KNOWLEDGE AROUND CANCER & PREGNANCY

Answers to your cancer and pregnancy questions

 
 

Frequently asked questions

Can I have treatment for my cancer while pregnant?


Depending on the stage of your pregnancy and any other health conditions that you and/or baby may have, chemotherapy, radiotherapy and surgery are all options that may be considered by your specialist team.

They will explain the treatment options and the risks involved. You will be part of this discussion and can ask any questions that you need. You also have the right to decline or accept treatment or to ask for a second opinion.

The team caring for you will recommend a course of treatment. The stage of your pregnancy and the type of cancer will help to determine this.

When making treatment recommendations for cancer during pregnancy, the doctor considers the best treatment options for the mother and the possible risks to the developing baby. The type of treatment chosen depends on many factors, including the stage of the pregnancy; the type, location, size, and stage of the cancer. The wishes of the expectant mother and her family are central. As some cancer treatments may harm the baby, especially during the first trimester (the first three months of pregnancy), 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, or they may consider offering an early induction of labour.

Some cancer treatments may be given during pregnancy but only after careful consideration and treatment planning to optimise the safety of both the mother and the unborn baby. These can include surgery, chemotherapy, and rarely, radiotherapy.




If I have a cancer during my pregnancy, what does this mean for my baby?


As each person’s cancer diagnosis and medical condition are different, we cannot give you a specific answer to this question. During this time your midwife and nurse specialist will support you. They will be able to help you understand what your cancer diagnosis and treatment means for you and your baby.




Can I have Surgery?


Surgery may be appropriate and can be carried out during pregnancy and this will be discussed with you.




Can I have Chemotherapy?


Chemotherapy may be offered as a treatment during your pregnancy. Chemotherapy is not usually given during the first 12 weeks of a pregnancy (first trimester) when the baby is in a very early stage of development.

After week 12 of the pregnancy (the second and third trimesters), some types of chemotherapy may be given. The placenta acts as a barrier between the mother and the baby, and many drugs cannot pass through this barrier, or they only pass through in very small amounts. The placenta is not fully developed in the first trimester.




Can I have Radiotherapy?


Radiotherapy can harm the baby’s development and so this treatment is generally avoided during pregnancy unless it makes an important difference to results. The risks would be discussed with the family.




What are the effects of treatment?


Feeding Choices

Unfortunately many of our mums are unable to breast feed because of their treatment. This can be upsetting for them. They may miss the physical closeness and bonding they have with their baby through breast feeding. Thye may have breast fed other children. Our mums may be able to access to donor milk from nationwide organisations and we advise our mums to ask their health care professional to refer them to a lactation consultant who can offer specialist advice about feeding this.

Other mums may have to stop breast feeding to start treatment and this can be distressing when their babies have been solely breast fed. They may worry about the impact this will have on their baby in the short and long term and some may refuse to take formula, the bottle or cup. Many of mums have found that their baby’s did with a bit of perseverance take milk. If you or your baby are distressed about feeding please contact Mummy’s Star and we can offer our support about this.

Hair loss

Some treatments for cancer cause hair loss for our mums. This can affect all body and scalp hair. Hair forms part of our identity and a way in which we express ourselves and hair loss can affect confidence and be a very upsetting side effect of treatment. Hair loss can be a visual reminder of cancer for you and others.

Some of our mums who have longer hair like to have it cut shorter so they can prepare for the loss. Others may be able to wear a ‘cold cap’ while they are having chemotherapy to slow down or prevent the hair loss. Some of our mums choose to wear a wig and look for a style and colour to match their own whereas others choose something completely different. Some mums like to get used to wearing the wig before the hair loss takes place. You maybe able to access a wig or help towards the cost of a wig through the NHS.

As your hair thins your scalp maybe more sensitive to cold or sunny weather and you may prefer to wear a hat, scarf or bandana. There are lots of videos on the internet about how to tie and style bandanas and scarves.

Others hair changes may occur during treatment. It can become thin and brittle. Speak to your hairdresser about how you can look after your hair during and after treatment. After treatment most people will gradually regrow their hair as it was. Some people can find their hair comes back a different colour or it could be more curly than before.

