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Preserving dreams: Utah bill will allow Medicaid to cover fertility treatments for cancer patients

Brittany Watkins poses for a photo outside of her home
in Payson on Friday March 12, 2021. The 26-year-old has been
diagnosed with rare, advanced form of the skin cancer and started
treatment with an oncologist. Her specific treatment — Keytruda, a
relatively new form of immunotherapy — comes with unknowns about
its potential effects on fertility.

(Annie Barker, Deseret News)



Estimated read time: 5-6 minutes

This archived news story is available only for your personal, non-commercial use. Information in the story may be outdated or superseded by additional information. Reading or replaying the story in its archived form does not constitute a republication of the story.

PAYSON — Brittney Watkins dreams of becoming a mother.

But the 26-year-old's path to having children might look a bit different than others after she got diagnosed with melanoma a year ago.

A serious sunburn led her to get tested due to a family history of cancer, and doctors at Intermountain Medical Center in Murray soon discovered she had melanoma. She underwent surgery to remove a mole and infected lymph nodes. But about two months later, Watkins learned she had a rare, advanced form of the skin cancer and started treatment with an oncologist.

She's since dealt with side effects like fatigue, swollen ankles, some hair loss and facial swelling.

"It gets really hard on the people in my life and the people I'm around, and I'm like, 'I'm sorry I can't do this. I need to sit,'" Watkins explained.

The adventurous Payson woman loves visiting Utah's outdoor getaways like Moab. "And I can't do that stuff because I get easily worn out," she said.

But perhaps the most painful aspect of all: Her specific treatment — Keytruda, a relatively new form of immunotherapy — comes with unknowns about its potential effects on fertility.

The issue isn't all that uncommon, especially in the Beehive State, which has a younger population.

Dr. Mark Lewis, an oncologist at Intermountain Healthcare, says that 1 of every 7 of his patients on average are of childbearing age.

A bill passed recently in Utah, HB192, seeks to help young cancer patients on Medicaid who are undergoing treatment that could risk their fertility. The bill would direct the Utah Department of Health to apply for a Medicaid waiver to cover fertility preservation treatments. The bill awaits Gov. Spencer Cox's signature before becoming law.

If Cox signs it, Utah will become only the second state to pass such legislation, Lewis said, which demonstrates the value the state puts on family.

Cancer is not just a "disease of the aging," he said.

About 1,200 adolescents and young adults will be diagnosed with cancer in any given year in Utah, according to Lewis, and of them about 1 in 4 will have Medicaid coverage as their form of insurance, some after being removed from their parents' insurance plans at age 26.

Stories like Watkins occur "tragically, often," Lewis said.

He sees them dozens of times each year.


I want my kids to know, and everybody to know that no matter what you're going through, you have somebody, you have other people that love you besides your family and friends. There's people out there rooting for you.

–Brittney Watkins


Even if the cancer occurs in an area of the body not linked to the reproductive system, fertility can be endangered through the treatments, despite doctors' efforts to minimize "collateral" damage, Lewis explained.

While reeling from their cancer diagnoses, patients often need to think about additional procedures to preserve their fertility. Those procedures often aren't covered by their insurance plans, Lewis said.

They also face an urgency in making decisions about fertility preservation, as treatment for their cancer often needs to start quickly.

"And it is just such an awful whirlwind that patients go through," he said.

The cost of such procedures leads some patients to choose not to get fertility treatments. Some, however, instead choose to delay cancer treatments or undergo ones that might be less risky to their fertility but also less effective, according to Lewis.

Doctors told Watkins if she wanted to be able to have children, she would need to have her eggs preserved.

"I've always wanted to be a mom to nine kids, because I love kids ... and their little hearts. I just love kids," Watkins said, her voice breaking with emotion.

But the procedure for retrieving and preserving a woman's eggs carries a hefty price tag. Watkins had to come up with $5,500 — against a ticking clock as she also needed to begin immunotherapy.

"And it was really hard because at one point, they said I was not going to be able to do it. You come up with the money, and you have to have it within so many weeks, otherwise they don't want to do it because then it prolongs the immunotherapy," Watkins said.

But fundraising efforts brought her one step closer to preserving her dream.

"It wasn't all just family and friends, it was people I didn't know and neighbors, the town I live in," Watkins said.

"It was a sigh of relief. Because when we counted it to make sure ... we really had enough money, it was exactly the amount that we needed to pay it. And it was just, like, really? I was shocked and amazed. I started crying that I was able to start that process and be able to fulfill that dream," Watkins recalled.

After going through immunotherapy, Watkins will then need to wait at least five years before trying to have children, which she describes as "a struggle."

"I've looked at other options too, like having a surrogate and adopting. For me, I would be willing to adopt kids and make sure that they have a home and someone to love them. But it was just so, for me, I wanted to be able to know that I had the chance of having my own kids," she said.

She said she hopes to teach her future children to "never give up."

"No matter what you're going through, you can come out very strong."

Her parents, brother and other loved ones call her "Wonder Woman" because of all she's going through — a nickname she works to live up to.

"I just go along like Wonder Woman and just fight for my life, fight to be cancer-free and to do what I need to do to come out strong and courageous and be Wonder Woman," she said.

"And I want my kids to know, and everybody to know that no matter what you're going through, you have somebody, you have other people that love you besides your family and friends. There's people out there rooting for you."

Watkins praised lawmakers for making moves to help those in her situation.

"I think it's amazing that they're working on a bill so people will have a chance to be able to have kids and not be told that you can't have kids and be denied that opportunity," she said.

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UtahPolitics
Ashley Imlay covers state politics and breaking news for KSL.com. A lifelong Utahn, Ashley has also worked as a reporter for the Deseret News and is a graduate of Dixie State University.

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