Oncologist has a heart for women who want to be mothers

Patients diagnosed with cancer have someone who understands when they wish to become pregnant.

By TJ Banes, IU Health Senior Journalist, tfender1@iuhealth.org

Ask Dr. Rita Assi how she got interested in working with patients diagnosed with cancer, who want to become mothers, and she’ll talk about a real life experience.

“I was in training. I was pregnant with my first child, and a patient came to my clinic. She was pregnant, she was my age, and she had leukemia,” said Assi. “At first I couldn’t see her. I kept thinking, ‘I’m pregnant and healthy, and she’s not.’” At the urging of another practitioner, Assi met with the patient. “She passed and the baby passed, but she empowered me with her battle,” said Assi. Since she joined the staff of IU Health, in February 2023, Assi has treated about eight patients with lymphoma or leukemia who were pregnant.

When they speak of her, her patient’s faces light up.

“Dr. Rita is the best. She gave me hope,” said one 23-year-old patient who found out she was pregnant at the same time she was diagnosed with non-Hodgkins lymphoma. She miscarried at six weeks. “Dr. Rita knows my whole story and has given me confidence that I can get pregnant again,” said the patient.

A cancer diagnosis is challenging. A cancer diagnosis for a pregnant mother is double challenging, said Assi. Certain standards and protocol are put in place to manage treatment and reduce fetal harm. Chemotherapy does not start until the second trimester.

“That’s even risky. Even if the mother does well, chemo can cross the placenta and cause congenital abnormalities, skeletal and heart defects or compromised immunity. We keep track of every step of treatment and also monitor the psychological ramifications,” said Assi.

For patients who have been treated for leukemia and lymphoma, Assi’s specialty, they can still have a healthy pregnancy. They are checked regularly by a team of caregivers.

“There are certain treatments that impact fertility but we have so many options, we can save the fertility,” said Assi. Her dream is to start a clinic at IU Health to specialize in treating women with cancer who are or want to become pregnant.

Assi comes from a family of doctors and grew up exposed to hospitals early in life. As she leaned in toward a career in medicine, she layered in science and the challenges of problem solving. “I didn’t apply for anything else and if I had to do it over again, I would still go into medicine. It’s a privilege to work with patients,” she said.

A native of the Republic of Lebanon, Assi completed her fellowship at the University of Texas Anderson Cancer Center and then returned to the Middle East to work.

“I grew up at a time of war and financial crisis, but we also learned compassion and making ends meet; making do with minimal resources,” said Assi. “I went back and worked in post-war Iraq, building hospital wards and educating on how to treat patients with lymphoma and leukemia.” Her brother and her mother remain in Lebanon. Her father passed in 2022.

“When I went back, the country started collapsing. I was pregnant and I feared for myself and my kids,” said Assi. Her husband is also from Lebanon. They have two children.

“Moving here has been an adjustment but I have a great team. I give a lot of credit to my preceptor, Megan Stevenson, a nurse navigator.”