Pregnancy and cancer
Being diagnosed with cancer during pregnancy can be hard. We have information about treatment you may have, and how to cope with the emotional and practical issues you may experience.
Cancer during pregnancy is rare. Finding out you have cancer is difficult and upsetting at any time. But when you are pregnant, it can be frightening and confusing.
Pregnancy is often a positive time, while a diagnosis of cancer is always upsetting. Coping with both at once can be very difficult. But there is lots of help and support for you. This includes the different health professionals, in your cancer or haematology (blood cancer
s) team and your pregnancy team.
Mummy’s Star is a charity that supports women who are diagnosed with cancer during pregnancy. They can help to put you in touch with other women who have been in a similar situation.
Questions and concerns
You are likely to have some immediate concerns and questions. Talk to your cancer doctor or nurse. They will help you to understand more about your individual situation.
Some common questions are:
Can I have effective cancer treatment during pregnancy?
Research shows pregnant women with cancer can usually be treated as effectively as women who are not pregnant. Doctors try to make your treatment as similar as possible to a non-pregnant woman with the same type and stage of cancer. But because cancer in pregnancy is uncommon, there is less evidence from large trials to guide treatment options.
They need to balance your health with the safety of the baby. Sometimes they advise avoiding certain treatments or delaying them until later in the pregnancy or after the birth.
Your treatment depends on the type of cancer, its stage and how many weeks pregnant you are.
Your doctors and nurses will give you all the information you need to help you make treatment decisions.
In certain situations, they may advise you to end the pregnancy. This is usually if the pregnancy is in its early stages and the cancer is growing very quickly. It may be essential for your health to start having cancer treatment that is not safe for a developing baby.
Can pregnancy make the cancer grow faster?
Doctors have researched this in different types of cancer. There is no evidence that being pregnant can make a cancer grow faster.
Can cancer affect the baby?
It is extremely rare for cancer to affect the baby. For cancer to affect a baby, the cells must pass through the barrier of the placenta. The placenta is attached to the womb during pregnancy. Oxygen and nutrients from your blood pass through it to the baby. It is very rare for cancer cells to spread to the placenta and even rarer for cells to spread to the baby.
Your midwife and pregnancy doctor (obstetrician) work closely with the team treating the cancer. During pregnancy you will have extra ultrasound scans of the baby to make sure there are no problems. If your doctor has any concerns, they will look at the placenta after the baby is born to check for any cancer cells.
Common cancer diagnosed
Any type of cancer can happen during pregnancy. But they are often cancers that are more common in younger people. As women are having families later in life, it can also include cancers that are more likely to affect women as they get older.
The common types of cancers diagnosed during pregnancy are:
Pregnancy does not change the symptoms of a cancer. The symptoms depend on the type of cancer.
Some cancer symptoms may be similar to certain changes that can happen in a woman’s body during pregnancy. For example, breast changes that can happen in pregnancy may mean a lump is not suspected as a symptom of cancer. This could delay a cancer diagnosis.
It is important to see your GP about any symptoms you have. You should have the same symptom checks you would have if you were not pregnant.
We have more information about cancer symptoms while pregnant.
If you have symptoms that your GP or pregnancy doctor (obstetrician) thinks could be cancer, they will refer you to a hospital specialist for tests. The doctor you see will depend on your symptoms. They will examine you and explain the tests you need. You also usually see a specialist nurse.
Tests to diagnose cancer can usually be done without harming he baby. Doctors usually try to avoid certain tests, such as bone scans, CT scans and PET scans, so there is not a risk of exposing the baby to harmful amounts of radiation.
We have more information about having cancer tests while pregnant.
Coping with cancer during pregnancy
A cancer diagnosis can cause different feelings. When you are pregnant at the same time as being diagnosed with cancer, your feelings can be more complex. It may be hard to accept that cancer and pregnancy can happen together. There are different types of support you can get.
Taking care of yourself and getting as much support as possible, will help you cope during treatment. It also prepares you for when the baby is born.
We have more information about coping with cancer and pregnancy.
During your pregnancy, you will have regular check-ups with your midwife and pregnancy doctor (obstetrician). They will check your baby’s development as well as your own health. They will work closely with your cancer team.
You will have the usual checks and care that all pregnant women have. But your midwife and doctor will see you more often. They will do more checks, such as ultrasound scans to look at the baby. They will also talk to you about your birth plan.
Your team will try to make sure your pregnancy goes to full term (over 37 weeks). Sometimes your cancer doctor may advise the baby is delivered early. They will talk to you about this in advance.
We have more information about cancer and your pregnancy care.
A team of specialists will meet to discuss the best possible treatment for your situation. This is called a multidisciplinary team (MDT). This will include a cancer doctor and nurse and your obstetrician and midwife will also be part of the MDT.
The MDT will work closely together to decide on the best possible care for you and your baby. You should be involved in decisions about your treatment and pregnancy. Your specialist doctor will make sure everyone understands your views and preferences.
Some treatments need to be delayed or given after the birth. Your treatment options will depend on:
- How far on you are in pregnancy (this affects the timing of different treatments)
- The type of cancer and its stage (its size and how far it has grown from where it started)
- How slowly or quickly the cancer is growing (its grade)
- if the aim of treatment is to cure the cancer or to control it.
Your doctor and nurse will talk to you about your options. It is important to fully understand the risks and benefits of each before you decide. You can usually take time to talk it over with a partner or family and friends and think about which options feel right for you.
We have more information about making treatment decisions during pregnancy.
