Being pregnant and welcoming a new baby is like beginning of all new things in life. Priorities change, expectations from life, and partner change. Women disorganize their lives to organize a new life. In these emotional times, if a new expecting mom is diagnosed with cancer and that too in the child-bearing uterus, the whole world comes to a standstill, and words cannot express that grief.
Pregnancy complicated with cervical cancer is very rare. About 1 to 3 % of women suffering from cervical cancer are diagnosed either in pregnancy or immediate postpartum and majority of patients present with complaints of bleeding per vaginum. Often this is mistaken for threatened abortion.
Once a patient comes with these symptoms, they will be immediately evaluated for confirmation of diagnosis with a biopsy from the cancerous mass with some basic blood tests and as all X-Rays and CT scans are contraindicated in pregnancy. For staging the patient, an ultrasound or MRI abdomen would be advised.
Treatment of cervical cancer depends on different stages of cancer, the term or stage of pregnancy and as well as on the wishes of the mothers. A pre- invasive cancer treatment can wait till the pregnancy is completed but if preservation of pregnancy is not contemplated, then termination of pregnancy followed by surgery or chemo-radiation according to the stage of the disease is advised.
Majority of the patients present in early stage of the disease continue the pregnancy by delaying the treatment till baby matures and attempt a cesarian section to deliver the baby.
In this period to keep the disease under control, patients are given chemotherapy drugs which can be safely given during pregnancy. Curing the disease is the main objective, and the maternal survival should not be compromised in favour of holding the pregnancy while at the same time giving a fair chance to the little one to see the sunlight.
By Dr. Suneetha is a Radiation Oncologist at American Oncology Institute