I wanted two kids. He wanted four. Then I was diagnosed with uterine cancer

“I would know if I have cancer, right?” I asked my partner as we neared the hospital.My doctor had asked us to come in to discuss results. It was this past April, and a few weeks after a routine, long-awaited and long-advocated endometriosis surgery that’s considered elective but felt mandatory after a life of chronic pain.I don’t know if either of us answered the question. We arrived and sat down. The doctor looked pained, as if she didn’t want to share what she was about to say. She quickly changed course, asking me how I was healing after the surgery, and invited me to lie down on the table to inspect the four already-scarred incisions on my belly. “Everything looks great … Just make sure you put sunscreen on the scars when you’re wearing a bikini.” The mention of bikinis instantly made me think that everything must be OK.As soon as we sat back down, I knew what she was trying to avoid.Months before my surgery, I had a sonohysterogram, a quick imaging procedure to look inside the uterus, to make sure that endometriosis tissue was not blocking my Fallopian tubes. (I hadn’t yet been able to conceive, but I was probably being dramatic; it had only been a few months). “All clear,” she had said at the time when the results came back from that scan. “You just have a little polyp on your uterine wall. Not to worry, most women have them and they don’t cause any issues. But while we’re in there, we might as well clean everything up.” She added, “And your uterus is shaped like a heart.” Aw, that’s cute, I thought. Fast forward to the present. “Natasha … the tissue and polyp we removed is cancer.” She continued: “It is very rare for your age and body type. I had them double check. It was done by the best oncologist. We could preserve your uterus if you want to conceive. Or we could remove it, even through the same incisions so there’s no more scarring.”She went on.“There’s also adoption and surrogacy. You have lots of options. They’ll know more once they do a biopsy and MRI to double check it hasn’t spread into the muscle or other organs. It’s grade one. The uterus acts as a container so it’s unlikely to spread. I’m shocked. This is extremely rare for someone so young and healthy with no symptoms. There is an extremely high five-year survival rate for uterine cancer.”The mention of survival rate was when I realized tears were streaming down my face. My mind was blank and my face was wet. All of the information was flooding in too quickly. “What do you mean preserve my uterus?” is one of the questions I asked. An image of my uterus in an iodine-filled jar came to mind. “They give you hormones to restore the lining so that you can hopefully carry your baby, if the cancer hasn’t spread too deep … Or, if you decide your health comes first, you can remove your uterus and look into other options.” I’m sure she said other less alarming things, and that she was just laying out my options. But that was what stuck: preserving my uterus, and that putting my health first could mean removing it. It wasn’t cancer that scared me — I knew I could survive it. It was the so-called fertility journey that I would now have to go on at 32.“Are you OK, Simon?” the doctor asked my partner. I think I was too scared to look at him until she said that. I turned to him and his eyes were red and wet with tears. I couldn’t see if they were coming down his face; we were all wearing masks. I’m an avid mask-wearer, but at that moment, nothing felt more futile than to have only our wet eyes to genuinely communicate. Even the doctor had to pause to take a collective breath. A week later, I still had that light blue surgical mask in my pocket. I’m not sure why I didn’t throw it out, and I knew it from the others stuffed in there by its pale hue.Every conversation with family in recent years always included the ‘name game.’ After years of playing it, we finally decided: Leo for a boy, Nel for a girl. I love any girl’s name that could end in a playful ‘ie.’ Nellie will be her nickname, I thought.The double-barrelled surname was always a back and forth, with me not backing down. Simon always joked about wanting to have four kids; he was the eldest of four himself. I was always an adamant two, with the possibility of adopting a third. I’m passionate about my work so the thought of being pregnant for four years, and on maternity leave for four more seemed like a huge sacrifice. Now I was looking into the possibility of sacrificing — or preserving — my uterus, and nothing seemed more silly than to worry about work, or anything for that matter. My eight-year window to be able to have kids was now shuttered. And our jokes about our dogs being our children seemed less funny, and our conversations about double-barrelled names frivolous. The incidence of uterine cancer, also known as endometrial cancer, has been increasing for the past 30 years, especially among Black women, who experience the highest mortality rate. And yet, it is one of the most poorly funded

I wanted two kids. He wanted four. Then I was diagnosed with uterine cancer

“I would know if I have cancer, right?” I asked my partner as we neared the hospital.

My doctor had asked us to come in to discuss results. It was this past April, and a few weeks after a routine, long-awaited and long-advocated endometriosis surgery that’s considered elective but felt mandatory after a life of chronic pain.

I don’t know if either of us answered the question.

We arrived and sat down. The doctor looked pained, as if she didn’t want to share what she was about to say. She quickly changed course, asking me how I was healing after the surgery, and invited me to lie down on the table to inspect the four already-scarred incisions on my belly.

“Everything looks great … Just make sure you put sunscreen on the scars when you’re wearing a bikini.”

The mention of bikinis instantly made me think that everything must be OK.

As soon as we sat back down, I knew what she was trying to avoid.

Months before my surgery, I had a sonohysterogram, a quick imaging procedure to look inside the uterus, to make sure that endometriosis tissue was not blocking my Fallopian tubes. (I hadn’t yet been able to conceive, but I was probably being dramatic; it had only been a few months).

