The appearance of cancer during pregnancy is a challenge that goes beyond the clinical. Expecting a baby is a time of hope and joy, while receiving a cancer diagnosis triggers fears and dilemmas. The interaction between these two worlds creates a complex context for doctors and patients.
Pregnancy-associated cancer, defined as any malignancy diagnosed during pregnancy or up to six months after delivery according to the World Health Organization (WHO), is very rare. Although the incidence is low (around 0.07% according to studies published in Medline), the emotional and medical impact is considerable.
What to do? Will I be able to carry my pregnancy to term? How will the fetus be affected? Are there treatment options? Let's take a look.
Read also: Cancer risk factors: what is in your hands?
Diagnostic and types of cancer during pregnancy
Diagnosing cancer during pregnancy can be challenging, as many of the symptoms can be similar to normal changes that occur during pregnancy. Therefore, it is important to take into account several aspects to identify any problems and see an oncology specialist as soon as possible.
Diagnostic
A combination of methods is used to diagnose cancer in a pregnant woman. Imaging tests such as computed tomography (CT) and magnetic resonance imaging (MRI) are helpful, but care must be taken, especially in the first trimester, due to the sensitivity of the fetus. These techniques allow detailed images of the body to be obtained and possible problem areas to be detected.
Another important aspect of diagnosis is a biopsy, which involves taking a small sample of tissue to be examined in the laboratory. This helps confirm the presence of cancer cells and determine the type of cancer.
Although the thought of cancer is frightening, a timely diagnosis will ease the burden that comes afterward. An oncology specialist will also be able to treat you in the safest and most appropriate way for your case, always taking care of your health and that of the fetus.
Types of cancer
The most common types of cancer during pregnancy include breast cancer, cervical cancer, thyroid cancer, melanoma, and ovarian cancer. These cancers can affect women at different stages of pregnancy, and each type may require different approaches to diagnosis and treatment.
Breast cancer: This can be difficult to detect during pregnancy because of changes in breast tissue. Ultrasounds and biopsies are often used to identify abnormalities.
Cervical cancer: This is often diagnosed through routine screening, such as cervical cytology. Colposcopy may also be used to take a closer look at the cervix.
Thyroid cancer: This is detected through imaging tests and blood tests that assess thyroid function. Fine needle aspiration biopsy (FNA) is a key tool to confirm the diagnosis.
Melanoma: This type of skin cancer can be diagnosed by looking at moles or skin changes. Biopsies are essential to determine the depth and extent of the tumor.
Ovarian cancer: Often discovered during prenatal ultrasounds, transvaginal ultrasound is especially useful for evaluating ovarian masses.
Cancer treatment during pregnancy
In the treatment of cancer during pregnancy, of course, both the health of the mother and the fetus must be considered. In this regard, the approach to treatment depends on several factors, such as the type of cancer, its stage and the stage of pregnancy.
In general, cancer treatment during pregnancy follows a basic principle: treat the mother's cancer without putting the fetus at risk. However, there are exceptions to this rule, and each case must be carefully evaluated.
You may be interested in: The importance of psychological care in cancer
Surgical Treatment
Surgery is one of the safest treatments during pregnancy. Depending on the type and location of the cancer, tumors can be removed without harming the fetus. Surgery is usually preferred over radiation therapy or chemotherapy, especially in the early stages of pregnancy.
Radiation Therapy
Radiation therapy uses radiation to destroy cancer cells. It is used with caution in pregnancy because radiation exposure can be dangerous to the fetus. It is usually avoided during the first trimester, when the fetus is most vulnerable. Beginning in the second trimester, radiation therapy may be an option if the treated area is far from the abdomen.
Chemotherapy
Chemotherapy uses drugs to fight cancer. During the first trimester, it is avoided because of the risk of birth defects and miscarriage. Beginning in the second trimester, some chemotherapy drugs may be safe, although caution should always be taken. In the third trimester, the risk to the fetus is lower, but there may be other side effects, such as premature birth.
Alternative treatments
There are other treatments, such as hormone therapy and biological agents, that are used for certain types of cancer. These must be evaluated on a case-by-case basis to ensure that they are safe for pregnancy.
Cancer and pregnancy: Ethical and safety decisions
In all cases, it is important to talk to your medical team to understand the options and risks. Sometimes, decisions can be difficult, such as postponing treatment to protect the fetus or terminating the pregnancy to receive aggressive treatment. These decisions must be made with the support of professionals, including psychological care.
Impact on fetal development
If you are pregnant, this may be what worries you the most. But the first thing you should know is that most types of cancer do not have a direct impact on the fetus. And although, certainly, some aspects of cancer and its treatment can influence pregnancy and fetal development, the medical team at your side will be responsible for giving you the information and all the necessary guarantees so that the approach to your case is the most appropriate.
Impact of cancer
In general, the disease itself does not usually directly affect the fetus. However, some types of cancer can have complications that can impact the course of pregnancy. For example, cervical cancer can increase the risk of difficulties with vaginal delivery.
Risk of metastasis
Most cancers do not tend to spread to the fetus. However, some types, such as melanoma, have a small risk of placental metastasis, which could lead to fetal complications. This is very rare, but it is something that doctors monitor closely. In these cases, monitoring the newborn is crucial.
Impact of treatments
Cancer treatments such as radiotherapy and chemotherapy can have a more significant impact on the development of the fetus. Radiotherapy, especially if applied near the abdomen, can be harmful, so it is generally avoided during the first trimester, when the fetus is at its most sensitive stage. Chemotherapy can also be risky during the first trimester, as it can cause birth defects or increase the risk of miscarriage.
Beginning in the second trimester, the risk to the fetus decreases, allowing for more treatment options. However, doctors are always looking for a balance between treating the cancer effectively and protecting the developing fetus. As we said, treatment can sometimes be delayed until after delivery if the cancer is not aggressive or is in its early stages.
Premature births and other risks
In some cases, cancer treatment can increase the risk of premature birth or low birth weight. These complications can be managed by the medical team, but they require careful monitoring to ensure the health of the newborn.
Each case is unique, so it is essential to have a specialized medical team that can assess and manage the risks to ensure the best care for both the mother and the fetus.
If you are in Medellín, at the Astorga Oncology Clinic we offer you a comprehensive approach and care with the highest quality standards from diagnosis and throughout the course of your pregnancy and your treatment.
Comments