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Cancer During Pregnancy- How Cancer Impacts a Pregnant Woman?

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Although pregnancies affected by cancer are very rare, it is impossible for cancer cells to go from mother to child in the great majority of situations. Likewise, breast milk cannot transmit cancer to a child. However, cancer during pregnancy still harms the unborn child. Because cancer treatments like chemotherapy and radiation pose risks to unborn children, women with cancer are cautioned against becoming pregnant.

It’s natural to worry about how cancer, cancer therapy, and cancer diagnostics may affect your unborn child. Pregnant women may get several types of cancer therapy without risk to their unborn child. Most malignancies in women do not pass on to their offspring. 

  • Cancer treatment during pregnancy can increase the risk of preterm birth.
  • Some cancer drugs can cross the placenta, affecting the fetus.
  •  Certain cancer treatments may affect future fertility even after pregnancy.
  • Pregnancy can reveal early-stage cervical cancer through routine screenings.
  • Pregnant women undergoing cancer treatment often require more frequent fetal monitoring.
  • The emotional impact of a cancer diagnosis during pregnancy can be significant for both the mother and partner.
  • Some cancers may grow faster during pregnancy due to hormonal changes.
  • Chemotherapy is typically postponed until the second trimester to reduce fetal risks.

In this article, we will see which treatments are less harmful for both pregnant women and children.

Effect on Unborn Child

Recent advances in therapy and diligent monitoring make it more probable that pregnant women with cancer will be able to safely birth their babies. If you are pregnant and coping with cancer, realize that you can still have a healthy kid.

Cancer transmission from mother to child during pregnancy is conceivable but quite unlikely. Very few cases have been documented to the time, and they have almost exclusively occurred in people with leukemia or melanoma. 

Pregnancy-Related Cancer

Cancer is not caused by pregnancy, and neither is the risk of cancer increased during pregnancy. Cancers of the breast (by far the most prevalent) and uterus are among the most often diagnosed in pregnant women.

Molar Pregnancies

Molar pregnancies are uncommon, yet they have been linked to cancer. Diseases of the trophoblast during pregnancy include molar pregnancies. Tissue that would typically develop into a fetus instead becomes a tumor in the uterus. Molar pregnancies may produce pregnancy-like symptoms but are not true pregnancies. In the case of a molar pregnancy, no fetus develops.

Prenatal Cancer Detection

Pregnancy brings on a host of uncomfortable side effects, including exhaustion, sickness, breast changes (lumpiness), bloating, rectal bleeding, exhaustion, and headaches. However, these signs might show a certain kind of cancer. If you have symptoms late in your pregnancy or at other times that are out of the ordinary, discuss them with your doctor.

Having a baby may sometimes lead to the discovery of cancer at an earlier stage than would have been possible otherwise. Cervical cancer may be detected, for instance, with a Pap test that is part of standard prenatal care. Ovarian cancer may sometimes be detected using an ultrasound during pregnancy.

Radiation Risk for Child

You may be concerned that putting your unborn child through cancer diagnostic testing is not worth the risk. X-rays, CT scans, and nuclear medicine exams all expose you to radiation, and this might make you nervous. Some of these tests, however, may be performed without risk to the unborn child and provide vital information to help your doctor treat the cancer effectively.

Diagnostic Imaging Using X-Rays And CT Scans

The risk of injury to the unborn child from these examinations varies with the gestational age of the mother, the number of x-rays taken, and the strength of the radiation. For the mother’s safety, a lead shield is always placed over her stomach during x-rays and CT scans.

The amount of radiation in an x-ray used to detect cancer (with proper shielding) is too low to damage the unborn child.

CT scans are more accurate in showing internal organs and structures than standard x-rays, but they also utilize more radiation. They aid in making a cancer diagnosis and tracking the disease’s progression. Head and chest CT scans are safe. Abdominal and pelvic CT scans should be reserved for cases when they are medically required.

Biopsy, Ultrasound Imaging, and MRI

Because magnetic resonance imaging (MRI) and ultrasounds do not involve radiation, they may be safely used during pregnancy. Cancer may also be safely and effectively diagnosed via the use of physical examinations and many biopsies. 

Cancer Treatment During Pregnancy

Cancer treatment during pregnancy presents unique challenges. Your obstetrician will evaluate your baby’s age, physical maturity, and due date to help you plan your cancer treatment and ensure the baby is developing normally during your pregnancy.

The medical staff will weigh the benefits of various treatments against any potential dangers to the unborn child in order to choose the best course of action. Pregnant women have access to the same cancer treatment choices as non-pregnant persons, albeit the timing and mode of administration of their therapy may vary.

Which Factors Determine if and When Therapy is Administered?

  • The cancer’s location
  • Its kind, stage
  • Mother’s and the child’s ages
  • Trimester of pregnancy, and 
  • Mother’s and child’s preferences

Options for the Treatment of Pregnant Woman

Your care is individualized; surgery, chemotherapy, and radiation therapy are all options for treating cancer during pregnancy. These are carefully planned to ensure the best possible outcomes for both mother and child.

