Rare cancers in pregnancy – what should a doctor do?

bad news - doctor talking to female patientThere’s growing research into the role of the placenta as a “filter,” protecting unborn children from the effects of cancer treatments, such as chemotherapy. But most of the research out there focuses on more common types of cancer. But what happens when a pregnant woman is diagnosed with a more unusual type of cancer? Such as one affecting the blood?

Academic research gives pregnant women mixed messages as to what they should do. This paper, for example, finds that if doctors diagnose cancer of the blood at a later stage of pregnancy, then there are treatment options available that may not affect the unborn child. However, early on, physicians tend to suggest termination as the only solution.

Anecdotal evidence gives other suggestions as to what’s best. One mother wouldn’t heed doctors’ advice to abort – she was diagnosed with a rare form of leukemia when pregnant. Doctors advised her to terminate her pregnancy as the chemo she needed to save her life would have killed her unborn child. She made the decision to postpone aggressive treatment, and have her child. To doctors’ surprise, she responded to a gentler course of treatment, which did not affect her baby.

Elsewhere, another woman found out she had a form of non-Hodgkin’s lymphoma towards the end of her third pregnancy. Given the severity of the disease (she had been given just weeks to live), and the late stage of her pregnancy (32 weeks), doctors delivered her daughter and began aggressive treatment of the cancer immediately afterwards. Against the odds, she’s still here to tell her tale.

There are few clear answers about what to do when a pregnant woman has cancer, and fewer still when that cancer is less common. With so many factors to consider (from personal decisions to medical advice), not one person (be it doctors, researchers, or patients themselves) has all the answers.

Do you have a story to share about pregnancy and cancer?

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