Vy Yamat and her husband, Anthony, were already the parents of two little boys when they decided it was time to try for a third child to complete their family. Little did they know that one decision would send Vy on a two-year roller coaster ride and cervical cancer journey with hope to preserve her fertility.
“In July 2020, my husband and I decided we were ready to start trying for another baby, so I went for a routine exam since I hadn’t been in a while,” she recalls.
“I went in expecting it would be all clear, but a week later I got a call from my doctor saying he wanted me to go in for a biopsy. A few days later, he said it was cancer and he referred me to an oncologist. It all happened so quickly. I remember thinking, ‘One week ago we decided we wanted to have another baby. Now, I have cancer.’”
Vy went to see an oncologist referred to her by her OB-GYN. She received devastating news that threw her plans to expand her family into a tailspin: She would need a hysterectomy.
“I was in so much shock and it was hard to accept that my ability to have kids was being taken away from me. Even though I have two already, I said, ‘I’m not done having babies,’” Vy says. “The doctor said, ‘You have two kids you have to be around for.’ It was just so unexpected. I was in so much disbelief and thought there had to be something else she could do.”
Her doctor offered to do another biopsy, and when it came back as an invasive cancer, Vy thought she had no other option but to have the hysterectomy. As the doctors worked on scheduling the surgery, she and Anthony worked on processing the news and how it would affect their family’s future.
“They gave me all the surgery paperwork, and I was just so overwhelmed and couldn’t believe this was the end-all, be-all answer,” she says. “I took all the paperwork home and started trying to come to terms with it. We decided we would look at adoption, fostering and surrogacy — any options we could think of to help me accept that even though I wouldn’t be able to have another baby of my own, we would still expand our family.”
A conversation with a physician friend altered Vy’s course once again.
“She said, ‘Why don’t you get a second opinion? Why don’t you look at Scripps?’” Vy says. “Honestly, I hadn’t even thought about getting a second opinion.”
Vy took her friend’s advice and made a phone call. Thankfully, it turned out to be exactly the call she needed.
“I feel so lucky with the choice I made,” she says.
“The office staff was awesome, and they scheduled me right away,” she recalls. “I met with Dr. Janco and explained everything.
“I thought I had gotten past the shock, but it had only been a few weeks to accept something I just didn’t want to accept, so I started crying telling her what the first doctor had told me.
“Dr. Janco was so kind and understanding, and I knew right then that even if she proposed the same outcome of a hysterectomy, I would have chosen her anyway because she was so sweet and caring.”
Instead, Dr. Janco mentioned another option — one that Vy herself had researched but did not know if she was a candidate.
Called a radical trachelectomy, the procedure spares fertility by removing most of the cervix and surrounding tissue, while preserving the upper part of the uterus and reattaching it to the vagina.
“Traditionally, hysterectomy is the standard of care for cervical cancer. But for younger patients, we need to talk to them about where they are with their fertility, and how we can treat their cancer while considering their fertility goals,” Dr. Janco explains. “There must be very careful counseling about who is a candidate for this procedure, as not everyone is.”
Dr. Janco explained to Vy the requirements for candidacy, the potential risks associated with the procedure and all the steps that need to go right for it to be a success.
“First, we have to look at the size of the tumor and make sure there is no sign of spread,” she says. “So, I start with removing some lymph nodes. If we see cancer there, we won’t do the procedure.”
“If we don’t find cancer in the lymph nodes, then we can move forward with the planned surgery. I also need clear margins and clear tissue close to the uterus, and there needs to be a little of the cervix left to reattach to the vagina.”
Dr. Janco adds there are a very complex series of steps and considerations during the surgery. Even if all that is successful, she says there’s still a risk of infertility due to scarring of the remaining cervix, and there’s a risk of miscarriage and pre-term delivery because the remaining cervix may dilate early. If they do have a successful pregnancy, they will have to deliver by C-section because labor and vaginal delivery may disrupt where the remaining cervix has been reattached to the vagina.
“I generally have patients see a maternal fetal medicine specialist for counseling before they decide, so they have some idea of the risks of subsequent pregnancy,” says Dr. Janco. “Then they can also have the additional support, if they do choose to try and become pregnant.”
For Vy, the potential reward of having a third baby completely outweighed all these risks.
“I knew it wasn’t going to be easy, but it was something we wanted so badly,” she says.
On September 21, 2020, three months after she was diagnosed with cervical cancer, Vy had the radical trachelectomy. She spent a few days in the hospital and went home to recover. Dr. Janco advised that she wait six months to a year to try to get pregnant. On September 22, 2021 — one year after her surgery — Vy took a pregnancy test. It was positive.
“The following day was my one-year checkup with Dr. Janco, and I was worried she’d be concerned because I hadn’t waited a full year!” Vy laughs.
Instead, she walked in to greet a smiling Dr. Janco, congratulating her on the good news. She received a clean bill of health, and the next nine months of her pregnancy went off without a hitch.
“We named the baby after Dr. Janco, because without her, there would not have been a chance for me to have a baby at all. Without her, Maddie Jo wouldn’t be here today.”Vy Yamat
On May 10, 2022, she had a scheduled C-section at 36 weeks and delivered a healthy, 5-pound, 6-ounce baby girl named Madeline Jo — with her name “Jo” in honor of Dr. Janco.
“We named the baby after Dr. Janco, because without her, there would not have been a chance for me to have a baby at all,” Vy says. “Without her, Maddie Jo wouldn’t be here today.”
Dr. Janco says that it’s still very important that Vy be monitored for cancer recurrence. However, Vy is eternally grateful for her daughter and her health. She even recently ran her first-ever 5K race and is training for the Las Vegas Rock ‘n Roll 10K in February.
Overall, she’s thankful she advocated for her own health and made the call to Scripps MD Anderson that changed her life — and allowed her to create a new one.
“I really don’t have enough words to describe the care that I received from Scripps MD Anderson — from my initial call to Dr. Janco’s office and ever since. It was how every cancer patient should be treated,” she says.
“Everyone has been so helpful and kind. If I ever meet anyone in a similar situation, I will tell them to go to Dr. Janco. In fact, I wish Dr. Janco was the doctor for all things,” she laughs. “I always want to call her, even if it’s totally unrelated to an OB-GYN. She’s the most responsive and the most detail-oriented doctor I have ever met. I don’t know how she does it.”
This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.