Chemotherapy is 'safe during pregnancy'
Pregnant women with cancer need no longer choose between their own life and their baby's
Jeremy Laurance
Jeremy Laurance is Health Editor of The Independent and the i and has covered the specialism for more than 20 years. He thinks the harm medicine does is under-appreciated, the harm it prevents over-rated, and that cycling works better than most drugs. He was named Specialist Journalist of the Year in the 2011 British Press Awards.
Friday 10 February 2012
Related articles
Women diagnosed with cancer during pregnancy no longer need to choose between their own life and that of their baby. It is possible to save both.
A series of studies published in The Lancet and Lancet Oncology shows that children born to women given chemotherapy while they were growing in the womb developed as well as children in the general population.
About one in 1,000 pregnancies is affected by cancer and in the past women have faced a terrible choice: delay treatment until the baby is born, putting their own life at risk, start treatment while pregnant and risk damaging the baby, or terminate the pregnancy.
Now the trend is to preserve pregnancy wherever possible and the evidence shows the outcomes for mother and baby are good.
Chemotherapy involves administering toxic drugs to kill the cancer but which also kill healthy cells in the mother's body. Its effects on the foetus have been unclear but a study of 68 women who each had three to four cycles of chemotherapy during pregnancy showed their children were unaffected.
Tests of cognitive ability on the children were "within normal ranges", the researchers from Leuven Cancer Institute in Belgium say. Only those born prematurely had lower scores of cognitive ability but the researchers say this applies in the general population too.
"Our findings do not support a strategy of delay in chemotherapy or [induced] pre-term delivery with [subsequent] chemotherapy to avoid harm to the foetus," the authors write.
In a second paper, researchers from the Institut Gustave Roussy say women must not have chemotherapy in early pregnancy when it can harm the foetus but from the second trimester (12 weeks) onwards evidence shows it is safe. "The use of chemotherapy during pregnancy helps increase the chance of foetal preservation. Children exposed to chemotherapy in utero after the first trimester do not seem to have more congenital abnormalities," the authors say.
However, they admit that women with advanced cervical cancer would benefit most from a combination of chemotherapy and radiotherapy which is likely to necessitate termination of the pregnancy.
The authors of a third paper in the series say chemotherapy for breast cancer can be given in the second and third trimesters and termination of the pregnancy "does not seem to improve maternal outcome". But they add that the decision whether to continue or end the pregnancy is a personal one.
Case study: 'Certain drugs don't pass across the placenta. Not everyone knows that'
Caroline Swain's positive pregnancy test should have brought joy. She had been trying for a baby with her husband to be a sibling to their first-born, Max. Instead the result brought terror. Aged 35, she had taken the test as a precaution, before going into hospital for treatment for breast cancer, which had just been diagnosed
"I went through all the emotions. Will I live to see my child grow up? Will I live long enough for him or her to know me? We wanted to save the baby but the first issue was: would that be possible?"
It was. Caroline's consultant at Southend Hospital in Essex advised that if she had a mastectomy immediately and waited until she was 12 weeks pregnant to start chemotherapy, her baby should be safe. Luke was born and is now nine.
"When my consultant told me it was possible to have the baby and the treatment it was unbelievable. Certain drugs don't pass across the placenta. Not everyone is aware of that. We are very lucky."
Life & Style blogs
Million pound investment to bring Liverpool homes back into use
Dozens of empty homes in two of Liverpool’s most deprived areas will be brought back into use thanks...
London renters are getting poorer and moving further out
Plus, do energy saving measures boost house prices?
-
The 10 Best new smartphones
-
Microsoft drops controversial Xbox One DRM pre-owned game and connection policies following outcry from gamers
-
End the scepticism! Environment Secretary Owen Paterson urges UK to adopt use of GM crop technology
-
Stripes set to be big for Dolce and Gabbana as fashion designers get 20 months in prison for tax evasion
-
Study claims ‘inner peace’ can help pupils to cope with exams
- 1 ‘Hello, NME? I’d like to complain about your Tom Odell review. Why? I’m his dad’
- 2 Richard Nieuwenhuizen death: Six teenagers and 50-year-old father convicted of manslaughter in shocking case of referee killed over a game of football
- 3 Exclusive: Newcastle United's star talent-spotter Graham Carr on brink as Joe Kinnear sparks walkout at St James' Park
- 4 Vast methane 'plumes' seen in Arctic ocean as sea ice retreats
- 5 From charmer to bully: My encounter with Charles Saatchi
How will you make today delicious?
Tell us how you plan to make today delicious and you could win a £50 M&S gift card.
Win a Nook® Simple Touch eReader
Find out how Nook® is supporting the Evening Standard's Get Reading campaign - and your chance to win one.
Free reading festival for families
Follow The Standard's campaign to get London's children reading - and experience this unique event at Trafalgar Square on 13 July.
Enter the latest Independent competitions
Win anything from gadgets to five-star holidays on our competitions and offers page.
Business videos from commercial thought leaders
Watch the best in the business world give their insights into the world of business.
iJobs General
Commercial Refrigeration Engineers
TBC: Capital Refrigeration Services Ltd: Capital Refrigeration Services requir...
****Primary Key Stage 2 Teacher ****
£90 - £120 per day: Randstad Education Preston: We are currently recruiting fo...
Key Stage 1 Supply Teacher Blackpool
£90 - £120 per day: Randstad Education Preston: . Blackpool
Are you a dynamic Primary teacher looking for work in Bromley?
£5520 - £31200 per annum: Randstad Education London: If you are then please ap...
Babies behind bars
Sonic youth: The high-pitched sound alarm
The art of living in small spaces
'Teaching bright children isn't rocket science'
Can technology lure us back to the high street?





Comments