Cancer Diagnosis in Pregnancy: You Have Options

A cancer diagnosis is daunting under any circumstance, but receiving such news during pregnancy can feel overwhelming. For expectant mothers, questions about treatment, risks and the well-being of their unborn child are at the forefront. The good news is that advances in medical care mean that pregnant women with cancer have more options than ever before. With multidisciplinary cancer care and personalised treatment plans, many mothers and babies go on to thrive. This article explores what to expect and the available options when faced with cancer during pregnancy.

Table of Contents

• What Happens If You Have Cancer While Pregnant?
• Can You Still Have a Baby If You Have Cervical Cancer?
• How Is Cancer Treated During Pregnancy?
• Chemotherapy in Pregnancy
• Radiation Therapy During Pregnancy
• Surgery During Pregnancy
• Can I Have Chemo While Pregnant?
• Can a Baby Survive if the Mother Has Cancer?
• Managing Cancer in Pregnancy
• Pregnancy Complications and Cancer
• Fetal Health and Cancer
• Emotional Support During Cancer and Pregnancy
• Cancer and Childbirth Options
• High-Risk Pregnancy Cancer Care
• Multidisciplinary Cancer Care
• Conclusion

What Happens If You Have Cancer While Pregnant?

Receiving a cancer diagnosis while pregnant is rare, with approximately one in 1000 pregnancies affected. The most common cancers during pregnancy include breast cancer, cervical cancer, lymphoma and melanoma. A diagnosis often arises from routine prenatal check-ups, where abnormalities prompt further investigation.

The approach to managing cancer during pregnancy depends on several factors, including the type and stage of the cancer, how far along the pregnancy is and the mother’s overall health. In some cases, treatment may be postponed until after delivery, while in others, it may begin immediately.

Can You Still Have a Baby If You Have Cervical Cancer?

Cervical cancer is one of the more common cancers diagnosed during pregnancy. The possibility of continuing the pregnancy depends on the stage of the cancer and how early it is detected. For women with early-stage cervical cancer, it is often possible to delay treatment until after childbirth. However, in advanced cases, immediate intervention may be necessary.

In some instances, a planned preterm delivery may allow for cancer treatment to begin sooner while still giving the baby a chance of survival. Women with cervical cancer should consult with specialists in maternal cancer care to explore their options.

How Is Cancer Treated During Pregnancy?

Cancer treatment during pregnancy is a complex process that requires balancing the needs of the mother with the health and safety of the fetus. Fortunately, many cancer treatment options during pregnancy can be safely pursued, depending on the type of cancer and the gestational stage.

Chemotherapy in Pregnancy

Chemotherapy in pregnancy is generally considered safe during the second and third trimesters. By this stage, the baby’s organs have already developed, reducing the risk of congenital abnormalities. Certain chemotherapy drugs, such as doxorubicin and cyclophosphamide, are commonly used with minimal risk to the fetus. However, chemotherapy is typically avoided during the first trimester due to the high risk of miscarriage and developmental issues.

Radiation Therapy During Pregnancy

Radiation therapy during pregnancy is more complex, as it can pose significant risks to the fetus, particularly during the first trimester. Depending on the location of the cancer, radiation may still be an option if precautions, such as shielding the abdomen, are taken. However, in most cases, alternative treatments are pursued to minimise potential harm to the baby.

Surgery During Pregnancy

Surgery is often the safest cancer treatment option during pregnancy. It can be performed in many cases, especially during the second trimester when the risks of anaesthesia and complications are lower. For some cancers, surgery alone may be sufficient to manage the disease, allowing chemotherapy or other treatments to be delayed until after delivery.

Can I Have Chemo While Pregnant?

Yes, chemotherapy can be administered during pregnancy, but it is generally reserved for the second and third trimesters. Studies have shown that babies born to mothers who received chemotherapy in the later stages of pregnancy often develop normally. However, there is a slightly increased risk of preterm birth and low birth weight.

