Cancer Treatment During Pregnancy

If you are pregnant and have been diagnosed with cancer, your treatment options may be more limited. Because of the potential risk to you and your child, you may want to get a second opinion before starting any treatment.

Diagnosis of Cancer During Pregnancy

If your provider thinks you may have cancer, they may want you to have tests to help make the diagnosis. These could be blood tests, radiology (imaging tests), or a biopsy. However, not all tests are safe during pregnancy. If you know you are pregnant or think you may be pregnant, be sure to tell your providers before any testing.

MRI and ultrasound are safe for pregnant women. Tests that use radiation, such as X-rays and CT scans, are not safe. A biopsy may be safe, depending on the area being biopsied.

Treatment Options

When planning your treatment, your oncology team will think about both your health and the health of the baby. Your care team will need to know:

• The type, stage, and location of the cancer.
• If the cancer has spread.
• If the cancer appears to be aggressive or slower-growing.
• How far along you are in your pregnancy.

Surgery

Some cancer treatments are safer than others during pregnancy. Surgery may be the safest treatment during all stages of pregnancy. For example, if you were diagnosed with breast cancer you could have surgery to remove cancer and lymph nodes and it would be considered generally safe. But if your cancer involves the uterus, surgery would not be safe for the baby.

Chemotherapy

Chemotherapy can be used during some stages of pregnancy, but not all.

• Chemotherapy should not be used during the first trimester of pregnancy. The risk of birth defects or losing the baby is also highest during the first trimester.

• During the second and third trimester, you may be able to have chemotherapy. Your care team will weigh the risks and benefits. Some chemotherapy drugs are lower risk to the baby. The placenta acts as a barrier, stopping certain drugs from passing through.

• After 35 weeks of pregnancy or within 3 weeks of delivery, chemotherapy is not recommended because you may have low blood counts. This can increase the risk of infection or bleeding.

Radiation Therapy

In general, most women cannot have radiation therapy while pregnant. Radiation can harm the developing baby. It is best to avoid becoming pregnant while getting treatment. If you believe that you may have become pregnant while getting treatment let your provider know right away.

Hormone Therapy and Targeted Therapy

Hormone and targeted therapies could harm the baby and aren’t usually used during pregnancy. They can be used after delivery.

Immunotherapy

Because these treatments are so new, we need more research to understand how they may affect a developing baby. Immunotherapy may be a treatment option after delivery.

Questions for Your Provider

Be sure to talk with your provider about your treatment options during pregnancy. Some questions may be:

• What are my cancer treatment options?
• Which treatment plan is best for me? Why?
• Do I need to start treatment right away, or can it wait?
• Could a delay in my treatment affect my outcome?
• Is it safe to continue my pregnancy?
• What are the short- and long-term risks to me and my baby?
• Will I be able to breastfeed?

Receiving a cancer diagnosis or starting cancer treatment while pregnant can be scary and overwhelming. Your care team wants to help you find the treatment plan that is best for you and your baby.

Resources for Cancer During Pregnancy

Hope for Two – This pregnant-with-cancer network offers support and peer connections.

https://hopefortwo.org/

Information about breast cancer during pregnancy from the Young Survival Coalition.

https://www.youngsurvival.org/faqs/pregnancy-and-breast-cancer