped her and to reach out to other women who were facing cancer.
“All I could think about were the simple things that I want to do with the kids like go to the park. I wanted to hold Everly. All I could think about was my daughter. I want to see her get married. Throughout it all, I kept telling myself, ‘I will not take myself for granted. I’ve got to get through this. I didn’t have these children to have them grow up without a mother.’’
Amber’s mother was unwavering in her love for her daughter and granddaughter. She got up every two hours in the middle of the night to feed Everly. Most nights, Amber did not have the strength to get out of bed, let alone hold her newborn. One night, as she lay in bed, she heard Everly crying. Her mother, drained by lack of sleep, was exhausted. After hearing her baby cry, Amber mustered the physical strength she needed to get out of bed and feed Everly. She admits she was only going through the motions.
“I remember getting up, and I had no emotion, no empathy, no anything for her. My brain was even numb. Chemo does some pretty nasty things to you. When you are so numb and your body has literally defeated you and you feel like, ‘Guess what? You are no longer in control.’ I was in a very dark place. And as a new mother, it was killing me inside but I just didn’t know how to fight it.’’
Two years later, Amber draws on her memory of that night to help other women who are battling gynecologic cancer. Now cancer free, she has become one of the regional spokeswomen for a group called Cervivor, a nonprofit organization that brings cervical cancer survivors together and helps to spread awareness, educate and support.
Amber advocates in a support group at UCHealth for patients diagnosed with obstetrical cancer. The group meets every month, offering patients an opportunity to share their sisterhood, ask questions and learn from each other. Topics range from healthy diets and exercise to improving emotional well-being. Clinicians offer tips and education about the cancer journey.
Pikaart said that patients going through a stressful diagnosis need proper support as much as proper treatment.
“Family, friends, pets and medical teams are important parts of this support. The patients all play a mind game and go through a lot psychologically. Let’s face it, the mind is a powerful thing and positive thoughts can help patients as much as negative thinking can hurt them,’’ Pikaart said.
Amber finished her treatment in July 2017. Admittedly, she said, she was in the worse shape of her life, mentally and physically. She’d gained 80 pounds, which she has since lost.
“In the last year and a half, I’ve gotten back to running, which I really enjoy. I got back to doing what I like to do. Then I began advocating and talking about the resources that are out there and the help and support that is available,’’ she said. “It’s amazing how much is out there.’’
In talking with other women, she has two key messages for others. The first is a reminder for women to take care of themselves.
“A woman must advocate for her body. Advocate for yourself. Looking back in my life, I feel like there are moments when I could have been more diligent. And that’s a story I hear a lot – I didn’t go to the doctor. Women tell me they put their families or their work first and their health was not a priority,’’ she said.
The second lesson, she said, is for parents to make sure their children get the HPV vaccine.
“I would have never had this cancer if I had had the vaccine. It wasn’t around then – I didn’t have that privilege. But now parents can do something about it for their children,’’ she said.
Amber sees Dr. Pikaart every three months. She is doing well physically and emotionally. She’s kept her promise to always seek the high road and to help others.
Whenever she can, she takes her kids to a park.