Following options regarding the time for treatment may be planned

First Option  Second Option Third Option
Particularly dangerous are cancer therapies given in the first trimester of pregnancy. During this time, the baby’s organs and skeleton begin to take shape. Cancer therapy is sometimes postponed until the second or third trimester of pregnancy. In cases when cancer is detected later in the pregnancy, treatment may be postponed until after the birth of the baby. In such cases, the doctor may recommend inducing labor to speed up the process. It may be safe to carry the pregnancy to term and defer treatment for certain malignancies, such as extremely early stage cervical cancer, until after the baby is delivered. Or, if cancer is caught early enough, a small operation to remove the tumor poses little risk to the unborn child.

The decision to continue a pregnancy is one that you and your doctor may need to make under certain circumstances. If an advanced or dangerous cancer is detected early in the pregnancy, immediate treatment may be the safest choice.

Surgery

After the first trimester, surgery may be the safest approach for treating some malignancies. The dangers to you and your baby may be minimized because of technological advances in surgery and vigilant monitoring.

Drug Treatments

Chemotherapy refers to the practice of treating cancer using anticancer medications. It’s a treatment that works on a systemic level. As a result, the medicine may go through the circulatory system and target cancer cells wherever they may be. Some cancer treatments, including chemotherapy, may be harmful to an unborn child, particularly if administered during the first trimester, when the fetus’s organs are still maturing.

In order to lessen the potential harm to the unborn child, doctors may occasionally put off administering chemotherapy. Delaying chemotherapy treatment may be an option depending on the stage and progression of the disease.

First Trimester Drug Treatment

First trimester chemotherapy increases the risk of miscarriage, low birth weight, and congenital abnormalities. Different types of chemotherapy have different risks of birth abnormalities when administered during the first trimester of pregnancy.

Second and Third Trimester Medicinal Treatment

Many chemotherapy and other treatments may be administered throughout the second and third trimesters without causing damage to the infant, however other chemotherapy drugs given during these times are linked to low birth weight and stillbirth (delivery of a baby who has died). The placenta offers a great deal of safety. 

During pregnancy, the placenta forms to link the mother’s and baby’s circulatory systems. It’s a source of nourishment and a sink for toxins. In addition, it creates a barrier that prevents many chemotherapeutic agents from reaching the developing fetus.

Other Considerations for Drug Treatment

  • Because of the increased risk of bleeding and infection during labor, chemotherapy is not suggested beyond 35 weeks of pregnancy, which is three weeks before delivery. 
  • If you’ve lost bone marrow due to chemotherapy, stopping treatment now may help you get it back. 
  • It may also give the placenta time to aid in medication elimination from the infant’s system and give your blood count time to normalize before delivery.
  • The long-term consequences of several medication treatments, such as biological therapies and targeted therapies, on an unborn child remain unknown. 
  • Infection, anemia, and nausea and vomiting are just a few of the side effects a woman may experience with chemotherapy and other pharmacological regimens.

A Radiation Therapy

In order to kill cancer cells and reduce the size of tumors, radiation treatment makes use of high-energy x-rays or particles. Since a baby’s organs and nervous system are still growing in the first trimester of pregnancy, radiation is generally avoided at that time. The dosage and location of radiation treatment determine whether it may be used in the second or third trimester of pregnancy.

Careful planning is employed to treat you with radiation treatment if you have a malignancy that is distant from the developing baby in the pelvis. The radiation exposure of the infant is minimized by using lead shields or blocks. 

Treating Breast Cancer During Pregnancy and Pelvic Cancer Through Radiation

Radiation treatment is not safe for treating pelvic cancers at any stage of pregnancy because it may harm the developing baby. Miscarriage, congenital abnormalities, impaired brain development, and a slowed fetal growth rate are all outcomes at this period. 

  • Most doctors will advise against continuing a pregnancy beyond the first 26 weeks. 
  • Many times, cancer treatment may be postponed until after birth if it is detected later in the pregnancy.
  • Breast cancer radiation treatment is often postponed until after the baby is delivered.

Takeaway

When it comes to risks and treatments, cancer during pregnancy is not like any other cancer. When a woman is pregnant and diagnosed with cancer, her prognosis (expected result) is frequently the same as that of a woman of the same age who is not pregnant and who has the same kind and stage of cancer.

Cancer does not get transmitted from mother to fetus or infant. Breast milk does not transmit cancer to infants. However, chemo and other medications used during pregnancy may be passed on to the infant. Babies are also vulnerable to radioactive chemicals that are ingested orally such as radioactive iodine used to treat thyroid cancer if the mother continues to breastfeed. If you need systemic medication, such as chemotherapy, you may be instructed to discontinue nursing, at least temporarily.

Cancer During Pregnancy- How Cancer Impacts a Pregnant Woman?

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