The decision to proceed with chemotherapy during pregnancy should involve a multidisciplinary cancer care team that includes oncologists, obstetricians and neonatal specialists. This ensures that both the mother and the baby receive the best possible care.

Can a Baby Survive if the Mother Has Cancer?

In the majority of cases, babies can survive and thrive, even when their mothers are undergoing cancer treatment. Advances in prenatal cancer diagnosis and maternal cancer care have improved outcomes significantly.

That said, certain cancers or treatments may increase the risk of pregnancy complications, including preterm birth, low birth weight or fetal growth restriction. Close monitoring of fetal health and cancer treatment is essential to minimise these risks. Regular ultrasounds, fetal heart monitoring and assessments of amniotic fluid levels can help ensure the baby’s well-being.

Managing Cancer in Pregnancy

Managing cancer in pregnancy requires a tailored approach that prioritises both maternal and fetal health. A high-risk pregnancy cancer care team typically includes specialists from multiple disciplines, such as oncology, obstetrics, neonatology and psychology.

Pregnancy Complications and Cancer

Cancer and its treatment can increase the risk of complications during pregnancy. These may include preterm labour, preeclampsia or low birth weight. Women should attend all scheduled prenatal visits and report any unusual symptoms promptly to their healthcare provider.

Fetal Health and Cancer

One of the primary concerns for expectant mothers with cancer is how their illness and its treatment might affect their baby. While some treatments, such as chemotherapy in pregnancy, are considered safe after the first trimester, others, like radiation, carry higher risks. Ongoing monitoring and coordination between maternal and fetal healthcare providers are key to safeguarding the baby’s health.

Emotional Support During Cancer and Pregnancy

A cancer diagnosis during pregnancy is not only physically challenging but also emotionally overwhelming. Women may struggle with feelings of fear, guilt or uncertainty about their future and their baby’s health. Emotional support, such as counselling and support groups, can provide valuable coping mechanisms.

Family and friends also play a vital role in offering encouragement and practical assistance, such as helping with childcare, appointments or household tasks. Women should not hesitate to reach out for help when needed.

Cancer and Childbirth Options

When it comes to childbirth, most women with cancer can have a normal vaginal delivery. However, certain factors, such as the type of cancer, stage of treatment or any pregnancy complications, may influence the decision.

For example, a caesarean section may be recommended if the cancer is located in or near the pelvic area, as in cervical or ovarian cancer. Women should discuss their labour and delivery options with their healthcare team to determine the safest approach.

High-Risk Pregnancy Cancer Care

Pregnancy with cancer is typically classified as high-risk, requiring specialised care to address the unique challenges of managing both conditions simultaneously. High-risk pregnancy cancer care includes regular monitoring, frequent consultations with specialists and personalised treatment plans.

For some women, delivering the baby early may be necessary to begin more aggressive cancer treatment. In such cases, neonatal care teams are prepared to provide support for preterm infants.

Multidisciplinary Cancer Care

The key to successful management of cancer during pregnancy lies in multidisciplinary cancer care. This approach brings together experts from various fields to develop a comprehensive treatment plan that considers both maternal and fetal health.

By working together, specialists can coordinate treatment schedules, monitor fetal development and address any complications promptly. Women should feel empowered to ask questions and advocate for their needs throughout this process.

Conclusion

A diagnosis of cancer during pregnancy is undoubtedly challenging, but it does not mean you are without options. Advances in maternal cancer care, chemotherapy in pregnancy and multidisciplinary approaches have made it possible for many women to receive effective treatment while safeguarding their baby’s health.

If you are pregnant and facing a cancer diagnosis, remember that help is available. Get in touch with one of our specialised oncologists and obstetricians.

Working closely with your Lenmed healthcare team will help to develop a treatment plan that meets your needs and ensures the best possible outcome for both you and your baby. With the right care and support, you can navigate this difficult journey with hope and strength.

For more information, please contact:

Dr L. Blaauw
Discipline: Oncologist
Hospital: Sunningdale Private Hospital, Wilmed Park Private Hospital, Daleside Day Hospital
Telephone: +27 18 468 1420