Oncological treatment and pregnancy are possible, but not excluding some short-term and long-term effects on the unborn child. Cancer treatment can be categorized as surgery, radiation therapy, and chemotherapy.
Surgery is a crucial part of treating cancer. With special precautions, surgery is possible during pregnancy, although not without the added risk of miscarriage, premature delivery, and fetal distress. During surgery, the mother is at risk of hypotension, hypoglycemia, hypoxia or stress, adding a greater risk to the fetus then the possible risks of anesthesia (Vandenbrouke, Verheecke, Fumagalli, Lok & Amant, 2017).
Radiation therapy uses high energy x-ray to shrink tumors and destroy cancer cells. Radiation is not recommended during pregnancy due to the harmful effects on the rapidly growing fetus, causing death or malformations. From animal studies and atomic bomb survivors that were exposed to radiation, findings showed growth restrictions and organ defects of the fetus (Vandenbrouke, Verheecke, Fumagalli, Lok & Amant, 2017). A stochastic effect of radiation therapy is an increased risk of childhood cancers.
Chemotherapy is a cytotoxic drug, interfering with cell growth. Potential risks of the fetus are malformation, preterm labor and effects the child to adulthood causing hematological problems, cardiac problems, neurocognitive dysfunction, hearing impairment, dental deformities, behavior issues, fertility problems and cancer (Vandenbrouke, Verheecke, Fumagalli, Lok & Amant, 2017).
Not only does cancer and cancer treatments affect the fetus, but also affects the mother physically, mentally and spiritually. Depending on the type, stage, and aggressiveness of cancer, the mother may not have the option to postpone treatment in order to stay alive, resulting in the option of aborting the unborn child to continue treatment. This can go against the mother’s religious preferences, severely affecting her emotional wellbeing.
Expecting mothers have different resources like therapy and support groups to help them continue their journey through cancer. ‘Hope for Two’ is a nonprofit cancer network for women diagnosed with cancer during pregnancy, where they provide support, offer hope and share experiences with one another through phone and email conversations, serving all religious backgrounds worldwide, providing respect and support without judgment to every woman’s personal decision.
Mothers can also receive information regarding their options from their doctors or by the recourses that the American Cancer Society or the American Society of Clinical Oncology provides. The American Cancer Society and American Society of Clinical Oncology Provide accurate information regarding specific cancer diagnosis, different treatment options and support group information.
Education is the most important resource that can be provided. Properly educating expecting mothers and giving them every option, can offer them the knowledge to make a confident and educated decision that is best for their specific situation. Unfortunately, there is not enough research provided to support the different options available.
Those that are willing to treat during pregnancy, the fetus will be studied. Adding on to the current research that is provide, but researching more specifically on the long-term effects of the different types of treatments regarding the different diagnoses. The ongoing collection of data would be long term, assessing the different outcome of the fetus when they are adults. What complications arouse during their life time? Did the treatments cause cancer? If so what type of cancer is most common? What age did the cancer start growing? Is it more aggressive in contrast to someone who did not undergo intrauterine cancer treatments?
Once enough evidence is evaluated, expecting mothers have more information to help them make an educated decision regarding what treatment option is best for them and their unborn child.
For a short-term idea, those planning pregnancy should be educated to undergo preventative cancer screenings. By doing so, you are able to identify and provide treatment to an early cancer giving the parents knowledge to postpone pregnancy until treatment is over.
Young parents may also test their genes with genetic testing to assess their potential of getting cancer, and base their pregnancy plans according to their results. If the potential is high, couples could choose to postpone pregnancy, possibly preserving the eggs through embryo cryopreservation.
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During my research, I have found that there is not much evidence supporting the effects of different treatments. Because of this, mothers cannot confidently choose a treatment plan that is best for her and her child during her fight through cancer. Further research is needed to determine the safety of the different cancer treatments and the short term and long-term effects it has on the fetus.
Knowledge helps avoid delay of maternal treatment, termination of the fetus or induction of preterm delivery. An informed discussion can be made when outcome data is provided to the patient.
- American Cancer Society. (n.d.). Retrieved from https://www.cancer.org/
- Hope for Two…The Pregnant with Cancer Network. (n.d.). Retrieved from http://www.hopefortwo.org/
- Last American Society of Clinical Oncology. (n.d.). Retrieved from https://www.cancer.net/
- Vandenbroucke, T., Verheecke, M., Fumagalli, M., Lok, C., & Amant, F. (2017, November). Effects of Cancer Treatment During Pregnancy on Fetal and Child Development [Scholarly project]. Retrieved from http://www.thelancet.com/child-adolecent