Chemotherapy and pregnancy treatment are generally not done at the same time as chemotherapy could be lifesaving for a pregnant woman but could adversely affect the fetus directly or indirectly. Chemotherapy also affects lactation. Concerns about administration of cytotoxic chemotherapy during pregnancy occur as these drugs kill the fast growing and proliferating cells and the fetus is a proliferating cell mass. The risk of chemotherapy during pregnancy depends on the drugs used and the trimester of pregnancy.

Most chemotherapy drugs affect the epithelial and non-epithelial cells and hence there is a risk of spontaneous abortion, fetal death, or fetal malformations varying with the use of specific drugs.

However, a pregnant woman with cancer can give birth to a healthy baby, as some cancer treatments are safe during pregnancy. It is important to discuss this with the doctor. Cancer generally does not affect the fetus directly although some cancers spread to the placenta.

The common cancers occurring during pregnancy are cervical cancer, breast cancer, thyroid cancer, Hodgkin lymphoma, and melanoma. A gestational trophoblastic tumor is a rare cancer that develops in a woman’s reproductive system that results out of an abnormal combination of the sperm and egg.

Age is also a risk factor for the rate of cancer during pregnancy because nowadays, there are many women who have late pregnancy due to various reasons like late marriage, career preferences, etc.

Being pregnant at times could delay a cancer diagnosis because certain symptoms like abdominal bloating, headaches or bleeding are not considered abnormal during pregnancy. Pregnancy-related breast enlargement makes it difficult to detect small breast tumors.

If cancer is suspected during pregnancy, there could be a concern raised about tests like X-ray, MRI, etc. However, a woman can use a protective shield while doing these tests. Also, these tests have very low levels of radiation to harm the fetus. They are relatively safe, as these tests do not use ionizing radiation.

Risk factors

The drug used during chemotherapy depends on many factors like pregnancy stage, type of cancer, stage of cancer, priorities of the to-be parents, etc. Some drugs harm the fetus, especially during the first trimester as the baby’s organs are in a developing phase in which case the treatment could be delayed until the second or third trimesters. If the cancer is detected in the later stages of pregnancy then the treatment could be started after the child is born or early labor could be induced if possible.

During the second and third trimesters, some chemotherapy drugs could be given safely as the drug cannot pass through the placenta and hence cannot harm the fetus directly. However, some chemotherapy drugs side effects  are loss of appetite and anemia that could indirectly harm the fetus. In addition, some drugs given in the second or third trimesters could result in an underweight baby, premature delivery, trouble in breastfeeding and future problems concerning the baby like the baby could struggle to gain weight or fight infections. Most women are not allowed to breastfeed after chemotherapy as some drugs could be transferred to the baby through breast milk. Life after chemotherapy  will be changed. The person’s daily tasks and quality of life can be affected.

Pregnancy after Chemotherapy

As more young people are surviving cancer, women should consider conceiving post treatment, as this is the safest option for the baby and the mother. In addition, there are hardly any chances of the cancer coming back after pregnancy although a rigorous follow up is required. Most doctors advise women to wait to conceive for some years after completing cancer treatment until the risk of recurrence is reduced. Before becoming pregnant, it is good to evaluate all the vital organs like heart, kidneys, etc, as chemotherapy drugs tend to damage these organs.

Chemotherapy drugs tend to cause infertility. Hence, it is advisable to discuss various childbearing options and fertility preservation techniques with your doctor. Despite all the above options, it is best to deal with chemotherapy and pregnancy separately to avoid unnecessary complications.