A complication-free pregnancy is what every woman wants. However, it is not always under your control. Are you aware of cervical cancer during pregnancy? Can you continue your pregnancy? Do you get it treated? Read on to find all your answers.
What is Cervical Cancer?
Cervical cancer, as the name indicates, is cancer in the cells of the cervix. The cervix is the narrow lower end of the uterus that connects to the vagina. Cervical cancer starts as dysplasia – abnormal cell growth in the cervical tissue. If these abnormal cells are not destroyed or removed in time, they turn cancerous. They can start growing and developing further into the cervix and surrounding areas.
Causes Of Cervical Cancer During Pregnancy
Cervical cancer most commonly is caused by sexually transmitted HPV infection. In most cases, this infection will clear out in 2 years without causing any issues. Sometimes, when the body's immune system fails to fight the virus completely, the infection can cause the cervical cells to turn cancerous after a few years.
Symptoms of Cervical Cancer During Pregnancy
Some common symptoms of cervical cancer are:
- Pelvic pain during sex
- Vaginal bleeding after intercourse
- Bleeding between periods or after menopause
- Heavier than usual menstrual bleeding
- Long periods.
Cervical Cancer During Pregnancy
Cervical cancer during pregnancy is rare. In most cases, due to the various scans and tests taken during pregnancy, cervical cancer is identified in the early stages itself. The doctors will try to confine it to the cervix.
However, if the cancer develops later in the pregnancy, is fast-growing or is already in an advanced stage, immediate treatment is necessary. In such a case, the expecting mother must discuss all her treatment options with her doctor. It is important to understand how the treatment will work and affect the baby, the mother, and the mother's fertility.
Treatment of Cervical Cancer During Pregnancy
The treatment for cervical cancer during pregnancy will depend on when the cervical cancer is diagnosed and how advanced the cancer is. It can be broadly classified into slow-growing and advanced or fast-growing cancer. The treatment will vary depending on the trimester of your pregnancy as well.
Cervical Cancer in the First Trimester
In the first trimester, you still have the option to choose if you want to go ahead with the pregnancy or abort it. Cancer can be very unpredictable, and choosing to abort due to cervical cancer does not mean you are harming your baby. Talk to your doctor and make an informed decision.
- Slow Growing
If the cervical cancer is slow growing and you want to continue the pregnancy, your doctors might suggest you wait until after the delivery to start your cervical cancer treatment.
Your doctor can also suggest you deliver the baby at around 37 weeks via caesarean delivery. A fetus takes 37 weeks to develop fully. During the caesarean section, your doctor may perform a hysterectomy and remove both the uterus and the cervix and surrounding structures if any are damaged due to cancer.
- Fast Growing
If the cancer was identified late, is fast growing or is in the advanced stages, the doctor will keep a close watch on the cancer growth. They will take regular cervical cancer tests to understand if and how fast the cancer is growing and where it is spreading. If the cancer starts growing outside the cervix, it can begin affecting the surrounding organs and tissues. In such cases, immediate treatment is required.
The treatment options include –
- Hysterectomy (removal of organs or tissues affected by cancer)
- Chemotherapy
- Radiation Therapy
None of the above treatments are safe for the pregnancy or the fetus. Hence, the doctors will suggest either aborting the baby or delivering it early. It depends on multiple factors, and only a detailed discussion with your gynaecologist and oncologist can help you identify the best option for your condition.
Cervical Cancer in Second & Third Trimester
- Slow Growing
In case of stage 1 or slow-growing cervical cancer in your second or third trimester, your doctor might suggest
- Cold Knife Conization
Removal of a piece of the cervix when you are under anaesthesia.
- Radical Trachelectomy
Removal of the entire cervix, the tissues nearby and the upper part of the vagina and lymph nodes if needed. After the removal, the uterus will be directly connected to the remaining part of the vagina. A Cerclage procedure will help keep the uterus closed.
- Advanced Stage
If you are diagnosed with stage 2, 3 or 4 cervical cancer that is fast growing in your second or third trimester, your doctor might advise you to continue the pregnancy and undergo chemotherapy for the cancer.
Certain types of chemotherapy, like cisplatin, paclitaxel or carboplatin during the second or third trimester of pregnancy, do not usually harm the fetus. However, it may cause early labour or low birth weight in the baby.
Yes, this is a side effect you don't want, but you cannot let the cancer proceed either. Your doctor will give you the chemotherapy and may suggest a caesarean delivery as soon as the baby is ready so that you can continue with stronger treatments for your cancer.
Getting Pregnant With Cervical Cancer
Can you get pregnant after Cervical Cancer diagnosis?
The answer depends on what type of treatment you underwent for your cervical cancer. If you were diagnosed with stage 1 or slow-growing cancer and underwent only Conization or a Simple Trachelectomy (removing a larger portion of the cervix), you will still have your uterus. You can wait for about 6-12 months before you start trying to conceive. Ensure you check with your doctor before you start planning for pregnancy.
If you underwent chemotherapy, radiation or a hysterectomy where your uterus was removed or your fertility was affected then you cannot carry the baby. You can opt for surrogacy instead. You can use your egg and your partner's sperm, but let a surrogate carry the baby to term. If your treatment has affected your fertility, you can opt for a donor egg. You can also choose to freeze your eggs before going in for treatment.
Conclusion
Cervical cancer is a common type of cancer many women across the world suffer from. A diagnosis of cervical cancer does not mean your dreams of becoming a mother or having a larger family have to be compromised. With timely diagnosis and the right treatment, you can continue your pregnancy or even have children in the future using ART. Find the right medical team to support your dream and challenging journey.
FAQs
1. What happens if you have cervical cancer during pregnancy?
If you have stage 1 cervical cancer, you can undergo treatment after the delivery. In case of advanced cancer, you may have to undergo chemotherapy or other procedures. They are not harmful to the baby or the pregnancy. However, they may lead to preterm delivery or low birth weight. In rare cases, you may have to terminate the pregnancy to undergo strong treatments.
2. Can you have cancer treatment while pregnant?
Yes, if you have advanced Cervical Cancer during pregnancy, you can undergo certain procedures to remove the cancer and affected areas or undergo certain types of chemotherapy that won't affect the baby.
3. Is chemo safe during pregnancy?
Chemotherapy like cisplatin, paclitaxel or carboplatin can be safe during pregnancy as they will only work on the cancer cells and not affect the baby.
4. Is radiation treatment safe during pregnancy?
No, radiation can harm the fetus and the pregnancy itself. If you have to undergo radiation for your cancer, your doctor might suggest an early delivery via a C-section.
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