What You Should Know About Cancer in Pregnancy

In general, cancer during pregnancy is an uncommon occurrence. Statistics show that about 1 in every 1,000 pregnant women are diagnosed with some form of cancer.

However, experts expect the number of pregnant women with cancer to increase. This is because more people are waiting until they’re older to have children — and the risk of developing most cancers increases as you age.

Breast cancer is one of the most common type of cancer during pregnancy. About 1 in every 3,000 pregnant women will get this diagnosis.

Some common cancers that are diagnosed during pregnancy include:

• breast cancer
• cervical cancer
• Hodgkin’s and non-Hodgkin’s lymphoma
• ovarian cancer
• melanoma
• leukemia
• thyroid cancer
• colorectal cancer

Other cancers, like lung, brain, and bone cancer, can also occur during pregnancy — but they’re extremely rare.

Sometimes, certain symptoms of cancer may overlap with pregnancy symptoms, which can delay a diagnosis. Common signs of both pregnancy and certain cancers include:

• bloating
• headaches
• nausea
• vomiting
• fatigue
• breast changes
• rectal bleeding

There are a rare group of diseases in pregnancy, called gestational trophoblastic diseases, that are caused by abnormal growth of cells (known as trophoblasts) in a woman’s uterus.

They start in early pregnancy and are related to the pregnancy. Some forms can metastasize (spread) and cause death in rare cases.

However, most cases are benign.

If your doctor suspects cancer during pregnancy, they may require you to take certain tests so they can give you an accurate diagnosis. These might include:

X-ray

An X-ray uses low doses of radiation to create images of the inside of your body.

Experts have found that the level of radiation used in an X-ray isn’t high enough to harm an unborn baby. That said, pregnant people should wear a lead shield to cover their belly during an X-ray when possible.

Computed tomography (CT) scan

A CT scan takes detailed pictures of your organs with an X-ray machine that’s hooked up to a computer. CT scans of your head or chest are typically safe to have during pregnancy.

During pregnancy, a CT scan of your abdomen or pelvis should be done only if it’s absolutely necessary. You should also wear a lead shield during a CT scan.

Magnetic resonance imaging (MRI) scan

An MRI uses magnets and a computer to see inside your body. It’s generally considered a safe test for pregnant people because it doesn’t use ionizing radiation.

Ultrasound

An ultrasound uses sound waves to create images of certain areas in your body. It’s considered a safe diagnostic test during pregnancy.

Biopsy

With a biopsy, doctors remove a sample of tissue to test for cancer in the lab. Biopsies are thought to be safe procedures for pregnant people.

Additional diagnostic tests and exams

Your doctor might want to perform a physical exam and lab tests to get more information about your condition.

Sometimes, routine tests done during pregnancy can actually discover a cancer earlier than it would have been found otherwise. For instance, a Pap test can spot cervical cancer and an ultrasound can uncover ovarian cancer in its early stages.

In many cases, cancer will not result in the need to terminate your pregnancy. However, in some cases, you might have to deliver your baby earlier than planned.

You and your healthcare team will need to discuss all the risks and benefits of managing your cancer and pregnancy.

In addition to your OB-GYN specialist, you’ll also need to see an oncologist. An oncologist is a doctor who treats cancer.

You’ll likely have many more doctor appointments than a pregnant person without cancer.

Experts don’t know all the ways that cancer can affect an unborn baby. Though it’s possible for some cancers to spread from the mother to the placenta, most cancers rarely have a direct effect on the fetus.

There have been very rare cases of cancers such as melanoma or leukemia spreading from the placenta to the fetus. If this happens, your doctor will discuss how to treat the baby during pregnancy and once you deliver.

After you deliver your baby, your doctor will check for early signs of cancer. If your baby is cancer-free, they won’t need any additional treatments.

Some cancer treatments can harm an unborn baby. The risk for damage is more likely during the first 3 months of pregnancy, known as the first trimester. This is because during the first trimester, a baby’s organs and body structure are developing.

If you choose to breastfeed or chestfeed your baby while you have cancer, don’t worry — cancer cells won’t pass from you to your baby. Many people with cancer or who have recovered from cancer are able to successfully nurse their babies.

Chemotherapy and other cancer treatments, however, can transfer through breastmilk to your baby. Because of this, you’ll likely be advised not to breastfeed if you’re receiving cancer treatment. Talk with your doctor about the risks and benefits involved.

Years ago, doctors weren’t sure how to safely treat cancer during pregnancy, so many recommended terminating the fetus. Today more women are choosing to treat their cancer while they’re pregnant.

You’ll need to discuss all the pros and cons of receiving cancer treatment during your pregnancy with your doctor. Every situation is different, and they can advise on what’s best for you.

Treatment choices for pregnant people with cancer are the same as treatment choices for nonpregnant people with cancer. How and when treatments are given might be different during pregnancy.

Your treatment options will depend on many factors, including:

• the type of cancer you have
• where your cancer is located
• the stage of your cancer
• how far along you are in your pregnancy
• your personal choices

Common treatments might include:

Surgery

Surgery is usually considered a safe treatment option for parent and baby, particularly after the first trimester of pregnancy.

The type of surgery will depend on the type of cancer. The goal of surgery is to remove cancerous tumors.

If you have breast cancer while pregnant, surgery may affect your ability to breastfeed if you have a mastectomy or radiation. Be sure to talk with your doctor about how surgery will affect nursing if this is something you’re considering.

Chemotherapy and other medications

Chemotherapy involves using toxic substances to kill the cancer in your body.

Chemo and other anticancer drugs can harm the fetus, cause birth defects, or lead to miscarriage — especially if they’re used during the first trimester of pregnancy.

Some chemotherapies and other cancer-fighting drugs can safely be given during the second and third trimesters.

Radiation

Radiation uses high-energy X-rays or particles to destroy cancer cells in your body. This therapy can harm an unborn baby, particularly if it’s used during the first trimester.

Sometimes, radiation can safely be used in the second or third trimesters of pregnancy, but this depends on the type, dose, and area being treated.

Should you delay treatment?

You might choose to wait to start your treatment until the last trimester or even after your baby is born. This is especially common if the cancer is diagnosed later in pregnancy or if it’s a very early stage cancer. Your doctor might be able to induce your labor early if necessary.

In general, pregnancy shouldn’t affect how well a cancer treatment works, but delaying treatment because of pregnancy might affect your outlook.

While cancer during pregnancy is rare, it can and does happen to some people. Often, a pregnant person with cancer has the same outlook as a person with cancer who isn’t pregnant.

Typically, being pregnant while having cancer shouldn’t affect your overall outlook. If a cancer isn’t found early because of pregnancy or you choose to delay treatment, this may affect your outlook.

Talk with your doctor about the best way to treat your cancer during pregnancy. Many people go on to recover from cancer and have healthy babies.