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Cancer is an inherently confusing disease. Such a diagnosis can overwhelm an individual with a myriad of questions. Sometimes these questions pour out, one after another. Other times, the stream of questions is too overwhelming to articulate the hundreds of questions clouding the mind. Approximately 3500 women diagnosed with cancer this year will have just one question: ‘How will cancer affect my pregnancy?’

Though a relatively small number of women battle cancer while pregnant, there does not appear to be a key risk factor or any specific preventative measures aside from basic healthy habits. This means that any woman who is pregnant or going to be pregnant should be aware of the cancer symptoms that may occur during a pregnancy. Whether or not you believe to be at risk for developing cancer, knowing the answer to these five questions could prove to be lifesaving.

1. How is cancer detected in pregnant women?

   A cancer diagnosis during pregnancy is thankfully a rare occurrence. It is estimated that this coexistence only affects 1 in every 1000 pregnant women. However, in addition to being uncommon, cancer is especially difficult to detect in pregnant women. Pregnant women experience many changes in their body as the fetus grows. Some common changes include bloating, headaches, nausea, vomiting, fatigue, breast changes, and rectal bleeding. While considered normal in pregnancy, these are also common symptoms of cancer. Because of this overlap, cancer diagnoses are typically delayed in pregnant women.

   The best opportunity for cancer to be detected early in one’s pregnancy is to have an open line of communication with the care team. If a woman experiences any symptoms that may be linked to cancer, she should discuss them with her obstetrician or visit a general practitioner as soon as possible.   

2. What kind of cancers are common amongst pregnant women?

   The most common type of cancer amongst pregnant women is breast cancer, affecting approximately 1 in 3000 pregnant women. Pregnant women may also be affected by cervical cancer, thyroid cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, melanoma or gestational trophoblastic tumor. Pregnant women may be diagnosed with nearly any type of cancer, though these cancers are more likely to affect younger women.  

3. Are diagnostic tests and treatment safe while pregnant?

   Many of the commonly used diagnostic tests are safe for both the woman and the baby. This includes X-Rays, magnetic resonance imaging (MRI), computed tomography (CT) scans, ultrasounds and biopsies. X-Rays and CT scans, however, should be used cautiously due to the radiation. The radiation produced from X-Rays has been proven to be too low to cause harm to a fetus. Despite this finding, many doctors continue to recommend a lead shield to cover the abdomen for added caution. CT scans, on the other hand, give off a higher quantity of radiation. A CT scan of the head or neck is perfectly safe for all parties involved. Scans of the pelvis or abdomen should only be done if absolutely necessary and after a discussion with the health team. 

   If diagnosed with cancer, both the obstetrician team and the oncology team will work together to decide the best option for treatment. Both surgery and chemotherapy can be safe for both the woman and the fetus. The health team will consider many factors, including the type, location, size, and stage of the cancer. Depending on these factors, the woman may be able to receive treatment immediately. Depending on the drug, the health team may recommend waiting until after the first trimester (when the baby’s organs are developed) or waiting until after the birth to start chemotherapy. 

4. How will the cancer affect my pregnancy?

   With a knowledgeable care team, cancer rarely affects the baby during pregnancy. If administered in the first trimester, chemotherapy may cause birth defects or pregnancy loss. Administering chemotherapy after the first trimester has far less severe risks, the most important being possible preterm birth and the possibility of babies being small for gestational age. While these are important risks to be aware of, they are not necessarily common. Once the baby is born, the mother can continue with treatment. If receiving chemotherapy, however, she should not breastfeed as the drugs can transfer through breastmilk.

5. Is any research being done in cancer during pregnancies?

   Cancer treatment is constantly evolving. Immunotherapy is just one of the promising advances. As new treatments become available, researchers are constantly working to determine which treatments are safe for pregnant women. There are many researchers currently studying the effects of new drugs, how they move through the body, and the breastmilk concentration. There are also ongoing studies involving children who were exposed to cancer treatments in utero.