Cancer complicating Pregnancy

Pregnant women are inevitably in their youth or occasionally in their early middle age. This means that they are at risk of those cancers that affect people in this age range. It also means, this problem is relatively uncommon; even rare.

In this age group, cancer of the cervix, ovary, breast, blood (leukemia), skin (melanoma) and lymphatic system (lymphoma) come to mind. While it is true that most of these are commoner in late middle age and beyond, they are also seen in the younger reproductive age groups. This is why roughly one in a thousand pregnant women will be found to have cancer.

This obviously raises very serious questions:

v Is the cancer treatable?

v Is the treatment compatible with continuing pregnancy?

v Will the cancer affect the baby?

v Will the treatment affect the baby?

v Should a termination be performed and is this an acceptable proposition? These and many more.

Cancers are a very diverse group and one will be well advised not to give or expect sweeping all-encompassing statements. For some, such as cervical cancer, treatment is required almost promptly or at the very least within a few short weeks of diagnosis to maximize the chances of a favorable outcome. Nor is treatment in this casecompatible with continuing pregnancy and very rarely with future pregnancy. These facts are discussed in detail here.

Other forms of cancer treatment - such as that of the breast or thyroid - may be compatible with continuing pregnancy, depending on the stage of the disease and the pregnancy itself. Again, all these facts are tackled here.

Black and white answers are uncommon with cancer and that is even before pregnancy adds another dimension to the equation.

Pregnancy and cancer risk

Pregnancy does not increase cancer risk. A woman's risk of developing any of the various forms of cancer remains the same when pregnant.

Risk of cancer for the fetus

If a woman develops cancer during pregnancy, her baby is likely to be affected but not directly. Instead, the action that is likely to be taken to treat the condition is more likely to have an adverse effect on the fetus than the actual cancer. Three factors are important: The type of cancer, the form of treatment adopted and the stage of pregnancy.

Cancer spreading to the fetus

This is exceedingly rare. Only a handful of cases have ever been reported in the world. The working assumption is always that this is not going to happen.

Treating cancer diagnosed during pregnancy

Again, this depends on the type of cancer, the stage of the disease and occasionally the patient's wishes, as we shall see (next page).