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A dream realized
Endometrial cancer nearly derailed Leighanne Dunckley’s hopes of having a baby — but neither she nor her doctors would give up
Leighanne Dunckley had always wanted to be a mom. She and her husband Andrew knew that might not be easy: Seven years into their marriage and ready to start a family, they understood that her polycystic ovary syndrome (PCOS) could be an obstacle. The condition can cause hormonal imbalances and irregular periods, among other things, and make it hard to conceive.
Little did they know that PCOS wouldn’t be their only hurdle on the way to achieving a pregnancy. It took a decade-long odyssey through life-threatening health issues, but Dunckley eventually found a Northwell team that could help manage her complex conditions and guide her to pregnancy and motherhood.
At the beginning of her journey in 2012, Dunckley, who works in tech support for the Jericho school district on the North Shore of Long Island, tried to tackle her PCOS on her own by losing weight. This had always been an issue — as it is for many women with PCOS. She began biking with her husband, Andrew, a building-department clerk with the town of North Hempstead, and went to a weight-loss clinic that put her on a low-calorie diet.
She and Andrew had just begun working with a fertility specialist when disaster struck. Dunckley had had a procedure to remove what appeared to be polyps from her uterus, but the pathology report came back indicating something much more serious: She had endometrial cancer, or cancer of the uterine lining. She was just 32.
It was terrifying. More than that, “it was heartbreaking,” she says.
At first, she thought she’d need a hysterectomy, but the oncologist told her surgery wasn’t necessary at this point: Because her cancer had been diagnosed at an early stage, it could be treated with a synthetic version of the hormone progesterone. That would block her body’s production of estrogen, which endometrial cancer cells need to flourish. Dunckley got a progesterone-releasing intrauterine device (IUD), plus a three-month course of high-dose progesterone pills.
But the IUD meant Dunckley couldn’t get pregnant — and removing it could trigger the return of her cancer. Making matters worse, her PCOS meant she probably wouldn’t be able to conceive without fertility treatments, including estrogen, which would raise her risk of recurrence even higher.
“This was just a black shadow of a time,” she says. “On the way to work, I would cry in the car, and on the way home, I would cry.”
Fertility, interrupted
Of the 60,000 women diagnosed with endometrial cancer each year, most are 55 or over. But the disease has been on the increase among younger women: Its incidence among women ages 30 to 39 jumped more than 60% between 2001 and 2017. One reason may be the rise in obesity. Endometrial cancer is spurred by estrogen — and fat cells in the body can actually convert testosterone into estrogen, increasing its levels. (All women have some testosterone.) Endometrial cancer is twice as common among overweight women compared to women of normal weight; it’s three times more common among obese women.
Dunckley’s weight was a risk factor; so was her PCOS. That condition is known to raise the risk of endometrial cancer, because it leads to relatively high levels of both estrogen and testosterone.
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Fortunately for Dunckley, the progesterone-emitting IUD worked. Every six months, her doctors would take a biopsy of her endometrial tissue, and each time the test indicated that her cancer was in remission.
After a few years, she was ready to try again to conceive, so she had the IUD removed. At first, it looked like her gamble would pay off. But within a few months, a biopsy showed abnormal cells, and her doctors told her she would have to stop fertility treatments and replace the IUD.
“Otherwise, they said I could wind up right back where I started,” Dunckley says. “And it could be worse this time.
A different path
It was around this time that Dunckley began seeing gynecologic oncologist Jill Whyte, MD, at Long Island Jewish Medical Center. For the first time, Dunckley felt she was in the right place. “I made an appointment to see her and fell in love,” she says. “Dr. Whyte answered questions that I’d had for the longest time. When I had a biopsy, she’d call personally to give me the results. It was mind-blowing to have a doctor that cared that much.”
By now, Dunckley and her husband had been trying for a while to adopt, without success. They had closed the door on the possibility of pregnancy. But Dr. Whyte told her that they might be able to reopen that door — if Dunckley was willing to make some changes.
