By the time it was 2002, the incidence of cases related to cancer associated pregnancies increased to 38 percent, per one hundred thousand deliveries from 16 percent in about twenty thousand deliveries. The coexistence of these two, i.e. cancer and pregnancy, is expected to grow higher in future. This makes it very important for the clinical community to understand and allow research to discover the best treatment to toe the line for such a complex problem.
The numbers involved
Cancer occurs in at least one pregnancy out of every one thousand pregnancies. The common types of cancers that occur in pregnant women are melanoma, cervical cancer and hodgkin lymphoma.
The reason why a lot of progress hasn’t been seen in this sector along with treatment of immunology in pregnancy is because the clinical expertise in this patient population is very rare. However, the goal of treatment of cancer during pregnancy is pretty much the same as for the ones without pregnancy. It is to control the disease and prevent metastasis but more guidelines should be added to prevent the cancer cells from harming the foetus.
Pelvic and abdominal radiation must be avoided because most of the chemotherapeutics used are FDA category D because of the positive evidence for the fetal risk that takes place but varies throughout the gestation period
Pregnancy and timing the cancer treatment
The first trimester is very risky for the baby if you have cancer. The risk of fetal malformations, spontaneous abortions and fetal death are extremely high during this time.
The first trimester is the riskiest because it is 17 percent for single ageing therapy, 25 for combination. There aren’t too many citations of increased malformations from administered chemotherapy. However the chemotherapy must be stopped 3-4 weeks before the delivery to prevent adverse effects on the baby like myelosuppression and other complications. Radiation and chemotherapy so close to the delivery of the baby is not good for it at all.
However, till date, no such reported problems have been seen in children who have been exposed to chemotherapy when they were in the uterus.
A number of doctors are now coming together to do a multidisciplinary management research of pregnant cancer patients because the nature of cancer is complex in itself and with pregnancy coming into the picture, important human lives are being lost. This research will help in providing optimal care for the foetus, the mother and in determining the future for gynecologists, oncology specialists and obstetricians.
Taking care of the patient’s psychological health
Cancer during pregnancy is nothing short of a real life horror story for the mother. During this period the patient can fall into acute depression. This is why the patient needs intensive care and her relatives and friends need to be around her to take care of her and make her feel like there is ample hope left. Positivity is the key to keep the patients happy. Take them out for morning walks and make sure they enrol themselves in classes that will keep them busy.