Having a Baby, Having Chemo – It May Be Safer Than You Think

PJ Hamel Health Guide
  • What’s every woman’s nightmare? Breast cancer. But for some women, the nightmare is compounded when they’re diagnosed while pregnant.

    “Will I be able to keep the baby? What will those powerful chemicals do…?” Imagine what would run through your mind while trying to balance your baby’s well-being against your own – possibly against your very life.

    Thankfully, the preliminary results of a new German study show that women undergoing chemotherapy while pregnant deliver healthy babies just as often as women not having chemo treatment – good news for moms-to-be diagnosed with breast cancer. About 2% of all breast cancer diagnoses are in pregnant women; put another way, about 1 in 3,000 pregnant women will develop breast cancer before delivery.

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    The German study followed 260 women diagnosed with breast cancer while pregnant; most had grade 3 cancer with lymph node involvement, which would usually mean a treatment plan including chemo. 142 of these women chose to start chemo during pregnancy, while the remaining women decided to wait until after their baby was born.

    The women who received chemotherapy during their pregnancy delivered babies of slightly higher birth weight, though researchers point to the fact the women not undergoing chemo tended to have their babies earlier by choice, which would account for the difference.

    Babies exposed to chemo were more likely to have low blood cell counts, both red and white; and to be more likely to develop an infection in the first 4 weeks after birth, compared to babies not exposed to chemo. But the difference was so slight as to be “not statistically different,” according to Dr. Sybille Loibl, the study’s lead author.

    As for the mothers, both groups showed similar results in disease-free survival (though at the time of the study’s publication the women had only been followed for 2 years, post-diagnosis). Those who opted for chemo were generally diagnosed earlier in pregnancy than the women who chose to hold off (20 weeks vs. 28 weeks), which would account for their decision to go ahead with treatment while pregnant.

    Dr. Edith Perez, a well-known breast cancer researcher allied with the Mayo Clinic, cautioned that the type of chemotherapy might make a difference in how well babies tolerate it. Anthracyclines (chiefly, Adriamycin) are probably a better bet, as they stop cancer by killing cancer cells directly, rather than interrupting cell division in fast-growing cells – which could very well include those of your developing baby.

    In addition, taxanes (Taxotere, Taxol) were generally avoided by women having chemo during pregnancy.

    So, if you’re one of the unlucky women diagnosed with breast cancer during pregnancy, what should you do?

    Speak with your doctor about your options. How early is your pregnancy? If you’re in the first trimester, it’s best for the baby if you can wait to start chemo until at least the second trimester. You’ll also want to end your chemo 3 to 4 weeks before the baby’s due date, so that you’re in the best health possible for the delivery. You want to give your blood counts a chance to recover, as any neutropenia (low blood cell counts) can have an adverse effect on your child.

  • Oh, and by the way, don’t worry about your baby getting cancer. The placenta forms a barrier between you and your baby, effectively preventing that from happening. Luckily, the placenta also blocks most of the baby’s exposure to chemo drugs – another reason it’s safer than you might have thought to undergo chemo while pregnant.

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Published On: May 11, 2011