The Pregnancy Test: Cancer Treatment in a Post-Roe America

A woman receives a dose of trastuzumab, a targeted cancer drug and also known by other names such as Herceptin, Herzuma and Ontruzant. It is a treatment for early and advanced breast cancer. (Karen Apricot / Flickr)

On the morning of May 2, in the hours before the Supreme Court draft striking down Roe v. Wade was leaked to the press, I sat waiting for a 30-minute infusion of Herceptin. Herceptin, one of the essential drugs I was prescribed last year when I was diagnosed with breast cancer, is a targeted therapy given along with chemo to address early-stage HER2+ breast cancer.

This form of cancer is particularly aggressive, and Herceptin is a revolutionary and profoundly effective treatment that has transformed the prognosis for women with this diagnosis. I received it along with chemotherapy before undergoing surgery, and experienced what doctors describe as a pathologic complete response. In other words, my tumor disappeared completely. My access to Herceptin is undoubtedly why I experienced an excellent result.

While Herceptin has saved countless women’s lives since the first human clinical trial was performed at UCLA in 1990, it can cause fetal harm.

It was this potential risk which caused my infusion to be delayed on that fateful morning. Despite the fact that my clear bag of Herceptin was within reach of my beige medical recliner and ready to be hung from my IV stand, and even though my essential lab results—including my white blood cell and platelet counts—had already come in, my HCG quantities were delayed. 

Testing for HCG (human chorionic gonadotropin) in the blood can detect pregnancy about 11 days after conception. I knew two things that made a pregnancy test unnecessary:

  1. I was not pregnant.
  2. If I was pregnant, I would choose to terminate.

I explained this to my nurse and asked to begin my infusion without waiting on the results. I was denied.

Thirty minutes went by, then 45. An hour later, I again requested to waive the test. I offered to sign a release of liability so that I could proceed with my treatment and move on with my day. Again, I was denied. 

It might seem a mere inconvenience to wait an extra hour or two to receive an infusion. But my experience that morning reveals the dire consequences of placing the well-being of a fetus (in this case a hypothetical fetus) over the well-being of a woman. Why was I denied medical care—even temporarily—until I could prove I wasn’t pregnant? Where was my agency in this situation? This is just one example of the far-flung consequences of overturning Roe, of criminalizing abortion and of generally limiting women’s right to govern their own bodies.

Why was I denied medical care—even temporarily—until I could prove I wasn’t pregnant? Where was my agency in this situation?

If I had been in the early stages of a pregnancy at the start of treatment, a delayed dose of Herceptin could have meant the difference between my fast-growing cancer remaining local or metastasizing further. During the nearly two hours that I waited, I wondered what would have happened if my pregnancy test was positive. Would I have been denied the very drug that saved my life and which protects my future—which ensures that my young children will continue to have a mother—in order to protect a pregnancy I did not want or plan to keep?

When my nurse sheepishly returned with my results—negative for pregnancy—and started my infusion, I asked her. She told me that my infusion would likely have been canceled.  


I happen to live in California, where I would be able to terminate a pregnancy and prioritize my cancer treatment. But what will happen to the newly pregnant woman with my diagnosis in Arkansas or Louisiana, Oklahoma or Texas, or the many other states with trigger bans, six-week bans, or total bans? In a post-Roe America, women in more than half of U.S. states simply won’t have that right. They will be forced to carry a pregnancy that dangerously limits their essential healthcare options. 

Would I have been denied the very drug that saved my life and which protects my future—which ensures that my young children will continue to have a mother—in order to protect a pregnancy I did not want or plan to keep?

When the Supreme Court reversed the 1973 ruling on Roe v. Wade and returned the issue of the right to access abortion services to the states, the American Cancer Society released this statement

“When someone receives a cancer diagnosis, it is critical they receive immediate care. Up to one in 1,000 pregnant women each year receive a cancer diagnosis. We know timely cancer treatment improves a person’s chances of survivorship. As some states signal a determination to define personhood at fertilization, we are concerned about potential threats to a pregnant woman’s ability to receive rapid cancer treatment. Every patient should be able to increase their likelihood to survive cancer by having the option to start cancer therapy immediately, regardless of pregnancy status.”

It isn’t just cancer care that will be delayed or denied by this reckless decision. Criminalizing abortion is already putting women in grave danger, and much of the medical community is deeply concerned about how the decision will delay or prevent life-saving procedures in dangerous circumstances such as ectopic pregnancy and severe preeclampsia. As the ACOG has stated, “Abortion bans—even those with exceptions for ectopic pregnancy—can generate confusion for patients and healthcare professionals and can result in delays to treatment. Healthcare professionals should never have to navigate vague legal or statutory language to determine whether the law allows them to exercise their professional judgment and provide evidence-based care.”

Dr. Iffath A. Hoskins, president of ACOG, predicts that laws banning abortion—even those that include exceptions for when the life of the parent is as risk—will “leave physicians looking over our shoulders, wondering if a patient is in enough of a crisis to permit an exception. It leaves them fearing that the evidence-based care that they are providing is leaving them susceptible to discipline, punishment, lawsuits, loss of license and criminal penalty.” The loss of safe and legal abortion will mean the difference between life and death for innumerable women.

It’s been over 10 weeks now since my delayed infusion, and nearly three weeks since SCOTUS overturned Roe v. Wade, ending 50 years of federal abortion rights. I am nearly finished with my year-long course of treatment, and I am cancer-free. But, I am not free. 

No American woman is.

Sign and share Ms.’s relaunched “We Have Had Abortions” petition—whether you yourself have had an abortion, or simply stand in solidarity with those who have—to let the Supreme Court, Congress and the White House know: We will not give up the right to safe, legal, accessible abortion.

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Helen Jupiter is a writer based in Irvine, California.