Cancer During Pregnancy: What You Need to Know

Cancer during pregnancy is a situation that can occasionally take place in women. Fortunately, science has advanced in treatments to be able to face the situation with the best hope for the mother and the fetus.
Cancer During Pregnancy: What You Need to Know

Last update: 13 May, 2021

Having cancer during pregnancy is a matter of great concern for anyone who’s faced with this challenge. Evaluating several aspects before starting treatment is essential.

Pregnancy-associated cancer is any cancerous disease that doctors diagnose during pregnancy or up to one year after delivery. However, some experts reduce the period from one year to 6 months.

The diagnosis of cancer during pregnancy is a complex situation to deal with and full of contradictory feelings. Gestation is a process where one expects new life. However, cancer poses a real threat.

Due to the high complication of cancer during pregnancy, assessing several factors is crucial to know how to cope.

Some of the issues about which patients need information are:

  • The diagnostic and therapeutic scheme they need to follow.
  • Does pregnancy worsen the prognosis for the mother?
  • Is it advisable to interrupt the pregnancy?
  • How does the tumor affect the fetus?

In this article, we’ll take a look at these questions.

Therapeutic scheme for cancer during pregnancy

When this situation occurs, the main therapeutic objective is to cure the patient without affecting the fetus. However, this ideal goal is often very difficult to achieve, so on many occasions, taking initiatives that cause lesser evils is necessary.

In cases in which the cancer diagnosis has taken place during the first trimester and early second trimester, the mother’s health must take precedence. No treatment should be spared, even if it may lead to the death of the fetus.

However, it’s essential to emphasize the importance of assessing the type of cancer, the stage, the treatment in question, and the stage of gestation in each case to guide the patient. This way, she’ll receive detailed and clear information so that, ultimately, it’s she who can make the decision she considers best, according to her beliefs and values.

A doctor putting a stethescope on a pregnant woman's belly.


Effect of pregnancy on the disease

Although there are opposing opinions on this subject, the idea that pregnancy doesn’t alter the natural history of the disease is becoming more and more relevant. The mechanism by which the maternal body allows the growth of a foreign body may suggest a certain permissiveness of the immune system.

This greater facility for tumor development is a constant subject of study in research, as it could be a key to planning safe treatments. However, it seems that, while in pregnancy the orderly growth of gestation is tolerated, this facility doesn’t seem to exist with a disorderly growth such as neoplasia.

Tumor effects on pregnancy

Nor does there appear to be a significant effect on the fetus or the evolution of the pregnancy. The rate of miscarriages and premature births is similar in both cases, and only in some specific cancers -leukemia, cervical cancer– do the complications themselves increase, such as infections, hemorrhages, or difficulty in vaginal delivery.

Therefore, it’s important to know that the fetus is rarely affected. And, if it does occur, the statistics indicate that fetal complications occur to a greater extent with melanomas.

Basis of cancer treatment in pregnancy

The treatment of this disease is based on four main options:

  • Surgery: This involves the excision of the tumor.
  • Radiotherapy: Experts warn against radiotherapy during the first trimester. It can produce alterations in fetal development, mental retardation, and skeletal alterations.
  • Chemotherapy: Patients should avoid chemotherapy during the first trimester of gestation, especially drugs that alter folate metabolisms, such as methotrexate and aminopterin. Treatment with only one type of chemotherapy, such as vinblastine or doxorubicin, is recommended.
  • Biologic agents.
A pregnant woman talking with her doctor about medication.

Find out: What You Should Eat During Pregnancy

Breastfeeding and cancer

Most doctors recommend that women who’ve had their babies and are going to undergo treatment for cancer stop breastfeeding. In the case of breast cancer, if breast surgery is contemplated, stopping breastfeeding will help reduce blood flow to the breasts, causing the breasts to shrink, which may help with the operation.

Many of the drugs used in cancer treatment can leach into breast milk. Therefore, experts don’t recommend breastfeeding if you’re undergoing chemotherapy, hormonal therapy, or targeted therapy.

Conclusion

Cancer during pregnancy is a very compromising situation that requires an assessment from many different perspectives.

It’s possible to heal from cancer despite being pregnant without negatively affecting the fetus. However, it’s a delicate situation, and you must understand that it’s not easy to face.

Consult your doctor about all the options available and they’ll help you to understand which is the most appropriate for your case.

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