A couple of weeks ago, a friend of mine who is in her second trimester of pregnancy, called me in a panic. Due to her recent medical history, it was recommended that she get an MRI in addition to her yearly mammogram as a way to screen for breast cancer. She, like many women who have the same question, was relieved and grateful to get this information. She then asked, “do women get diagnosed with cancer in pregnancy? Can they be treated?”
What We Know about Cancer in Pregnancy
Yes, cancer occurs in about one in a thousand pregnancies every year. The most commonly diagnosed cancers in pregnancy are breast, cervical, Hodgkin’s disease, malignant melanoma, and leukemias. It can be tricky to diagnose cancer during pregnancy because common cancer symptoms such as fatigue, changes in the breasts, bloating, headaches, rectal bleeding, blotchy skin, and achy joints can also be symptoms of pregnancy.
Diagnosis
Cancer can be diagnosed in different ways, including physical exams, biopsies, blood tests, ultrasounds and pap smears – all of which are used in pregnancy. But what about other tests?
- X-rays can be used to diagnose cancer during pregnancy. The level of radiation used during an x-ray is too low to cause any known harm to the developing baby. When possible, women can use a lead shield that covers the abdomen during x-rays.
- Computed tomography (CT or CAT) scans of the head or chest do not directly expose the developing baby to radiation. CT scans of the abdomen or pelvis can be done in pregnancy if absolutely necessary.
- Magnetic resonance imaging (MRI) does not use radiation and can be used in pregnancy.
Once diagnosed, the next thing to consider are various treatment options. Cancer can be successfully treated during pregnancy, but there are some important things to think about such as the size and location of the tumor, if the cancer has spread to other body parts, how far along you are in the pregnancy, and any other health conditions you may have.
- Many medications used for cancer treatment (chemotherapeutic agents) are usually not given in the first trimester of pregnancy, because that’s when a lot of the baby’s development is happening. However, it’s possible to use them in the second or third trimesters. This can vary based on many factors, including the medication itself.
- Surgical procedures (including using anesthesia) can usually be done during pregnancy.
- For treatments such as radiation, hormone therapy, and targeted therapies, it’s often suggested to wait until after the baby is born.
- Depending on the exact treatments and medications, breastfeeding may or may not be recommended.
Thankfully, my friend’s MRI is normal at this time. She was reminded to watch for any changes in her breasts and keeping an eye on any symptoms. Remember, whether you are pregnant or not, it’s always best to report any concerns to your healthcare provider as soon as possible. This way you can be properly evaluated, and treated if necessary, because most of the time a healthier mom leads to a healthier baby.
