For many of us, the recent Supreme Court decision threatening a woman’s right to have control over her reproductive health is intensely disturbing. There are profound consequences of this ruling, and we have already seen reflex laws enacted in 11 states, which ban or severely restrict a woman’s ability to terminate a pregnancy. The social inequities and health care disparities resulting from this decision are monumental: the impact will be far, far greater for poor women than those with financial resources, far greater for women lacking an education than those who are well-educated, and far greater for underserved minorities – largely Black and Latina women – than those who are white. And we are all struck and saddened by our intensely divided nation.
As a cancer physician, a cancer patient advocate, and a cancer researcher, I want to focus on the impact of the Supreme Court ruling on patients with cancer, their families, and their clinicians. Sadly, there are settings in cancer medicine where the politics of abortion rights directly collide with what may be best for our patients. First, it is estimated that approximately one in a thousand pregnancies is complicated by a diagnosis of cancer. This can be a new diagnosis of cancer or a recurrence of a previous diagnosis. In either case, pregnancy may complicate the optimal course of cancer therapy. For example, can we effectively treat a 24-year-old woman with a new diagnosis of acute myelogenous leukemia who is also 8 weeks pregnant? Moreover, being pregnant may simply be more than a woman can sustain emotionally or physically in the context of a cancer diagnosis, even if the appropriate therapy can be administered. Second, a pregnant woman may be confronted with a cancer diagnosis in her partner, child, parent, or another close relationship. The situations will vary, but it is possible that some women will want to choose whether to be pregnant while providing intensive support and care to a loved one. Finally, a woman with a history of cancer, albeit in good health, may decide that having a child is simply not the right choice for her. In each of these cases, there is an impact on the family as well as the patient. As health care professionals trying to take the best possible care of our patients, we are all denied the ability to counsel our patients and participate in shared decision-making about one of the most important areas of a woman’s life.
There is little question in my mind that the Supreme Court decision and subsequent laws passed by individuals states will threaten our ability to provide the best care to pregnant women who are also touched by cancer. Tragically, the impact of the Supreme Court ruling will disproportionately affect those who are already faced with health care and cancer disparities. No matter what your own personal views are about abortion rights, I hope you will join with me in raising concern about the potentially harmful effects of Roe v Wade’s overturn on patients and families who are affected by cancer. YCC/Smilow will be honored to provide cancer care to any woman who moves to Connecticut to exercise her reproductive rights and is in need of our services.
Eric P. Winer, MD
Alfred Gilman Professor of Medicine and Pharmacology
Director, Yale Cancer Center
Physician-in-Chief, Smilow Cancer Network
President, American Society of Clinical Oncology