Women can usually have effective treatment for cancer while pregnant. It is not normally necessary to end the pregnancy unless there is a very serious risk to your health. Or you may decide to end the pregnancy for your own reasons. Whatever the reason, it is an upsetting decision to make.
Your treatment may include:
Monitoring the cancer
If you have a very early-stage or slow-growing cancer, your specialist may advise monitoring the cancer
Your doctors may suggest this if the cancer is not likely to change much during the rest of your pregnancy. It depends on the type of cancer you have and how many weeks pregnant you are. Monitoring may be an option if you have low-grade lymphoma or early Hodgkin lymphoma, stage 1 cancer of the cervix or chronic leukaemia. If monitoring is an option, your doctor and nurse will talk about it with you and explain the type of checks you will have.
Chemotherapy and pregnancy
Chemotherapy is the most common cancer treatment given in pregnancy. You do not usually start chemotherapy until after you are 14 weeks pregnant. At this stage, research shows most chemotherapy drugs will not harm the baby.
Chemotherapy may be used in pregnancy to treat different types of cancer. These include, breast cancer, cervical cancer, some lymphomas and leukaemias
We have more information about chemotherapy in pregnancy and cancers it may be used to treat.
Surgery and pregnancy
Most operations are safe during pregnancy. Your cancer doctor and obstetrician will decide the best time for you to have surgery. If you need a general anaesthetic, surgery may be delayed until you are at least 14 weeks pregnant.
Your obstetrician and an anaesthetist will explain how they check on you and the baby during surgery.
We have more information about surgery in pregnancy and which cancers it may be used to treat.
Radiotherapy and pregnancy
Radiotherapy uses high-energy rays to destroy cancer cells. It is not usually given during pregnancy as even a low dose may harm the developing baby.
If radiotherapy is urgent, it may be given to a part of the body that is not close to the womb. For example, if a tumour in the brain is causing increased pressure.
Your treatment may be adapted to leave out radiotherapy or to delay it until after the birth. We have more information about radiotherapy and pregnancy.
Hormonal therapy and pregnancy
Hormonal therapy drugs are often used to treat breast cancer. But they are not given during pregnancy as they have a high risk of causing birth defects. Your doctor will talk to you about starting these drugs after the baby is born.
Targeted and immunotherapy drugs and pregnancy
Most targeted and immunotherapy drugs cannot be used during pregnancy because they are harmful to the baby. Some drugs are still new, so there is not a lot of information about their effects during pregnancy. They are not usually given to pregnant women.
A drug called interferon is sometimes used during pregnancy to treat melanoma or chronic myeloid leukaemia (CML).
We have more information about targeted and immunotherapy drugs and pregnancy.
Taking good care of yourself helps you to cope during treatment and when the baby is born. You may have treatment side effects or symptoms to cope with. There are different ways these can be managed.
Sickness is a common side effect of chemotherapy. It is treated with anti-sickness drugs (called anti-emetics). Not all anti-sickness drugs are okay to use in pregnancy.
Doctors often prescribe anti-sickness drugs called metoclopramide or ondansetron. Steroids can also treat sickness. Always contact the hospital if the anti-sickness drug you are taking is not working.
If you get an infection, you will be given antibiotics. Most antibiotics are safe to take during pregnancy. But your doctor will avoid certain drugs, for example tetracyclines.
If you are having chemotherapy you will need to be careful about getting an infection. Your nurse will explain more about this.
A drug called granulocyte-colony stimulating factor (G-CSF) encourages the bone marrow to make white blood cells. This reduces the risk of infection. Doctors may recommend using it in pregnancy, but only if it is necessary. It does not seem to cause problems for the baby. But there is not a lot of information about its use in pregnancy.
Anaemia (low number of red blood cells)
Chemotherapy or losing blood during surgery may cause anaemia. Red blood cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this.
If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion, which you can have during pregnancy.
You can take different painkillers during pregnancy. But you need to check with your doctor or midwife first. If you are in pain, tell your doctor or nurse so they can prescribe you the right drug. Steroids may also be used to reduce swelling and control pain.
Feeling tired is a common side effect of chemotherapy
.It is often worse towards the end of treatment and for some weeks after it has finished. Try not to do too much and plan your day so you have time to rest. Gentle exercise, like going for short walks, can give you more energy. We have more information with tips on managing fatigue (tiredness).
Your obstetrician, specialist cancer doctor and midwife will talk to you about the best time to have your baby. Many women carry their baby to full term and have a normal birth. You and your midwife will talk about your birth plan.
Having an earlier delivery
If you need to start a certain treatment, your baby may be delivered earlier. You may need injections of drugs called steroids before the birth. This reduces the chance of the baby having breathing problems.
The further along you are in your pregnancy, the safer it is for your baby. Most babies born from 32 weeks do well and do not have any long-term problems. They are cared for in neonatal intensive care units (NICUs) or special care baby units (SCBUs).
Your specialist doctor, nurse and midwife will give you advice about breastfeeding. It depends on your treatment. For example, if your chemotherapy finished a few weeks before the birth you may be able to breastfeed straight away.
We have more information about breastfeeding and cancer treatments.
After the birth
You will still need a lot of support from your cancer and pregnancy team after the baby is born. Some women may be continuing with treatment or starting treatment. This can be difficult, especially with a newborn baby to care for.
Family, friends and a partner can usually help support you. Tell them the kind of help and support that would be best for you.
You can then decide what you want to focus on. This may be spending time with your baby. Talking to a social worker may be helpful. They may be able to arrange extra support to look after any other children.
Taking care of your well-being is important. It can help you care for your baby and cope with treatment.