Three Questions & Answers About Cancer Treatment During Pregnancy
Who does it affect?
While a cancer diagnosis during pregnancy is rare, it does occur. Typically, it is harder to detect because the symptoms often mimic those common in a normal pregnancy, such as bloating, headaches, and breast changes. However, basic prenatal screenings can discover cancer when it otherwise would have gone unnoticed, such as during a routine pap smear or an ultrasound. Regardless of how and when cancer is found, cancer can significantly impact and complicate a pregnancy.
Breast cancer is the most common type of cancer diagnosis during pregnancy, affecting approximately 1 in 3,000 women. It is difficult to detect during pregnancy, given that signs of breast cancer can be common physiological changes seen in pregnancy, like enlargement of the breasts and changes in tissue texture. This can lead to a later diagnosis than in those who are not pregnant.
How does it impact diagnostic testing?
Other types of cancer can also occur during pregnancy, although they are rarer. These include cervical cancer, thyroid cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, melanoma, and gestational trophoblastic tumors. Diagnosis and treatment can pose many challenges, as some of the procedures used to determine cancer status are harmful to the fetus. For example, x-rays are completely safe during pregnancy, as the level of radiation used is not significant. A lead shield to deflect the x-rays should still be used to cover the abdomen and pelvis as a precautionary measure. However, CAT scans should not be utilized anywhere near the abdomen and pelvis, as this will expose the fetus to radiation. CT scans of the head and chest are typically permissible. Regardless, a health care team should assess the situation and determine the best method of testing on an individual basis.
What are the cancer treatment options?
Planning treatment requires a specialized team of high-risk obstetricians and oncologists to assess what the best options are for the mother that pose the fewest risks to the fetus. This can be a complicated process, as physicians must take a variety of symptoms into account, including the term of the pregnancy, the type and stage of the cancer, as well as the concerns of the expecting mother. Depending on the term of the pregnancy and the treatment selected, physicians may recommend starting treatment after the birth of the infant. This is because some cancer treatments can harm the fetus, some during the first three months of pregnancy, and others in all trimesters. Surgery, however, is considered the safest method of cancer treatment during pregnancy because it poses very little risk to the developing fetus. Several types of chemotherapy can be utilized during the second and third trimesters after the baby’s organs have halted in growth, but mothers receiving chemotherapy should not breastfeed due to its transferability to the infant. Discussing individual treatment options and the factors that play a role in cancer treatment during pregnancy with one’s health care team is vital for the health of both the mother and baby.
Work cited in this post is from Cancer.net's article on cancer during pregnancy: https://www.cancer.net/navigating-cancer-care/dating-sex-and-reproduction/cancer-during-pregnancy