Our mums find it helpful to talk about hair loss and changes on our forum and find out tips and support for managing this. Please ask your support worker more about this.




What are the longer term effects of treatment


Premature menopause

A premature menopause can be brought on by many different cancer treatments- chemotherapy, radiotherapy to the pelvis, surgical removal of the ovaries and/or drug treatments to treat some hormonally driven breast cancers.

If the menopause is induced quickly in these ways, the symptoms can be more intense.

As everyone has different diagnoses and treatments, this is just a basic guide to some of the symptoms you may experience but you should speak to your medical/ nursing team if you have any worries or questions.

You may be worried about loss of fertility, which may be temporary or permanent. This is something that you should discuss with your team looking after you.

cancerresearchuk.org/about-cancer/coping/physically/sex/women/losing-fertility

There are many symptoms related to the menopause, but it is important to remember that you may suffer hardly any, or you may have a combination of these. These are some of the most common reported symptoms.

For many of these symptoms there may be things you can do or medications you can take to help. You must however check with your medical team and they will be able to advise you.

  • Hot Flushes/ night sweats.
  • Insomnia/ disrupted sleep pattern.
  • Weight Gain-especially around the waist area.
  • Headaches.
  • Changes to skin and hair.
  • Muscle and joint pain.
  • Lower sex drive.
  • Poor concentration/memory loss.
  • Fatigue/ low energy levels.
  • Mood swings/becoming irritable more easily.
  • Reduced self esteem.
  • Feeling tearful.
  • Urinary – bladder changes/infections.
  • Vaginal dryness/pain during sex.

Hot Flushes and night sweats

Many people think that this means you just get hot and sweaty. This can vary from just occasionally feeling a bit warm through to having to get up several times a night to change clothing/ bedding or even showering. This is turn can lead to disturbed sleep patterns and therefore tiredness and irritability can become a problem.

Many women experience a heat within the core of their body which starts to spread within them. Flushes can be a very strange experience and for some quite distressing. It can lead to reddening of the face and sweating profusely. One minute you’re red hot, then cold. If this happens in public or at work it can be embarrassing if people comment or joke about it, mainly because they don’t fully understand.

What can we do?

Simple things like layering clothes, wearing natural breathable materials, natural bedding materials.

Carrying a little spray bottle around with you with cool water or something like peppermint essence mixture to help make you feel more comfortable. Keep a spray at the side of the bed. Carry a mini fan around with you.

Keep a diary and see if there is a pattern or a trigger for your hot flushes. Food can be a trigger as can alcohol and caffeine.




What to do if you experience other symptoms?


What else can we do?

  1. If you are experiencing any of these symptoms, please discuss with your healthcare team, including your GP. There are medications that can help with flushes (e.g. Venlafaxine or Oxybutynin) and other treatments for other symptoms e.g. Vaginal moisturisers/lubricants.

  2. Healthy eating and exercise may help with some symptoms.

  3. Giving up smoking.

  4. Talking about the symptoms to health professionals or other women in a similar situation may help you to come to understand why you are experiencing these effects and this in turn may help you to cope with the side effects of treatment.

  5. Being aware that a lot of things you are experiencing may have an actual cause e.g. forgetfulness can be frustrating and upsetting but may be easier to deal with knowing this.

  6. Partners can be affected by women experiencing these symptoms and it is important that they are made aware of what is happening and why.

Further information can be found below:

Chemotherapy and the menopause

cancerresearchuk.org/about-cancer/coping/physically/sex/women/early-menopause

Breast cancer and the menopause

breastcancernow.org/information-support/facing-breast-cancer/going-through-treatment-breast-cancer/side-effects/menopausal-symptoms-after-treatment

Cervical Cancer treatments and the menopause

jostrust.org.uk/information/living-with-cervical-cancer/menopause

Ovarian Cancer Treatments and the menopause

ovacome.org.uk/menopause

Lymphoedema

Lymphoedema is a long-term condition that causes swelling in the body's tissues. It can affect any part of the body, but usually develops in the arms or legs. It develops when the lymphatic system does not work properly.

