Childbirth and cancer
Childbirth is a significant and often emotional life event that can be further complicated for women undergoing cancer treatment. The intersection of pregnancy and cancer raises numerous concerns, not just about the health of the mother but also about the developing baby. Common cancer treatments, particularly radiation and certain chemotherapy drugs, may pose risks during pregnancy, leading many women to postpone or adjust their treatment plans until after childbirth. While some women may not face additional risks after successfully treated cancer, others may experience complications if their body has been adversely affected by the disease or its treatment.
Research in this field is ongoing and complex, as it must prioritize both maternal and fetal health. There is no conclusive evidence linking childbirth with cancer recurrence, although certain studies indicate that the timing of cancer diagnosis in relation to childbirth may influence prognosis, particularly in breast cancer cases. Emotionally, the experience of managing cancer during pregnancy can lead to heightened anxiety and stress for expectant mothers. Support from healthcare professionals, family, and counseling services plays a vital role in helping women navigate these challenges, ensuring they make informed decisions that support both their health and that of their newborn.
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Childbirth and cancer
DEFINITION: Childbirth is an extremely emotional experience that, although often filled with happiness, can also be extremely stressful. Childbirth during cancer treatment, or shortly thereafter, can add more stress for the new mother and her family, as well as causing feelings of fear, anxiety, and depression.
Pregnancy during cancer treatment: Cancer treatment is an extremely stressful time for any woman, but pregnancy and childbirth during cancer treatment add many new concerns. Many of the commonly used cancer treatments, such as radiation therapy, are not appropriate for women who are pregnant. A woman and her doctor may decide to postpone certain cancer treatments until after the baby is born. Labor may be induced a few weeks early so that cancer treatment can begin as soon as possible.
Chemotherapy is not considered safe for women who are in their first trimester of pregnancy because of the risk of birth defects or miscarriage. However, some drugs may be appropriate for women who are in their second or third trimesters. Chemotherapy drugs reduce blood counts, so chemotherapy must be stopped for a few weeks before childbirth. This gives the mother’s body time to elevate blood counts back to normal levels and reduces the possibility of complications from childbirth such as infection and excessive bleeding.
Childbirth after cancer: For many women who have had successfully treated cancer, pregnancy and childbirth do not pose any special risks. For some women, however, pregnancy and childbirth can be a risk to the mother’s health. If the cancer or cancer treatment caused damage to any of the systems that are affected or stressed by pregnancy or childbirth, such as the lungs or the cardiovascular system, pregnancy or childbirth may cause adverse health effects. Many women are choosing to freeze their eggs, known as cryopreservation, prior to treatment as a way to ensure healthy, viable eggs.
Pregnancy and childbirth after cancer can also make it more difficult for the mother and her doctor to be vigilant in watching to make sure the cancer has not returned. Breast cancer, for example, is often much harder to detect in pregnant and nursing women because pregnancy and nursing cause the breasts to swell and become denser. This can disguise small lumps or changes in the breast that may indicate that breast cancer has returned. Mammograms are also harder to read accurately when a woman is pregnant or nursing because of the density of the breast tissue.
Research: Research on childbirth and cancer is an active and growing field. It has many complexities and challenges because of the number of physiological changes that occur during pregnancy and because of the number of different types of cancers and cancer treatments. It also poses special challenges because the health and well-being of the mother and developing baby are always of primary importance, so certain types of research cannot be undertaken. For example, it would be unethical to conduct studies on the effects of chemotherapy on the developing baby when the mother is in the first trimester because it is believed that chemotherapy would harm the developing baby.
Research has not shown that there is any statistically significant link between childbirth and the recurrence of cancer. Women who have children after successful cancer treatment are believed to be at the same risk of recurrence as women who do not have children. Researchers have, however, begun to uncover a link between childbirth and the prognosis of a breast cancer diagnosis. Swedish researchers did a large study of women in Sweden diagnosed with breast cancer and found that women who were diagnosed shortly after their last childbirth had a worse prognosis than women diagnosed a very long time after their last childbirth. A 2013 European Journal of Cancer retrospective study on women cancer patients in England found that the prognosis was much worse for those diagnosed with melanoma or breast cancer within the year of birth but was no better or worse for those diagnosed with Hodgkin lymphoma. The researchers hypothesized that immunosuppression, gestational hormones, or a tumor-conducive environment after birth could account for these outcomes. According to the National Cancer Institute, pregnancy can deter cancer but can also increase the likelihood. For example, the NCI states that certain factors, like having multiple children and breastfeeding for longer periods of time, can help deter breast cancer, while other factors, like older age during pregnancy, can present a higher likelihood of developing breast cancer.
Emotional considerations: Cancer treatment is an extremely stressful event in anyone’s life, but for a woman who is expecting, it presents even more challenges. After spending days and weeks trying to eat healthy food, do the right amount of exercise, and do everything possible to ensure the best atmosphere for the baby’s development, it can be devastating to consider the implications of a cancer diagnosis and treatment plan. The woman’s cancer care team can help her sort through the various choices and help ensure that she makes the best choices possible both for herself and for her developing baby.
Many women will have anxiety about issues such as what will happen to the baby if they are unable to care for it during their cancer treatment or what may happen if the cancer is difficult or impossible to treat. Counseling can help the mother-to-be work through her fears for the future, and many resources are available to help mothers care for their babies if they have to undergo treatments such as chemotherapy shortly after they give birth. Frank discussions with health care team members and the support of family and friends can help ease the difficulty of having a child during cancer treatment.
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