Developing cancer during pregnancy is uncommon, but it happens. That doesn’t stop most women from continuing to have a healthy baby. Cancers diagnosed during pregnancy are commonly those that appear at younger ages. The National Cancer Institute (NCI) estimates that about one in 3,000 pregnant women get diagnosed with breast cancer, usually between the ages of 32 and 38. Other potential cancer diagnoses include cervical, thyroid, Hodgkin lymphoma, non-Hodgkin lymphoma and melanoma. While it’s scary dealing with two big life changes at the same time, you have options and considerations available to you.
Cancer and Pregnancy: The Diagnosis
It’s tough to diagnose cancer during pregnancy because your symptoms may be similar to those experienced while pregnant, such as bloating, rectal bleeding or headaches. Your breasts also change during pregnancy, becoming denser and lumpier. That makes it harder to find small tumors. Your cancer diagnosis during pregnancy may come at a later stage in the disease. Many diagnostic tests such as X-ray, magnetic resonance imaging (MRI), biopsy and ultrasound are generally safe for your the fetus. A computed tomography (CT) scan should be limited to the head and chest, and your technician will cover your belly as an additional safety precaution.
Cancer Treatment During Pregnancy
Your treatment options will depend on how far along you are in the pregnancy, the stage of disease, prognosis and your overall health. In general, your doctor may try to avoid treatment in the first 3 months of pregnancy, according to the American Society of Clinical Oncology (ASCO). If you receive a diagnosis late in your pregnancy, you may decide to wait until after the baby’s born to being treatment.
- Surgery: Surgery poses the least risk to your fetus and is the most common choice for breast cancer. You may have surgery to remove the tumor, the breast or the breast and surrounding tissue.
- Chemotherapy: After the first trimester, your doctor may suggest chemotherapy. Your care team will always evaluate the benefits versus risk to the fetus. Many chemotherapy drugs are not able to pass through the placenta and pose little risk. According to ASCO, research so far has shown that babies whose mothers had chemotherapy didn’t have developmental problems. Chemotherapy late in pregnancy, however, can cause side effects that make labor riskier.
Radiation treatment is not recommended during pregnancy because of the risk of exposure to the fetus. It could lead to birth defects, says the American Cancer Society. Hormone and targeted therapy could also harm your fetus. If you’re pregnant and weighing your treatment options, talk to your cancer care team as well as your OB/GYN about the best path based on your specific disease and situation.
Other Considerations for New Motherhood
Because cancer and pregnancy don’t usually occur together, it’s important to find an oncologist who has experience with it. At the very least, this doctor can advise your existing care team. Continue with breast self exams during pregnancy, and talk to your doctor if you notice any major changes. This can help discover cancer at an earlier stage. ASCO advises that pregnancy shouldn’t impact the effectiveness of your cancer treatment, but may delay it, resulting in a prolonged bout with cancer or other negative consequences.
Cancer treatment can also affect your ability to breastfeed. Chemotherapy drugs do end up in breast milk, so it’s best if you avoid breastfeeding while undergoing treatment. Breast surgery may also affect breast milk production and make latching on uncomfortable.
Be sure to talk to your doctor about whether any treatment options will affect your ability to get pregnant in the future if you’re planning on having more children. Although getting cancer while expecting creates significant challenges, by working closely with a knowledgable care team, you can have a healthy and joyful pregnancy.