What are the Chances?
Cancer during pregnancy is uncommon and rare. But, nonetheless, it does occur. And when it does, it complicates matters for the mother and her healthcare team. The most common cancer that affects pregnant women is breast cancer. About 1 in 3000 pregnant women suffer from breast cancer during her pregnancy.
Compared to a non-pregnant woman, it is difficult to detect signs and symptoms in a pregnant woman as they mimic those of pregnancy– enlargement of breasts, breast tenderness, change in the type of tissue, bloating & headaches. However, routine prenatal screenings such as cervical pap smear and ultrasound can help detect any abnormality and point towards cancer.
Apart from breast cancer, other types of cancers that can occur during pregnancy(very rarely) are cervical cancer, thyroid cancer, Hodgkin and Non-Hodgkin Lymphomas, melanoma, gestational trophoblastic tumour, ovarian cancer, and colorectal cancer.
How Cancer during Pregnancy Impact Diagnosis? Is it Safe for the Child?
Diagnosing any form of cancer during pregnancy can be a tricky affair. Pregnancy can lead to a delay in diagnosis but in some cases, it can actually help reveal the condition. The challenge of cancer during pregnancy is not just because of the symptoms that can be confusing, but also because some forms of diagnostic methods are unsafe when performed during pregnancy. X-rays are completely safe during pregnancy and additionally lead aprons can be used to cover the abdomen and pelvic regions during the procedure. However, a more conclusive result is obtained from CAT and CT scans, both of which have high radiation exposure and should not be used anywhere near a foetus. CT scans of the head, neck and chest regions, MRIs and biopsy are, however, permitted.
What treatment options do I have?
The treatment for cancer during pregnancy is as complicated as it sounds. It requires a multidisciplinary team of physicians, high-risk obstetricians, and oncologists working together. In some cases, doctors advise the pregnancy to be terminated. But, there are many other ways to go about this. Before coming up with the best treatment plan, the doctors will assess the following:
- Term of the pregnancy
- Location of the cancer
- Type and stage of the cancer
- Age of the foetus, and
- What the mother wants
Keeping all these factors in mind, treatment for each woman is custom-made. In instances where the pregnancy has been detected later in pregnancy or in early-stage cervical cancer, the physicians recommend starting treatment after the birth of the child as aggressive treatments can harm the foetus. Treatments such as chemotherapy can be performed during the second and third trimesters when the baby’s growth has halted. In such cases, the woman is advised to not breastfeed her child as it can get transferred to her child. The best form of treatment that physicians prefer for cancer during pregnancy is surgery. It is considered the safest method of treatment as it poses almost no risk to the developing foetus.
It must be known that the prognosis of cancer is the same for a pregnant and a non-pregnant woman. Though some cancers like melanoma tend to increase due to hormonal fluctuations, cancer does not affect pregnancy and pregnancy doesn’t impact the outcome of cancer either. But, the treatment plans vary greatly keeping in mind the safety of the unborn child. Advanced treatments like fertility saving surgeries are possible in state of art institutes in London and New York so patients should look at every platform to educate themselves with treatment options.