Cancer Treatment During Pregnancy
If you are diagnosed with cancer while you are pregnant, your treatment options may be more limited. Most oncology teams do not have a lot of experience treating pregnant women. It may be a good idea to get a second opinion about your treatment options.
The most common cancer diagnosed during pregnancy is breast cancer, but it is possible for any type of cancer to be found during pregnancy. In some cases, the testing during pregnancy finds cancer. In other cases, the cancer symptoms are thought to be related to the pregnancy, so the cancer diagnosis is delayed.
Diagnosis of Cancer During Pregnancy
When cancer is suspected, your provider may order radiology (imaging) tests to learn more. Some tests, such as MRI and ultrasound, are safe for pregnant women. Tests that use radiation, such as x-rays and CT scans, are not safe. A biopsy may be safe, depending on the area being biopsied.
Your oncology team will consider both your health and the health of the baby when discussing treatment options. They will consider the stage, location, and behavior of the cancer (does it appear to be aggressive or slower growing). They will consider how far into the pregnancy you are as some treatments are not safe early in the pregnancy but are safe in the final trimester.
Some cancer treatments are safer than others during pregnancy. Surgery is often considered the safest treatment during all stages of pregnancy. For example, if you were diagnosed with breast cancer you could have surgery to remove cancer and lymph nodes and it would be considered generally safe. However, this is not the case if the cancer is in an area that involves the baby, such as the uterus.
Chemotherapy can be used during certain stages of pregnancy, but not all.
- Chemotherapy should not be used during the first trimester of pregnancy. The risk of birth defects or losing the baby is greatest during this time. Also, during the first trimester, the baby is still developing, and organs are growing.
- During the second and third trimester, it is possible to receive chemotherapy, if needed. There are certain chemotherapy drugs that are low risk to the baby. The placenta acts as a barrier stopping certain drugs from passing through.
- After 35 weeks of pregnancy or within 3 weeks of delivery chemotherapy is not recommended because there is a chance of low blood counts. This can increase the risk of infection or bleeding.
In general, most women would not be able to receive radiation therapy while pregnant. Radiation can harm the developing baby. It is best to avoid becoming pregnant while getting treatment. If you believe that you may have become pregnant while getting treatment let your provider know right away.
Questions for your provider
Below are some questions you may want to ask your provider if you receive a cancer diagnosis while pregnant.
- What are my cancer treatment options?
- Which treatment plan is best for me? Why?
- Do I need to start treatment right away, or can it wait?
- Could a delay in my treatment affect my outcome?
- Is it safe to continue my pregnancy?
- What are the short- and long-term risks to me and my baby?
- Will I be able to breastfeed?
Receiving a cancer diagnosis or starting cancer treatment while pregnant can be frightening and overwhelming. There are organizations that can offer you support – some are listed below. Talk to your provider if you are interested in joining a support group. Be assured that your care team wants to help you find the treatment plan that is best for you.
Resources for cancer during pregnancy
Hope for Two – The pregnant with cancer network offers support and peer connections.
Information about breast cancer during pregnancy from the Young Survival Coalition.
Dr. Elyse Cardonick is doing a research study following women who have a cancer diagnosis during pregnancy so researchers can learn more about the effects of treatment on pregnancy and the baby. You can learn more about pregnancy and cancer or the registry on her website.
American Cancer Society. Treating Breast Cancer During Pregnancy. (2019) Accessed at https://www.cancer.org/cancer/breast-cancer/treatment/treating-breast-cancer-during-pregnancy.html
Cancer.net (ASCO). Cancer During Pregnancy. (2020) Accessed at https://www.cancer.net/navigating-cancer-care/dating-sex-and-reproduction/cancer-during-pregnancy