I Was Diagnosed With An Incurable Cancer. How Do I Decide Whether Or Not To Have Children?

Until the winter of my 27th year, I was positive that my future would include being a parent. 

As a young child, I loved playing with dolls and would take care in naming them. It felt important, a practice in recognizing the identity and agency of something I was in charge of. I would dress them cautiously, my hand cupped behind their heads as I snapped the buttons on their onesies, just as I had seen my mom do with my two younger brothers. 

As I grew older, my interest in dolls ended; however, my passion for children did not. I babysat kids in my neighborhood during my early teens, nannied consistently for families in college, and after graduating, began pursuing a career in behavioral health, focusing on developmental trauma and foster care. I wanted to help children cope with the hardships of life, especially those who had experienced early abuse and neglect. I believe in the powerful resilience of children and place a high value on the importance of raising children in a way that makes our world better. 

While working in pediatric mental health, I continued to quietly dream of my own someday-family. The specific way my family would look was still up in the air — I had mixed feelings about whether I wanted to have children biologically, adopt or foster; however, I had little doubt I would be a mother in some way when I was ready. 

I was certain it was what I wanted, my intention set, my decision firm. 

Then, in January of 2019, at the age of 27, I was diagnosed with brain cancer. The diagnosis followed a six-hour brain surgery and four-day ICU stay. I had previously been assured the tumor that they removed from my right parietal lobe was most likely a low-grade glioma and that after the surgery, I’d be able to return to my life. 

Instead, a few days after leaving the hospital, I returned to a sterile exam room where a kind, somber doctor told me how the pathology report indicated that the tumor was cancerous: an anaplastic astrocytoma, grade 3 out of 4, one step before a terminal glioblastoma. This new doctor was to be my neuro-oncologist, part of a care team I’d need for the rest of my life. My cancer, while treatable, is considered incurable. 

My cancer tends to return, and when and where within the brain it returns is unpredictable. Many people with my diagnosis are able to live long and fulfilling lives. The treatments are improving, statistics are outdated and changing, and the specific beneficial factors in my situation — my youth, the success of the surgery, and the particular makeup of my tumor — mean I have a high chance of surviving for years. 

And yet, cancer does not always play by the rules or follow our hopeful guesses as to what will happen. My cancer is chronic and recurrent, and at any time, the microscopic cancerous cells could wake and spread and become terminal without warning.  

The diagnosis came with instructions for a rearranged life. Instead of graduate school, I’d be undergoing months of chemo and radiation, which can both leave behind lifelong side effects including infertility. My neuro-oncologist gave me pamphlets on egg retrieval surgeries and hormone treatments as well as a referral to a nearby fertility clinic. He told me that after treatment, I’d continue to have scans every three months to catch a recurrence of the tumor early on, giving me the best chance of survival. I walked out of the office stunned and devastated, my entire world having shifted in an hour. 

As radiation would start soon, I had a week to decide about fertility treatments. My partner and I, while very committed, weren’t ready to have kids together, so the decision was on me alone. What was I supposed to do, I agonized, how could I make this decision after receiving such a diagnosis? How could I decide something this big this fast?

Ultimately, I decided to freeze my eggs and decide the rest later. I want a choice, I told myself as I embarked on the adventure of injecting myself in the stomach four times a day with hormones, taking a complicated concoction of fertility meds in addition to those needed after brain surgery, and undergoing an egg retrieval surgery shortly before I started daily radiation treatments. 

The egg retrieval surgery was successful. Currently, 15 frozen eggs wait patiently for me to make my decision. I have the option now to have kids biologically if I should choose to. I could decide to adopt or foster. I have finished treatment, my scans are stable, I’m newly engaged and planning my wedding. It should be a time when I allow myself to start considering the actuality of being a parent, my years of dreaming coming closer to reality.  

Instead, I remain holding my breath, waiting to know the answer to an unanswerable question. While none of us knows what the future holds or whether we will remain healthy enough to watch our children grow up, my diagnosis means that every 12 weeks, my life could rearrange in the wake of a single image, a bright spot on a brain that should be dark. 

If I choose to have a child, I’m running a greater risk of potentially subjecting my child to deep grief. I am accepting the possibility that my child could watch me die, that I might lose the chance to mother them, that my life could end long before any of us are ready. My persistent dream of becoming a mother is now complicated, no matter what. 

Even if I choose to have a child, that child will always live within cancer’s reach. They will know what it is to spend time in the hospital with me, as I will continue to have to go in for check-ups and scans. They would know there is such a thing as an MRI machine that can take pictures of the inside of my brain. They will be aware of life’s fragility and I will not be able to protect them or shelter them from the reality of how random and cruel this world can be at times. 

Yet perhaps they would also learn what it is to love so deeply you are willing to risk loss. They would know fear and anger and grief — yes. But I hope they would also live the way my partner and I have learned to — reveling in joy when it comes washing over us, focusing on the present, understanding we can never know what will unfold in our lives, and rather, our job is to be aware of what is happening now. 

The choice of whether or not to have children is never an easy one. I believe that everyone has the right to make their own decisions. If I was talking to someone else in my position, I wouldn’t have the right answer, either. 

Instead, I’d hope to sit with them and hold their hand. I’d tell them that if they have a child, that child will be loved with a fierceness they will never lose. And I’d tell them that if they decide not to have a child, their life will still be full and rich and overflowing with warmth. 

When the time comes to decide, I hope I will walk into the choice bravely and accept whatever feels right without wavering, knowing that life can shift in an hour, and all we can ever do is trust ourselves to know what is right for us.