10/1/2009 - Marisue Alstott was 32 years old and joyfully pregnant with her first child when she discovered a breast lump that she was sure would turn out to be nothing. A diagnosis of breast cancer was the last thing she expected. Even more devastating was her physician’s suggestion that terminating her pregnancy might be necessary.

For Alstott, ending her pregnancy was not something she was prepared to consider. She immediately began looking for another physician who would help her beat the cancer and give birth to a healthy baby. NorthShore University HealthSystem’s (NorthShore) Janardan Khandekar, M.D., was that physician; eight years later he is like family to Alstott and her son Jonathan.

Just 15 weeks into her pregnancy, Alstott said Dr. Khandekar began treating both patients right away, managing her chemotherapy and closely collaborating with NorthShore’s high-risk physicians in Maternal- Fetal Medicine. "He immediately made me feel very comfortable, and I always felt like I was in safe hands," Alstott said.

Alstott had a modified radical mastectomy and began chemo treatments during her pregnancy, enduring a regimen of two weeks on and two weeks off. Dr. Khandekar found the most important thing was careful monitoring of the medications to ensure that the baby was not harmed during the mother’s treatments. Alstott jokes that she is the only person she knows who has a photo album of all her ultrasounds, taken throughout the pregnancy to monitor his progress.

"Marisue never thought she was going to die from this cancer," said her mother, Jeannie Prombo. "I think she is incredibly strong. If you know you are loved, you can do just about anything."

Alstott, Prombo and their entire family drew tremendous strength from Dr. Khandekar and the team of compassionate caregivers working together to keep the mother and baby healthy. "I remember crying the day he was born, and one of the doctors telling me ‘we were all crying,’ "Prombo said. At 5 pounds, 12 ounces, Jonathan was tiny but by all accounts beautiful and strong.

"I believe that every life is a miracle," Prombo said. "But when they put that little boy in my hands, I thought this is what a miracle looks like." Now an active eight-yearold, Jonathan is smart, athletic and "perfect," according to both his mother and grandmother. "The fact that he’s here is because of the doctors and nurses at NorthShore," Alstott said.

Two weeks after Jonathan’s birth, Alstott began a course of "hard-core" chemo, which was followed by a series of radiation treatments. Doctors prepared her for the likelihood of a cancer recurrence. But eight years later, she remains cancer free.

"I’ve been very lucky, I wouldn’t go anywhere else for care," Alstott said. She continues to see Dr. Khandekar every six months and generally brings Jonathan with her.

"It’s one of the most gratifying feelings to see them together," said Dr. Khandekar, Chairman of the Department of Medicine, Louise W. Coon Chair of Medicine and on faculty of the University of Chicago Pritzker School of Medicine. As treatment for breast cancer continues to improve, care for pregnant women like Alstott is no longer an impossibility, he added.