Understanding Pregnancy-Related Cancers: Key Points and Considerations

Verified by Dr Jyoti Bajpai– Lead Medical & Precision Oncology at Apollo Hospitals Navi Mumbai

Overview:

Pregnancy is a time of joy and anticipation, but it can also bring unexpected challenges. One such challenge is the occurrence of pregnancy-related cancers. Although rare, these cancers can have significant implications for both the mother and the baby. These cancers are diagnosed during pregnancy or in the postpartum period, typically up to a year after childbirth. The incidence of cancer during pregnancy is estimated to be approximately 1 in 1,000 pregnancies. 

Types of Pregnancy-Related Cancers:

1. Breast Cancer: The most common cancer during pregnancy, often diagnosed at a later stage due to the physiological changes in the breast tissue that can mask symptoms.

2. Cervical Cancer: Often detected during routine prenatal screenings. The prognosis can be favorable if caught early.

3. Melanoma: The risk of melanoma is not increased by pregnancy, but existing melanoma can progress more rapidly.

4. Lymphoma: Both Hodgkin’s and non-Hodgkin’s lymphoma can occur during pregnancy, and treatment depends on the stage of pregnancy and the extent of the disease.

5. Thyroid Cancer: Often detected through routine examinations. It generally has a good prognosis and can often be managed until after delivery if detected late in pregnancy.

Diagnosis:

Diagnosing cancer during pregnancy can be challenging due to overlapping symptoms between pregnancy and cancer (e.g., nausea, fatigue). Standard diagnostic tools include:

• Ultrasound: Safe for both mother and fetus, often used initially.
• MRI (Magnetic Resonance Imaging): Preferred imaging modality without the use of ionizing radiation.
• Biopsy: Necessary for definitive diagnosis, typically safe during pregnancy.
• Blood Tests: Can help in diagnosis but may have limitations due to physiological changes in pregnancy.

Treatment:

Treatment of cancer during pregnancy requires a multidisciplinary approach to balance the health of the mother and the fetus. Treatment options include:

• Surgery: Often considered safe during pregnancy and can be the first line of treatment.
• Chemotherapy: Certain chemotherapeutic agents can be used safely during the second and third trimesters but are generally avoided during the first trimester due to the risk of teratogenicity.
• Radiation Therapy: Typically avoided due to the risk to the developing fetus but may be considered in life-threatening situations or during the third trimester with proper shielding.
• Targeted Therapy and Immunotherapy: Use is limited and requires careful consideration due to potential risks to the fetus.

Management During Pregnancy

• Early Detection: Routine prenatal care and screenings are crucial for early detection.
• Multidisciplinary Team: Involvement of obstetricians, oncologists, pediatricians, and other specialists to tailor the best treatment plan.
• Patient Counseling: Providing thorough counseling to the patient and family about the risks, benefits, and potential outcomes of various treatment options.
• Delivery Planning: Timing of delivery may be adjusted based on the cancer treatment plan. In some cases, early delivery may be recommended to allow for more aggressive cancer treatment post-delivery.

Prognosis:

The prognosis for pregnancy-related cancers varies depending on the type and stage of cancer, as well as the timing of diagnosis and treatment initiation. Early detection and a carefully coordinated treatment plan can significantly improve outcomes for both the mother and the fetus.

Conclusion:

Pregnancy-related cancers present unique challenges that require careful consideration and a personalized approach to treatment. Advances in diagnostic techniques and treatment modalities, along with a multidisciplinary approach, have improved the management and outcomes of these cases, ensuring the best possible care for both mother and child.

Connect with our expert, Dr Jyoti Bajpai– Lead Medical & Precision Oncology at Apollo Hospitals Navi Mumbai

Call 022 6280 6280 for an appointment