Written by Bridget Shirvell
Reviewed for Medical Accuracy by Torie Croog
For cancer survivors, the wild emotions that come with pregnancy or trying to have a baby are often compounded with worry about what your cancer means for your child.
There’s a lot to know about pregnancy and cancer, from how it can affect your fertility to what happens if you’re diagnosed while expecting. A lot can be scary, but you are not alone.
If you're diagnosed with cancer while pregnant:
While a cancer diagnosis during pregnancy is a relatively rare occurrence, it does happen. About one in every 1,000 pregnant women are diagnosed with cancer, according to a recent study, with melanoma, breast cancer, cervical cancer, lymphomas, and leukemias being the most common types of cancer diagnoses women face while expecting.
The good news is that many cancer treatments are safe for women and their babies. Let's take a deep breath and really let that sink in: Many cancer treatments are safe for you and your baby.
Ask your diagnosing doctor to give you a suggested treatment timeline. Depending on that timeline, take the time to ask for second opinions and line up a care team that makes you feel most comfortable and who will work well with your obstetrician-gynecologist (OB-GYN) to help determine your best treatment options.
"There's a lot that can be done while a woman is pregnant that minimizes the risks to the baby, although there is no guarantee," said Dr. Michael Tahery, a Los Angeles-based OB-GYN, with a subspecialty in urogynecology. Dr. Taheryhas treated several women over the course of his career that were pregnant when diagnosed with cancer.
In addition to your OB-GYN and your oncologist, you will likely be referred toa maternal-fetal medicine (MFM) doctor. An MFM doctor will help manage some of the higher risk components of undergoing cancer treatment during pregnancy in conjunction with the rest of your care team.
Your particular treatment will depend on a variety of factors, including your type of cancer, its stage, and your current trimester. According to Dr. Tahery, you may be able to immediately start some treatments such as chemotherapy (not generally advised during the first trimester, but safer later on) or even undergo surgery. For instance, someone with very early-stage cervical cancer with no lymph node involvement may be able to have a very aggressive local incision and close monitoring followed by a more radical definitive surgery after pregnancy.
Make sure you review all your options and the possible outcomes with your doctors before making any decisions.
Depending on the type of cancer and its current status, women can have healthy pregnancies. While not all pregnancies are planned, if you're thinking about trying to conceive and you or your partner is a cancer survivor, it's a good idea to check in with an OB-GYN and your oncologist for a preconception consultation.
"Just like with any other medical problem, you want to have a full discussion with all the physicians involved," said Dr. Tahery.
These appointments give you the chance to update or review any health maintenance screenings, maximize nutrition, minimize risk , and ask any questions you may have.
How cancer can affect fertility
It's critical when facing a cancer diagnosis that you speak with your doctors if you think you want to have children, as many cancer treatments can affect your ability to conceive. You should ask your oncologist for a referral to a fertility specialist familiar with cancer treatments and their side effects.
Chemotherapy, for example, can affect the function of the ovaries, but ovarian preservation gives you a chance to conceive afterward. Radiation or surgery to areas in the abdomen or pelvis can also impact fertility or the ability to carry a normal pregnancy. In addition to ovarian preservation, there are egg retrieval and embryo freezing options.
"Be your own advocate when you go to the physician [and] bring it up," said Dr. Tahrey.
If your treatment will mean you'll be unable to carry a pregnancy or harvest eggs, you have other options, such as working with a surrogate or using donor eggs.
What type of monitoring to expect while pregnant
The type of monitoring you can expect while pregnant depends on your specific type of cancer and where you are in your cancer journey. According to Dr. Tahery, cancers that are associated with hormones such as estrogen -- namely, breast or gynecologic cancers, may have to be monitored very closely compared to other non-hormonal types of cancer.
Depending on your medical history, such as if there’s a risk of cancer recurrence or if there's any chance you suffered organ damage from your cancer treatment, you may want to consult with a maternal-fetal medicine doctor who can help manage any of the higher risks.
What to expect postpartum
If you're planning on breastfeeding your baby, make sure to speak with your OB-GYN and your oncologist. Many women who have recovered from cancer can successfully breastfeed. Still, if you're currently receiving some cancer treatments such as chemotherapy, which does get into breast milk, you'll be advised not to. Remember: Whether it’s breastmilk or formula, whatever is right for you is OK. (If you’re in a room of people, it’s not like you have any idea who was breastfed versus formula-fed!)
Give yourself permission to feel joy and the normal anxiety about being a parent, whether it’s for the first time or not. There's no reason you can't have the family you want with planning and the right care team. And if you ever need help, child care assistance for cancer patients is available through many different networks that are dedicated to providing assistance to families in need.