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Ovarian Cancer in Pregnancy

Overview

The risk of ovarian cancer in general is quite low. In the United States, only about 1.3 percent of new cancer cases are ovarian cancer. A woman is more likely to be diagnosed after reaching menopause, generally between the ages of 55 and 64, rather than during the childbearing years. Although it can occur, it’s rare to be diagnosed with ovarian cancer during pregnancy.

Signs & symptoms

Symptoms

In the early stages of the disease, you may not have any symptoms. If you do, they may be mild and difficult to distinguish from other pregnancy-related discomforts. Symptoms of ovarian cancer include:

  • abdominal bloating, pressure, and pain
  • upset stomach
  • heartburn
  • difficulty eating
  • feeling full too soon while eating
  • urinating frequently, sometimes with urgency
  • fatigue
  • back pain
  • constipation

Some of these symptoms may be due to pregnancy, but talk to your doctor if they get worse or persist. Tell your doctor if you have a family history of ovarian cancer. According to the National Ovarian Cancer Coalition, there’s a hereditary link about 5 to 10 percent of the time.

Diagnosis

Diagnosis

Your doctor will likely perform a physical examination, but ovarian tumors can’t always be felt. A blood test can detect the presence of CA-125 tumor markers, the marker tied to ovarian cancer. However, levels of this marker can rise and fall for a variety of reasons, so it can’t be relied upon for diagnosis.

Your doctor may also perform imaging tests. This can include a transvaginal ultrasound to check for tumors and estimate their size. If you’re beyond the first trimester of your pregnancy, your doctor may order a pelvic MRI.

A diagnosis of ovarian cancer can only be confirmed with a biopsy of the suspicious tissue.

Treatment options

Treatment

If you’re diagnosed with ovarian cancer while pregnant, you still have treatment options. Each case is different, so you should seek out expert opinions. Your medical team should include a doctor who specializes in ovarian cancer, an obstetrician, and a pediatrician. That way your best interests, as well as those of your baby, will be carefully considered.

The goals of cancer treatment during pregnancy are to save the life of the mother and to bring the baby as close to term as possible. Your treatment choices will depend on how advanced your cancer is, and how far along you are in your pregnancy.

It’s possible that surgery can wait until after you give birth. However, if you experience intense pain, or there’s a risk of serious complications such as hemorrhage or rupture, surgery may be necessary while you are still pregnant.

You can also start chemotherapy while you’re pregnant. One European study found that children whose mothers received chemotherapy in the second or third trimester of pregnancy developed normally. Children carried to full term fared better than children who were delivered prematurely. Chemotherapy is generally not recommended during the first trimester, due to the risk of birth defects. Radiation therapy may also be dangerous for your baby, especially in the first trimester.

Whatever your course of treatment, you’ll need close monitoring throughout your pregnancy.

Effects of ovarian cancer on the fetus

pregnant women

While a few cancers can spread to the fetus, ovarian cancer is not known to be one of them. Your healthcare team will still monitor you and your baby closely to make sure that your cancer doesn’t affect your fetus.

Breastfeeding with ovarian cancer

Breastfeeding

If you plan to breastfeed, there are a few things to consider. Breastfeeding is healthy for your baby, and the cancer won’t pass through your breast milk. However, chemotherapy drugs and other powerful medications can be passed through your breast milk and potentially harm your baby. Talk to your pediatrician about whether or not it’s safe to breastfeed.

Ovarian cancer and fertility

Outlook

Your ovaries are crucial to reproduction. They produce eggs, along with the female hormones estrogen and progesterone. There are several ways that having ovarian cancer can affect your ability to have children in the future. Cancerous tumors can damage your ovaries and your ability to produce eggs. You may also need to have one or both ovaries removed. Chemotherapy and radiation treatments can also trigger early menopause.

If you want to have more children, discuss your options and concerns with a specialist before beginning treatment.

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