“With this kind of cancer, you can have a successful treatment, but if you haven’t changed the underlying conditions that are stimulating the disease, there’s a high risk of relapse,” Dr. Whyte says. “So Leighanne and I had some really frank discussions about why she developed the disease and what were the risk factors she needed to address.”
Among other things, that meant her weight.
“I said right out, this is not about how you look or society’s expectations,” Dr. Whyte says. “This is about your health and what you can do to decrease the levels of excess estrogen in your body.”
Dunckley had already been working on her weight, but the stress of her cancer diagnosis and treatment, not to mention her PCOS, had made sustained weight loss impossible. So in 2017, Dunckley met with Larry Gellman, MD, program director of the minimally invasive surgery, advanced gastrointestinal and bariatric surgery fellowship and associate director of bariatric (weight loss) surgery at North Shore University Hospital (NSUH). With the rest of the NSUH team, Dr. Gellman has performed more than 5,000 bariatric surgeries in the past 20 years, helping patients control their weight and in many cases reversing diabetes, high blood pressure and other conditions. “We’re working more and more with oncologists who are treating obese patients, to help slow the progression of certain weight-related cancers,” Dr. Gellman says. “I told Leighanne we could help her get healthier.”
In February 2018, Dunckley had gastric sleeve surgery, a procedure in which up to 80% of the stomach is removed and a new, smaller stomach is created out of the remaining tissue. The procedure helps patients feel full faster and reduces the amount of hunger hormones that the stomach produces. Over the course of the next year, Dunckley lost 100 pounds.
She’d also adopted a healthier way of eating and started exercising regularly. “She’d had a series of normal biopsies and was really feeling good,” Dr. Whyte says. “She was in better health and better able to conceive and carry a pregnancy to term. So we decided to take the IUD out and see what happened.
A bumpy road
Dunckley was now 39. Seven years had passed since her initial diagnosis, and the idea of stopping the treatment that had kept her healthy was scary. “I was afraid of getting cancer again,” she says. “And my husband had always said that he’d go along with whatever I wanted to do, but the one promise he asked for was that at the end of all this, I’d still be here.”
But Dr. Whyte would be monitoring her closely, so Dunckley decided to try fertility treatments. Once again, though, her path wasn’t an easy one — and it was further complicated by a brewing pandemic.
The first egg retrieval for IVF took place in February 2020, right before Covid shut the clinic down. Once treatment resumed a few months later, Dunckley got pregnant after her second IVF cycle, only to find that it was an ectopic pregnancy. The fetus was developing in a fallopian tube instead of her uterus. It was a nonviable pregnancy that could threaten her life. “It was heartbreaking to finally be pregnant, only to lose it,” she says.
Finally, in June 2021, Dunckley found out she was pregnant again. Dr. Whyte’s notes from around this time are simple: “SHE’S PREGNANT!”
Dunckley suffered from intractable vomiting all the way through her pregnancy — she had a condition unrelated to her cancer called hyperemesis gravidarum, which roughly translates to excessive vomiting during pregnancy. But she worked with a nutritionist from Dr. Gellman’s office to ensure her baby was getting enough nutrition. And in February 2022, a healthy 7lb., 8oz. baby girl — Hannah Elizabeth — was born.
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A new life
Like most women who are medically treated for endometrial cancer, Dunckley will most likely get a hysterectomy at some point. But she and Andrew are glorying in their family and, like new parents everywhere, trying to hold onto those special, fleeting moments. “She’s already a year old,” Dunckley said recently. “It goes so quickly — it’s like trying to hold water slipping through my fingers.”
They feel very lucky that their doctors were able to crack open the door to a pregnancy and help Dunckley walk through it safely. “Being a mom is amazing,” she says. “It is more than I ever dreamed or could even try to dream. Even during the hard moments, I love every minute of it.”
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