Cancer and pregnancy: its management and the consequences on fertility

Cancer during pregnancy

Finding out about cancer while pregnant, carrying life and potentially death within, is a totally inconceivable situation. And yet this event is not so rare.

The occurrence of cancer, or in any case its diagnosis during pregnancy would affect one in 1000 pregnant women. And this figure should increase over the next few years because the risk of cancer increases with age and women have more and more children later. Breast cancer is the most common cancer diagnosed during pregnancy, followed by cervical cancer, skin cancer and blood cancer (lymphoma and leukemia). They are in fact the most common cancers in young people.

Chemotherapy authorized during pregnancy

Even 20 years ago, when a pregnant woman learned that she had cancer, she was offered to terminate the pregnancy, regardless of gestational age, so that she could begin treatment. It is still today the solution that prevails if the pregnancy is recent (less than 3 months). Beyond the 1st trimester, on the other hand, if the woman so wishes, an appropriate treatment can be put in place to allow the pregnancy to continue safely. “It all depends on the extent or the severity of the cancer, the treatments vary greatly from one patient to another,” explains Dr Loïc Boulanger, gynecological surgeon at the Jeanne de Flandre Hospital of the Lille University Hospital. In a general way, surgery and most chemotherapy are possible during pregnancy. »Radiotherapy, on the other hand, is contraindicated because the irradiation can cause malformations on the baby.

However, if the pregnant woman is near her term then it is most often decided to induce childbirth and then start treatment. “Decisions are always made in consultation with patients, obstetricians and oncologists,” says Dr. Boulanger. The aim is to minimize the risk to the child and decide the best time to treat the mother. ”