Cervical Cancer During Pregnancy - Everything You Need To Know

Cervical Cancer During Pregnancy

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The word cancer is a curse and is viewed as an untreatable condition. Contrary to popular belief, some forms of cancer, if detected in time, can not only be controlled but also be cured. And cervical cancer is one such cancer. Although, the unpredictability of cancer makes it difficult to prevent or avoid, a pregnant woman who has cervical cancer can deliver a healthy baby.

Below, we look at some information about cervical cancer during pregnancy, its treatment options, and how you can cope with the condition. Read on to learn more:

What Is Cervical Cancer?

The womb or the lower part of the uterus is also known as the cervix. Cervical cancer begins in the cells that line up the cervix. When you are pregnant, your unborn child develops in the upper part of the uterus or the ‘body of the uterus’, which is connected to the vagina, or birth canal, through the cervix (1).

Cervical cancer occurs when abnormal cells in the cervix multiply at an alarming rate. Unfortunately, cervical cancer is rather common among pregnant women all over the world. However, in some countries, doctors routinely test to identify any signs of cervical cancer during pregnancy. Consequently, such countries don’t record many cases of cervical cancer.

If cervical cancer is diagnosed in time, it can be fully cured with the right type of treatment. One of the most common ways to diagnose cervical cancer is to carry out a Pap test.

[ Read: HPV During Pregnancy ]

Causes Of Cervical Cancer During Pregnancy:

The cells in the cervix don’t get infected or turn cancerous overnight. In fact, they grow slowly into a pre-cancerous stage, before they turn cancerous. The cells take years to turn cancerous from a pre-cancerous stage. However, in few cases, the process can sometimes be extremely fast and take less than a year to turn cancerous. Most women who don’t have pre-cancerous cells in their body, don’t need treatment. In other cases, the pre-cancerous cells turn into cancerous ones.

In almost all cases of cervical cancer, a change in the cell DNA is caused by the Human Papilloma Virus (HPV). The change in the DNA structure is called mutation. When a mutation occurs, it can disrupt the instructions that restrict the growth of the cells. So, the cells keep growing even when they aren’t needed. These cells can lead to tissue lumps or tumors, and turn cancerous (2).

[ Read: Ovarian Cancer During Pregnancy ]

Diagnosing Cervical Cancer During Pregnancy:

While cancer is a serious medical condition to treat, and to be diagnosed with cervical cancer while you are pregnant can be quite stressful and taxing. Estimates indicate that almost 3% cervical cancer cases are diagnosed during pregnancy.

Often, a Pap smear test can detect the presence of cervical cancer. Your doctor may suggest you opt for a Pap smear test if you experience unexplained or regular bleeding during your pregnancy.

Treating Cervical Cancer During Pregnancy:

If you are diagnosed with cervical cancer while pregnant, the line of treatment you follow depends on the doctor’s analysis of the situation. Your doctor will decide cervical cancer treatment during pregnancy depending on some factors:

  • The type of cervical cancer
  • The size of the tumor and whether or not it has spread or is still in its original position (it will determine the stage of cervical cancer you are at)
  • How far along you are in your pregnancy
  • Whether you want to go ahead with the treatment of cancer while you are pregnant or if you wish to wait till after you have delivered your baby and then start the cancer treatment. Unless cancer has spread and there is a huge risk to both you and your baby if left untreated, the doctor will also give you the option of getting treated after you give birth.

[ Read: How To Prevent Miscarriage ]

Treatment Options For Cervical Cancer During Various Stages Of Pregnancy:

Your doctor will be the best judge of how and when you should start your treatment for cervical cancer while pregnant. Here are a few things you should be aware of regarding what your doctor may tell you about treatment at particular stages in your pregnancy:

1. Detection Of Cervical Cancer In The Early Stages Of Pregnancy:

  • If the cervical cancer is detected in your very first trimester of pregnancy, your doctor may ask you to start treatment immediately, so as not to wait for another six months without treatment.
  • However, it is important to remember that if you do agree to go ahead with the treatment, you will have to stop the pregnancy there and then. While it is risky to leave cancer entirely untreated for six months at the least, you will have to discuss the pros and cons of both situations with your doctor.
  • If you do not wish to start treatment right away and want to continue with the pregnancy, your doctor may decide to treat you once you enter your second trimester. Till date, there is not much medical study or data on treating cancer during pregnancy, and most of the treatments that are done for cancer during pregnancy are still at a very experimental stage.

2. Detection Of Cervical Cancer In The Second Or Third Trimester Of Pregnancy:

  • In case your cervical cancer diagnosis comes in when you are in your second or third trimester of the pregnancy, the doctor may still ask you to wait for treatment till after you have given birth.
  • However, in such a case, your doctor will probably ask you to go in for a cesarean delivery and have your baby early, instead of waiting for a natural delivery.
  • As soon as your baby is born, the doctors will start treating you for cancer. During the cesarean operation itself, the doctors may decide to remove your womb. The next course of treatment will be radiotherapy and chemotherapy.

