If you're diagnosed with cervical cancer when you are pregnant, what will happen depends on:
- the type of cervical cancer you have
- how big the tumour is and whether it has spread (its stage)
- how many weeks pregnant you are
- what your wishes are
Multi disciplinary team
Your doctor is part of a multi disciplinary team who will discuss your situation, and decide together what the best treatment options are in your case. This team includes a:
- doctor specialising in cancer drug treatment such as chemotherapy (medical oncologist)
- doctor specialising in radiotherapy and cancer drug treatment (clinical oncologist)
- surgeon specialising in cancer of the female reproductive system (gynaecological oncologist)
- doctor specialising in the care of women during pregnancy (obstetrician)
- doctor specialising in the care of newborn babies (neonatal doctor)
- expert in examining and identifying cells (pathologist)
- nurse specialist
To make a decision, you will need full information from your medical and nursing team about your options. They can tell you about the benefits and possible risks of each option.
Most women diagnosed with cervical cancer during pregnancy have early stage disease. Research so far suggests that cervical cancers diagnosed during pregnancy grow no more quickly and are no more likely to spread than cervical cancers in women who are not pregnant.
In the second or third trimester
If you are more than 3 months pregnant, your obstetrician will probably say that you can continue the pregnancy but you may have the baby early by caesarean section. You might have your womb removed at the same time. You may then need further treatment with chemotherapy and radiotherapy (chemoradiotherapy).
Less than 3 months pregnant
If you are less than 3 months pregnant, your doctor may want to treat you straight away. Your doctor may feel more than 6 months is too long to leave a cervical cancer without treatment.
If you decide to have treatment then you may need to end the pregnancy. This can be very distressing but remember that you will have support from your nurses and doctors.
If you want to continue with your pregnancy, your doctor will delay treatment until you are more than 3 months pregnant, during the second trimester. You can't have chemotherapy during the first trimester as it can damage the baby or cause a miscarriage.
Cancer treatment during pregnancy is experimental as there are few cases and no large trials. Also there is little information on the long term outlook of women treated during pregnancy.
For small tumours
For some small tumours it may be possible to have treatment with cone biopsy or trachelectomy. Trachelectomy means removing most of the cervix and the upper part of the vagina.
There are very few women who have had a trachelectomy during pregnancy. There is a risk of bleeding and of losing the baby shortly after the operation. Your doctor will talk this through with you before the operation.
For larger tumours
For larger tumours, your doctor may suggest having chemotherapy to shrink or control the cancer until the baby is born. You can't have chemotherapy during the first trimester as it can damage the baby or cause a miscarriage.
Research looking at chemotherapy given after the first trimester of pregnancy has so far not shown an increased risk of birth defects compared to the general population. But researchers need to collect more information over a longer time so we can understand more about the long term outlook for children.
Making decisions about treatment
Deciding on treatment when you are pregnant can be very difficult. You will need some time to think and to find out what all your options are. Make sure you have had the opportunity to ask all the questions you need to ask. You can also ask if there is anyone else you (and your partner) can talk to such as a specialist nurse or counsellor.