Every year 3,000 women across the UK will be diagnosed with cervical cancer, some of these during pregnancy. It is a cancer that is both rare and largely preventable thanks to the NHS cervical screening programme which detects abnormal cells on the cervix before they turn into cancer. A woman can reduce her risk of developing the disease if she attends screening regularly – in England, Wales and Northern Ireland she is invited every three years aged 25-49 and every five years aged 50-64, in Scotland it is every three years aged 20-60 (this will change to be in line with the rest of the UK from April 2016). If you are due a cervical screening whilst pregnant you should speak to your doctor or practice nurse for advice.
Jo’s Cervical Cancer Trust does, on occasion, speak to and support women who have been diagnosed with cervical cancer during pregnancy. They may have experienced abnormal bleeding – the most common symptom for the disease – but this can also be very common in pregnancy. It is important to report any bleeding during pregnancy to your doctor or midwife so that the cervix can be carefully examined.
It is vital that whatever stage of your pregnancy that a diagnosis of cervical cancer is not delayed. To investigate, the health care professional may refer you to colposcopy (a more in depth look at the cervix using a microscope) where they can safely take a biopsy during pregnancy. If cancer is detected a treatment team will discuss your options based on the stage of your pregnancy.
Peter Mason, Consultant Gynaecological Oncologist, Imperial College London, explains what to expect: “Once cervical cancer is detected the biopsies will determine whether immediate treatment is essential or whether the changes on the cervix can be removed using a cone biopsy without disturbing the pregnancy or whether the cancer is too large to safely do this.
“If the tumour is too large to manage in this way then the decision regarding treatment will be based on the size and extent of the cancer and the number of weeks of pregnancy. The extent of the problem can be readily determined using careful examination under an anaesthetic and MRI scanning which is safe in pregnancy.
“If the pregnancy is early (first trimester) the mother may decide not to go ahead with the pregnancy and undergo appropriate treatment without delay. This may take the form of removal of the cervix (a trachelectomy) which would potentially allow another pregnancy. If this is not appropriate a hysterectomy or radiotherapy treatment may be offered. If the mother is offered chemotherapy, this can be given when the mother is still pregnant.
“If the pregnancy is later (second and third trimester) the mother and her cancer care team will decide whether the pregnancy should be interrupted and the baby delivered early, so that treatment can start, or whether a short delay is appropriate to allow the baby to mature before delivery.”
Being told you have cancer of any kind during pregnancy is devastating; a cervical cancer diagnosis not only has consequences for your current pregnancy but on future fertility as well. Discuss all the options with your cancer care team and if you need further support use the Jo’s Cervical Cancer Trust services which include a helpline (0808 802 8000), forum and Ask The Expert service.
For more information on any of the issues discussed in this article visit www.jostrust.org.uk