Cancer diagnosis during pregnancy

Can I be diagnosed with cancer while I am pregnant?

Receiving a cancer diagnosis while you're pregnant is very rare and is a challenging situation to face.

Some people have no symptoms and are diagnosed with a cancer of their reproductive organs when their doctors perform regular screening. This includes screening for cervical and breast cancer during a routine visit in early pregnancy. The diagnosis may come as a shock, and you may need to take some time to come to terms with it.

Others may see their doctor with symptoms found to be from cancer. Pregnancy changes and symptoms can be similar to some cancer symptoms, so if you are unsure, it is best to see your doctor.

I am pregnant and have been diagnosed with cancer. What are my options?

There are a couple of reasons why you might need cancer treatment while pregnant: either you become pregnant while being treated for an existing cancer, or you've received a diagnosis of cancer during your pregnancy.

In both these situations, you will have a team of specialist doctors that can support and advise you about the risks and benefits of treatment, both to you and your pregnancy.

Your treatment options will depend on the type of cancer, how far it has spread and the stage of your pregnancy. In some cases, cancer can be treated during pregnancy. In other cases, you can delay treatment until after your baby is born.

In some situations, you might need treatment that is unsafe in pregnancy. In this case, your doctor may advise you to consider termination. Termination of pregnancy is a difficult and stressful option to consider. You might find it helpful to discuss your options with your doctor, a counsellor or psychologist or people you trust for support and advice.

How is cancer treated during pregnancy?

Cancer is usually treated by one or more of these 4 options:

• surgery
• radiotherapy
• chemotherapy
• hormonal therapy

Treatment will depend on the type of cancer, how advanced it is, and on the stage of your pregnancy. Decisions about your treatment will only be made after a team of specialist doctors, including oncologists (cancer specialist) or haematologists (blood specialist) and your obstetrician, have carefully considered all your options — and taken into account your views, wishes and concerns.

Can I have surgery to remove a cancer while I am pregnant?

Surgery to remove a cancer can often be performed safely during pregnancy. Cancers that are far away from the abdomen (such as skin cancers) can often be removed easily. Surgery to remove cancers in the abdomen or the reproductive system may need to be planned by your medical team, but they can often still be performed safely and effectively.

If you need to have surgery on your reproductive organs, your doctor may advise you to first have your baby by caesarean section to reduce the risk of damage to these organs.

Is radiation therapy safe during pregnancy?

Radiation therapy uses x-rays to kill fast-growing cells. Because your baby's cells are also fast-growing, radiation therapy is generally not recommended during pregnancy.

In rare cases, your doctor may still advise you to have radiation therapy during pregnancy. They will discuss with you the risks and benefits, both to you and your baby, of receiving this treatment.

Is chemotherapy safe during pregnancy?

Chemotherapy uses strong medicines that attack fast-growing cells, such as cancer cells. Since a pregnancy also involves many fast-growing cells, chemotherapy can be harmful to a developing unborn baby. The treatment can also increase the chance of miscarriage, premature birth and birth defects. This is especially true during the first trimester, when most of your baby's organs are developing.

However, in some cases where your doctor may still recommend chemotherapy to treat your cancer. If so, they will choose the medicines and doses of chemotherapy that have the greatest chance of treating your cancer, with the lowest risk of causing harm to your baby.

If you do receive chemotherapy during pregnancy, you doctor may advise you to stop it a few weeks before your baby is due to be born. This is to give your baby's immune system time to recover from the chemotherapy and offer them the best chance to fight off any infections they may be exposed to after birth.

Hormonal therapy is usually not recommended.

Will the cancer affect my baby?

It is very unlikely your baby will get cancer from you. Cancer and its treatment can, however, cause other changes in your body, which may affect your baby's health and development. Your doctors may recommend additional monitoring of your baby's growth while you have treatment for cancer in pregnancy. Your baby may also need extra blood tests, scans or have longer term follow up after being born, if you received certain chemotherapy drugs in pregnancy.

If you choose to delay cancer treatment until after your baby is born, you and your doctor may decide to induce labour. This may mean your baby will be born a little early (premature) and may need to stay in hospital if any issues associated with being born early occur.

Who can I talk to for more information and support?

Receiving a cancer diagnosis is stressful at any time, but especially challenging during pregnancy. You may be given a lot of information quickly and need to make difficult decisions that will affect you and your baby. You might find it helpful to have someone with you when you see your doctor. They can help by taking notes for you if you find the experience overwhelming.

Remember, you don't have to go through this alone. Your doctors including GP, obstetrician, oncologist or haematologist, are there to provide advice. They can refer you to psychologist or counsellor for further support. Other people you trust can support and help you consider your options.

The Cancer Council provides free confidential telephone support on 13 11 20.