[ Read: Breast Cancer During Pregnancy ]

3. If You Have A Small Tumor:

  • If you have a small tumor, the two treatment options that you will have available are a cone biopsy or a trachelectomy.
  • Trachelectomy is usually not done while you are pregnant, and only very few women have been treated with the particular type of procedure. It can result in a lot of bleeding and also in the death of the baby after the operation.

4. If You Have A Large Tumor:

  • IIf you have a large tumor, your doctor may ask you to for chemotherapy to help control the growth of cancer until the time that your baby is born.
  • Your doctor will not allow you to for chemotherapy in the first trimester, as it can be very harmful to your unborn baby. Chemotherapy can cause permanent and considerable damage to your unborn baby, and in some cases can also lead to a miscarriage.

The Right Line Of Treatment During Pregnancy:

can be a tough call to go ahead with the treatment while you are pregnant. It can all be confusing and quite sapping. It is rather important you determine whether you wish to be treated during your pregnancy, or you want to wait until you have delivered your baby.

As a mother who has an unborn baby growing inside of you, you will need a lot of time, support, information and help from others, especially your medical team and your partner. It is important that you keep talking to your doctor about everything that your body is going through and how cancer may or may not affect you and your unborn baby. You also need to ask your doctor and understand about how the treatment for cervical cancer in pregnancy can affect you and your unborn baby.

Cancer Treatment Options During Pregnancy:

Here are some of the treatment options your doctor may suggest if you are diagnosed with cervical cancer while you are pregnant:

1. Surgery:

Your doctor may use the option of surgery to remove the tumor and some healthy tissue that is present near the areas surrounding the tumor. Surgery does not pose much risk to your unborn baby and is one of the safest treatment options for cancer while you are pregnant.

2. Chemotherapy:

Chemotherapy uses a lot of drugs to destroy the cells that are cancerous. The drugs help to stop the growth of the cancerous cells. Chemotherapy is not advisable in the first three months of pregnancy, as there is a lot of risk for the unborn baby. During the first three months of the pregnancy, the organs of the unborn baby are still in the developing stage and chemotherapy during this time can lead to birth defects or even miscarriage. During the second and third trimester, the placenta creates a barrier around the baby, and the drugs do not reach your unborn baby as easily. Even if they do, they will reach in very small amounts, and the risk is comparatively less.

3. Radiation Therapy:

It involves high energy x-rays that destroy the cancerous cells. Radiation therapy can cause significant damage to the unborn baby. Hence, the doctors try to avoid it as much as possible during pregnancy. Also, the risk of radiation therapy to the unborn baby will depend on the dosage of the radiation (3).

Treat, Wait Or Interrupt?

Although the number of diagnosis of cervical cancer in pregnant women is rare, medical experts feel that the number is likely to grow, as more and more women are delaying the age at which they have babies. When the priority is also to take care of the unborn baby and continue with the pregnancy, the treatment options become limited.

There is not enough research or study done on treating cervical cancer during pregnancy, hence doctors are constantly re-evaluating the options that they have and trying to find out what will work best for the mother and the unborn baby (4).

Some Questions To Ask Your Doctor:

While you need to go for routine checkups and talk to your doctor about everything. But, before you make a decision about when you want to start the treatment for cervical cancer while you are pregnant, here are a few questions you may want to ask your doctor:

  • Do you need any special tests that will help the doctors more in understanding the type of cervical cancer you have? If yes, what are the tests and how will the same be carried out? Will the tests be invasive and will they cause any harm to your unborn baby?
  • What, according to your doctor, is the best way to treat your cervical cancer while you are pregnant? Why does your doctor feel it is the best treatment choice that you have?
  • Is it alright if you wait to start treatment till after you have given birth to your baby? If yes, how soon after the birth of your baby will you have to start the treatment? Is there any chance of your baby suffering any infection because of cervical cancer during the pregnancy or at the time of birth? vaginal birth or will you only be able to give birth through a caesarean operation?
  • If you choose to delay treatment can it affect you and your unborn baby or is it alright to wait?
  • What are the risks of treatment to your unborn baby and you?

It is understandable that once you find out in your pregnancy that you have cervical cancer, the situation may look quite grim. But as the data above suggests, there are various treatment options that can help you get completely cured, without causing any harm to your unborn baby. Make sure you speak to your doctor and ask them about all the options, including any fears or concerns you may have.

Moms, if you know of any woman who was diagnosed with cervical cancer during her pregnancy, do share the story here to help and support other moms. Leave a comment in the section below. We would love to hear your views about cervical cancer and pregnancy.

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