Advice, tips, and important information for any professional supporting a mum through cancer
Below you'll find relevant tips and information on how to approach different stages and elements of treatment and care for a person who develops cancer in or around their pregnancy. This is not an exhaustive list and you are encouraged to seek further advice and support from your own workplace, educational setting or by contacting Mummy’s Star directly.
Symptoms and Diagnosis
Due to the many changes experienced by the body during and the post-partum period, it is sadly common that some of the early signs of cancers can be mistaken for being pregnancy or birth-related symptoms. We refer to this as symptom shielding. While it is correct to not alarm anyone into thinking that all these changes and unusual feelings are sinister, promoting body awareness and the confidence to voice a concern is key to speedy and efficient diagnosis.
The message in the MBBRACE report 2018 Section 7 ndph.ox.ac.uk was clear: pregnant people should be leaving medical checks with a diagnosis of what their symptom likely is, rather than a diagnosis of what it isn’t.
Our Cancer and Pregnancy Awareness Week 2022 shared lots of useful information on this topic.
Treatment During Pregnancy
It is vital to remember that cancer during pregnancy does not always necessitate a termination and that chemotherapy, radiotherapy and surgery are all treatment options that may be considered, by a specialist team, during pregnancy. It is the specialist’s role to consider all impacting factors, including:
the health of the pregnant person
the health and gestational page of the baby,
any pre-existing health conditions
the type, location, size, and stage of cancer severity of the cancer
They will then explain all treatment options and what, if any, risks are involved.
The family should be part of this discussion and ask any questions that they need. While the specialists may offer a preferred treatment plan, the family always have the right to choose to accept treatment, to decline treatment or to ask for a second opinion.
Some cancer treatments may harm the baby, especially during the first trimester, meaning treatment may be delayed until the second or third trimesters. When cancer is diagnosed later in pregnancy, doctors may wait to start treatment until after the baby is born. Sometimes they may consider offering an early induction of labour, to allow treatment to begin as soon as possible.
If baby has been born prematurely or with other health needs, it is possible they will require a stay in the NICU. This may coincide with Mum’s treatment and could necessitate mum and baby being separated during those early, bonding days.
Supporting connection and contact as much as possible is vital at this time. As well as making time/space for visits, devices such as tablets and phones can be hugely beneficial, allowing mum to see and speak to her baby using video calls.
Breastfeeding can still be facilitated in many cases or, if this is impossible due to distance or particular cancer/treatment types, donor milk can be sourced with the help of Mummy’s Star and other organisations.
Care & Treatment After Birth
This period is often regarded by patients, and increasingly by healthcare professionals, as the most difficult and unpredictable part of any cancer diagnosis.
This is largely because the after-effects of diagnosis and treatment are both physical and psychological and there is simply no timeline or rule-book as to how everyone will react or feel. Some get straight back into life as they knew it before and may then struggle years later. Others feel the struggle very soon after their treatment/surgery ends.
This often coincides and is compounded with the withdrawing of support available to them, because of a perception that they are now okay because the treatment has been completed.
If you are supporting a patient who is finding the time after treatment difficult please get in touch and we can help you put support in place for them.
Many mums have shared that at their treatment and appointments after giving birth, their status as a New Mum is often dismissed or forgotten about; which diminishes their sense of excitement and joy. While we fully appreciate the pressures on health professionals to do their roles efficiently, small acts of compassion such as remembering to congratulate a Mum on her new arrival, asking how things are going at home, or trying to fit appointment times around naps or feeds, can all help Mum feel she is not missing out on this special time due to her illness.
Baby Loss or Termination
Some Mums make the heartbreaking decision to terminate their pregnancy in order to receive treatment that will save their lives. Others may lose their child due to a number of unpredictable factors, just like someone without cancer. When receiving a mum who was pregnant, for cancer treatment or follow-up appointments, it is vital you check their notes to confirm if this happened to them to ensure you can handle their needs with compassion and sensitivity.
Sadly, some of our families receive a diagnosis of secondary cancer (metastatic disease) and are thus incurable. The future here becomes very uncertain. For some there is scope for changing treatments on an ongoing basis to extend and support quality of life, for others treatment options can become very limited depending on the nature of cancer or where it has spread to.
Families experiencing secondary cancer may have complicated and challenging emotional responses as well as a number of unique practical considerations to manage. A referral to Mummy’s Star can allow us to help you put a sensitive support plan in place.
End Of Life Care
You may find yourself in the difficult position of supporting a pregnant person or new mum who will not live to see their child grow up. This is painful and distressing for everyone involved, including you as their healthcare provider. Please be sure to support yourself in whatever ways you can, so you can give the best possible care in turn. Additionally, reach out to other organisations, including Mummy’s Star who can offer specific support to guide you, and your patient in turn, through this difficult journey.