“All clear,” she had said at the time when the results came back from that scan. “You just have a little polyp on your uterine wall. Not to worry, most women have them and they don’t cause any issues. But while we’re in there, we might as well clean everything up.”

She added, “And your uterus is shaped like a heart.” Aw, that’s cute, I thought.

Fast forward to the present.

“Natasha … the tissue and polyp we removed is cancer.”

She continued: “It is very rare for your age and body type. I had them double check. It was done by the best oncologist. We could preserve your uterus if you want to conceive. Or we could remove it, even through the same incisions so there’s no more scarring.”

She went on.

“There’s also adoption and surrogacy. You have lots of options. They’ll know more once they do a biopsy and MRI to double check it hasn’t spread into the muscle or other organs. It’s grade one. The uterus acts as a container so it’s unlikely to spread. I’m shocked. This is extremely rare for someone so young and healthy with no symptoms. There is an extremely high five-year survival rate for uterine cancer.”

The mention of survival rate was when I realized tears were streaming down my face. My mind was blank and my face was wet. All of the information was flooding in too quickly. “What do you mean preserve my uterus?” is one of the questions I asked. An image of my uterus in an iodine-filled jar came to mind.

“They give you hormones to restore the lining so that you can hopefully carry your baby, if the cancer hasn’t spread too deep … Or, if you decide your health comes first, you can remove your uterus and look into other options.”

I’m sure she said other less alarming things, and that she was just laying out my options. But that was what stuck: preserving my uterus, and that putting my health first could mean removing it. It wasn’t cancer that scared me — I knew I could survive it. It was the so-called fertility journey that I would now have to go on at 32.

“Are you OK, Simon?” the doctor asked my partner.

I think I was too scared to look at him until she said that. I turned to him and his eyes were red and wet with tears. I couldn’t see if they were coming down his face; we were all wearing masks.

I’m an avid mask-wearer, but at that moment, nothing felt more futile than to have only our wet eyes to genuinely communicate. Even the doctor had to pause to take a collective breath.

A week later, I still had that light blue surgical mask in my pocket. I’m not sure why I didn’t throw it out, and I knew it from the others stuffed in there by its pale hue.

Every conversation with family in recent years always included the ‘name game.’ After years of playing it, we finally decided: Leo for a boy, Nel for a girl. I love any girl’s name that could end in a playful ‘ie.’ Nellie will be her nickname, I thought.

The double-barrelled surname was always a back and forth, with me not backing down.

Simon always joked about wanting to have four kids; he was the eldest of four himself. I was always an adamant two, with the possibility of adopting a third. I’m passionate about my work so the thought of being pregnant for four years, and on maternity leave for four more seemed like a huge sacrifice.

Now I was looking into the possibility of sacrificing — or preserving — my uterus, and nothing seemed more silly than to worry about work, or anything for that matter. My eight-year window to be able to have kids was now shuttered. And our jokes about our dogs being our children seemed less funny, and our conversations about double-barrelled names frivolous.

The incidence of uterine cancer, also known as endometrial cancer, has been increasing for the past 30 years, especially among Black women, who experience the highest mortality rate. And yet, it is one of the most poorly funded and researched cancers. An analysis of 119 cancer-related non-profit organizations in the U.S. showed that uterine (endometrial) cancer ranked second last in total revenue by type of cancer, tied with cervical cancer.

Based on the research out there, the risk factors for uterine cancer are obesity, older age (post-menopausal), no history of pregnancy, a high-fat diet, hormone therapy for breast cancer, more years of menstruation, changes in hormones, and polycystic ovarian syndrome (PCOS) or an inherited colon cancer syndrome called lynch syndrome. Other than never being pregnant before, I had zero attributing factors.

The symptoms can be bleeding between periods, lower abdominal pain or cramping, pain during bowel movements or intercourse, weight loss, lack of appetite and difficulty breathing — none of which I had other than my usual endometriosis pain once a month.

A 2015 cohort study was conducted in Taiwan that found a potential increased risk of developing endometrial cancer later in life for those diagnosed with endometriosis. But like endometriosis and endometrial cancer, much more research — and funding — needs to be gathered.

Throughout that conversation with the doctor, all I could do was keep thanking her. I had advocated for myself to get laparoscopic endometriosis surgery in the first place, but she was the one who listened. Had she not given me a surgery that many women are forced to go to the United States to pay for, I don’t know where I would be in a few years from now.

No blood work or routine check would indicate that anything was wrong in my body. I even had blood work done a few days before. All I wanted to do was hug her.

I was overcome by a strange calm as we left the appointment. For a chronic worrier who has had two heart procedures before 30, it felt like this was the diagnosis I was always expecting.

But as we drove on the straight road home I turned to Simon and said, “I don’t want to always be sick. I don’t want to always be the victim. That grows tiring for people.” By people, I really meant, it would grow old for him. Never, he said.

When we got back home, we just sat with each other in the sunshine at the bottom of the garden — the last sliver of sun for the day. Every worry in the world that we had before that day floated away, and we sat in silence listening to the birds.

No one tells you how much louder the birds are once you find out you have cancer. It’s not that they’re singing to you — no one human is that important — but their chorus makes everything else dissipate.

In a way, I had never felt so free. Every concern I had before the day melted away. I was just left with one: what the future of my heart-shaped uterus would mean for us.