Pregnancy and cancer: low risk, but increasing

A diagnosis of cancer during or just after pregnancy as possible at any other time. But how to live and treat the disease is, of course, very different. 

Cancer and pregnancy: a rare event 
Begin by recalling that being diagnosed with cancer during pregnancy is something very rare. This happens to between 0.07% and 0.1% of women. This is essentially of cancers of the breast, or cervical cancer of the blood (lymphomas, leukemias).

Breast Cancer and Pregnancy 
Breast cancer is the most common among pregnant women, it is still a rare phenomenon that affects 1-3 per 10 000 women with an incidence that increases with age. Breast cancer poses unique problems during pregnancy. Indeed, it is difficult to detect because the breasts are already changing because of pregnancy. In practice, mammography is possible during pregnancy, but subject to important precautions. Treatments are also more complicated: in anticipation of breastfeeding during pregnancy of new blood vessels form in the breasts making more complex surgery for surgeons.

Special treatment 
Needless to say that a cancer diagnosis brings a very important for pregnant women and for his family shock. For physicians too, the circumstances are not clear: we must take very special care, and all treatments are not possible. In addition, such cases are rare, it is not easy to find scientific data on the effects of drugs. This does not mean that cancer cases during pregnancy, the only solution is renunciation.

Chemotherapy: What effects on the fetus?
Like all other substances absorbed by the mother, drugs administered during chemotherapy may end up in the baby's blood. This can cause a number of problems ranging from abortion to birth ... or nothing at all. The result will depend on the exact type of chemotherapy, but also the stage of the pregnancy.

Risk that the baby in case of chemotherapy during pregnancy? 
In the first two weeks or the first month, it's all or nothing: either pregnancy stops because of chemo, or the baby has no risk. During the remainder of the first quarter, the chemo is a risk of birth: 10% if you use only one substance and 20% if given more. The second and third quarters, remains a risk of birth, but it is similar to the general population (2-3%). One can also have side effects of varying severity (fetal death, premature delivery, growth retardation), but for a minority of women between 10 and 30%.

The long term and perks 
Regarding complementary treatments of chemotherapy - which are used to improve efficiency or to fight against the side effects - the scientific evidence is lacking. Treatment should be decided case by case. In the long term, a study followed children exposed during pregnancy until their 29th birthday. No differences were found with the general population on IQ, size, school and other problems. The risk of cancer or fertility problems, however, must always be evaluated.

And radiation? 
The fetus is inevitably exposed to radiation during radiation therapy, albeit at low doses. As chemotherapy and surgery are less risky, it generally chooses to delay radiotherapy after pregnancy, although more recent studies suggest a possibility of reconciling the two.

Pregnancy and cancer can be experienced at the same time. But the decisions made ​​about the treatment can lead to serious consequences. Each act will have to be carefully weighed and discussed among several specialists.