What Does a Cancer Diagnosis in Pregnancy Mean for the Baby?

Cancer diagnosis is hard any time, especially when you’re pregnant.

A little over two years ago, I met John Kazi, a 26-year-old Nigerian woman in the second trimester of her pregnancy. She had a love-hate tug-of-war going on. She loved the little olive taking shape inside her womb but was frightened of her diagnosis, an advanced stage breast cancer in the sixth month of pregnancy.

A cancer diagnosis at any point is earth shattering but when you’re with a child, the fears are multifold. Pregnancy isn’t supposed to be like this: for Kazi, the best phase of her life suddenly turned into the worst, just like that. Nightmares, constant worry about the unborn child, topped with chemotherapy.

I would keep thinking, there’s no way I can carry this baby to term. When you’re delivering, a mom worries whether the child will have 10 fingers and 10 toes - magnify that 100 times. I was just praying he wasn’t going to be deformed!

John Kazi, Cancer Survivor

There is hardly any medical literature available on how cancer affects a developing fetus. Chemotherapy is poisonous - no doctor knows the exact side-effect of it on an unborn fetus.

A new study done by the International Network of Cancer, Infertility and Pregnancy in Europe, reassures thousands of pregnant cancer patients that their babies can turn out fine despite exposure to the disease and the harsh treatment.

With Child, With Cancer

For the study, scientists zeroed on 129 children whose mother’s had cancer during pregnancy. In this group, 74% children were exposed to chemotherapy in the womb, 2% to drug treatment and 11% to radiation. (Some of the children were exposed to more than one of these treatments).

Now all these children were matched with a child of the same gestational age for development landmarks till the age of 3.

Researchers found:

• Babies who were exposed to cancer in the womb, had a much higher rate of preterm births (and complications related to that) than the children born to cancer-free mothers.
  
• Heart rate, blood pressure and other measures of cardiac functions were same for both the group of kids.
• Clearly chemotherapy had no visible effect on the structural abnormality of any organ in children exposed to harsh treatment in the womb.
• Cognitive function in both the groups was almost the same as well.

These results might offer some comfort to pregnant women who are diagnosed with cancer. Clearly, the diagnosis is no indication to terminate the pregnancy.

Kazi gave birth to a healthy baby boy via a normal delivery. The travails of chemotherapy weren’t the only postpartum challenge: women with cancer are advised not to breastfeed even from healthy breasts because the poison of chemotherapy can be passed on to a nursing infant. Also, 70% of women become infertile following the cancer treatment.

New mums complain about postpartum syndrome. I had a newborn, was taking chemotherapy once a week, and dealing with menopause. Imagine hot flashes while changing your baby!

John Kazi, Cancer Survivor

Doctors still don’know why chemotherapy a poison to the healthy cells of an adult, doesn’t harm the fetus. This is mostly because we still don’t fully understand how the placenta handles drugs. The level of drugs in the mother’s blood are not the same as in her placenta.

What Causes Cancer in Pregnancy

Kazi was a vegetarian, did yoga all her life and never smoked. Got pregnant at 26, and still no doctor could explain why she got cancer. Most just said, it happens.

Why?

Can hormonal changes in pregnancy give cancer?

Oncologists say, there is some evidence that pre-existing abnormal breast cancer cells in the body can get aggravated with the pregnancy hormones.

Pregnancy lowers a woman’s immune system. A fetus is like a transplanted foreign body and the mother’s system is trying to adjust to it. In this environment, pre-existing cancer cells, take advantage of the dampened immunity and stir the perfect storm. It’s a highly estrogenic environment.

Recent studies have found a link between IVF treatment and a 60% higher risk of ovarian cancer compared to the general population. So is IVF a sure shot reason of cancer in pregnancy? Again, the answer is elusive.

While IVF increases the risk of ovarian cancer, it also decreases the risk of other gynecological cancers. It is very hard to study women who get IVF because no one wants to be identified - so it’s difficult to pinpoint the exact cause.

For now, Kazi is overjoyed with her bundle of joy - she named him “Miracle” (no prizes for guessing why). Still, sometimes at night, she lies awake in bed and the cancer hangs over. “I don’t know what gave me the big C, so I don’t know how to avoid it coming back”, she says.