As soon as most women find out they are pregnant, they want to protect their little baby as much as possible. So to discover they also have cancer will feel even more devastating, as the happiest time of their lives has now become the most challenging.
There are bound to be tons of questions pregnant women who have been diagnosed with cancer want answers to, so read on to find out what cancer means for the baby and what treatments options are still available.
Will cancer affect the unborn child?
The first thing expectant mothers will want to know is whether the cancer will spread to the baby.
It is, in fact, very rare for the cancer to reach the placenta and, therefore, be passed on to the foetus along with the oxygen and nutrients carried in the blood.
To ensure the health of the baby, there are likely to be more ultrasound scans during the pregnancy. After the baby is born, doctors might investigate the placenta to check whether there were any cancer cells inside that could have spread to the child.
What cancers are typically diagnosed during pregnancy?
Women can develop any type of cancer during pregnancy, but the most common are breast, gestational trophoblastic disease, cervical cancer, Hodgkin lymphoma, melanoma, non-Hodgkin lymphoma, thyroid cancer, and leukaemia.
It can be harder to detect cancer in a pregnant woman, as their body is already undergoing a lot of alterations, many of which are similar to cancer symptoms.
For instance, hormonal changes can cause tender, lumpy and bigger breasts; haemorrhoids in pregnancy can lead to rectal bleeding, which could, in fact, be colon or rectal cancer; and pregnancy fatigue could disguise signs of leukemias and lymphomas.
What’s more, it can be harder to feel for any ovarian tumours as the foetus is growing.
As a result, cancers might not be discovered until later on, giving it time to spread more in the body.
On the other hand, sometimes being pregnant could help with the discovery of tumours. For instance, ultrasounds to check on the baby could show ovarian cancer, while a smear test would show abnormal cervical cells.
Anyone who is concerned they might have cancer while pregnant should see a doctor, as there are some safe tests that can be done to determine whether there is a malignant tumour or not.
Bone scans, CT scans and PET scans might have to be avoided so the baby is not exposed to radiation, but there are other checks that can still be carried out, including mammograms, ultrasounds, chest x-rays, and MRIs.
What happens after you receive a diagnosis?
After being given a cancer diagnosis while pregnant, you will still be under the care of the midwife and obstetrician to ensure the pregnancy goes well and the baby remains safe and healthy.
This means all the usual checks and scans will take place, while they might fit in more appointments to reassure you about the baby’s wellbeing.
If the cancer is discovered at the beginning of the pregnancy, depending on the stage and spread of the illness, the oncologist might advise to terminate the pregnancy so you can begin aggressive treatment.
However, in women who are nearly at the end of their pregnancy, their delivery date might be brought forward.
Each case is different, and it is up to the mother and her doctor to decide what course of action to take for the sake of herself and the baby.
Is it safe to have cancer treatment during pregnancy?
Although mothers-to-be will be deeply concerned about whether cancer treatment will impact their unborn child, they can be reassured that a multidisciplinary team, made up of an oncologist, nurse, obstetrician and midwife, will determine the best thing to do to keep you both safe.
The treatment or medication you are given will depend on the stage of the pregnancy, the type of cancer and how far it has spread, how quickly it is growing, and whether you are hoping to control the cancer or cure yourself of it.
For those with early stage cancer or a tumour that is slow growing, it might be advised to delay the treatment until after the baby is born and let the doctors monitor its growth in the meantime.
However, if your oncologist recommends starting treatment before you deliver, there are a few options available.
What cancer treatment is safe during pregnancy?
After 14 weeks, it is typically considered safe to have chemotherapy, which is why it is commonly used for those with breast and cervical cancers, as well as lymphomas and leukemias, while pregnant.
While it carries the risk of birth defects or loss during the initial three months, after the first trimester it is thought to be a low-risk option, as the placenta is fully developed and is able to block the majority of the drugs from passing through.
According to Cancer.net: “Studies suggest that children exposed to chemotherapy during pregnancy do not show more health issues than children who are not. This includes right after birth and during the child’s growth and development.”
Towards the end of the pregnancy, chemotherapy could lead to a risk of infection for the baby and makes it more likely there will be bleeding during birth. That is why it is normally stopped three to four weeks before the baby is due.
Radiotherapy is not usually given during pregnancy, particularly if the tumour is close to the baby, as a result of the radiation exposure. This could result in miscarriage, and birth defects, as well as slow the growth of the foetus and increase the chance of childhood cancer.
If the tumour is in a part of the body that is away from the foetus and the doctors consider it safe to go ahead with the treatment, radiotherapy is typically conducted during the early part of pregnancy as the baby is smaller.
Alternatively, radiation therapy might be delayed until after the baby is born.
Hormone therapy is commonly given to treat breast cancer, but this is not given during pregnancy as it can cause birth defects. Therefore, pregnant mothers wait until after they deliver their baby before starting the drugs.
Immunotherapy and targeted drug therapy are also usually avoided during pregnancy as they might cause harm to the baby.
Cancer patients who require surgery can go ahead with the procedure during pregnancy, as the risk to the foetus is low.
A general anaesthetic will not usually be given until 14 weeks, so some women might have to wait until they are through the first trimester before they can have surgery.
What happens after the baby is born?
After the baby is born, some women will have to either start or continue their cancer treatment. This, along with looking after a newborn baby, can be extremely challenging.
This is particularly the case if they need to deliver their baby early to start their treatment, and, subsequently, their child has to be cared for in neonatal intensive care units.
It is important to make the most of the support from friends and family, and the multidisciplinary team that is taking care of you and the baby at this difficult time.