Lymphoedema in your arm/breast area can occur after treatment for breast cancer following surgery and radiotherapy. This can present as a swelling/tightness or heaviness in your arm (on the same side as your breast cancer) or swelling around your breast, underarm and back.




What are other common symptoms and side affects?


Other common symptoms and side effects could be: Lymphoedema Lymphoedema is a long-term condition that causes swelling in the body's tissues. It occurs when your body cannot effectively transport lymph fluid. When the flow of lymph fluid is disrupted in some way, excess fluid is unable to drain properly and some swelling may occur. This swelling (or oedema) can be in any part of the body, in the arms and legs, but also the breast or chest, head and neck, or genitals. People can be born with this condition but for many, Lymphoedema develops as a result of treatment in certain areas of the body. Lymphoedema has no known cure but its symptoms can be managed. It is important to understand the condition so you can manage your Lymphoedema as effectively as possible. For anyone undergoing any treatments/surgery, where Lymphoedema is a risk, this should be explained prior to this and information given. Further information and support can be found below. Lymphoedema in your arm/breast area can occur after treatment for breast cancer following surgery and/or radiotherapy. This can present as a swelling/tightness or heaviness in your arm (on the same side as your breast cancer) or swelling around your breast, chest wall, underarm, back. You may notice that your clothing on that side seems a little tighter, your jewelry may feel tighter or leave an imprint. For further information on Lymphoedema and breast cancer Lymphoedema in your legs/feet can occur following surgery/radiotherapy to the pelvic area for cervical and uterine(womb) and other gynaecological cancers. You may notice clothing/shoes feel tight and your legs/pelvis may feel heavy. You might notice that when you press on the skin, there is an indent. If you are concerned about Lymphoedema, please contact your healthcare team/specialist nurse for a referral to a specialist team. The sooner you are seen by a specialist Lymphoedema practitioner, the sooner any exercise/massage /treatment and advice can be given to help to manage the condition. Head and neck cancers Lymphoedema in the head or neck can also cause symptoms inside your mouth and throat. This may include swelling of your tongue and other parts of your mouth. You may experience swelling or a feeling of fullness or pressure, find it difficult to swallow or notice changes in your voice. Please contact your healthcare team if you experience any of these symptoms. It is important to point out that:

  • It usually takes some time for Lymphoedema to develop after cancer treatment.
  • Symptoms can take many months or even a few years to appear.
  • Some people have swelling immediately after surgery. This is not Lymphoedema.
  • It’s part of the healing process and should get better within a few weeks.
  • Swelling is not always due to Lymphoedema.
  • See your doctor if you have any swelling that doesn’t go away.





Knowledge around cancer and pregnancy (inc. Signs and Symptoms)

News of a cancer diagnosis during pregnancy or shortly after a birth is often met with shock. Many people tell us that they did not know it was possible. However, cancer can be diagnosed at any time in any person and therefore the diagnosis during pregnancy is a coincidence rather than a cause.

 

Due to the many body changes during the course of a pregnancy and in the weeks after delivery some of the early signs of cancers can be mistaken for being pregnancy related. We refer to this as ‘symptom shielding’. It is correct to not wish to alarm women into thinking that everything they feel could be the sign of something far more sinister but nonetheless, body awareness is key.

 

Approximately 2 women a day receive a diagnosis of cancer in pregnancy/postnatally. This equates to 1 in every 1000 pregnant women (Public Health England 2018).

 

While there has not been a huge amount of research carried out into this area, general guidance is to follow treatment plans for non-pregnant women as closely and safely as possible. This means working to maintain birth preferences and choices for your partner.

 

You can find good information about cancer and pregnancy by visiting INCIP (International Network on Cancer, Infertility and Pregnancy cancerinpregnancy.org.

We work closely with members of INCIP to raise awareness of the choices families have in this situation.

Treatment & options

We realise having a cancer diagnosis can be overwhelming and worrying. Being pregnant or a new mum with a baby to consider can bring additional fears and practical issues. These are some of the questions that our mums ask:

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