How to manage bladder cancer during pregnancy?

Question

Hello doctor,

My wife and I have been trying for a baby for so long, and we were overjoyed when she finally conceived. However, we recently received the devastating news that she has been diagnosed with bladder cancer during pregnancy. She is 45 years old, and we are extremely worried about both her health and our baby’s well-being.

The doctors have informed us that it is non-muscle invasive, high-grade bladder cancer. We are concerned about the treatment options available during pregnancy.

Can she safely undergo procedures like transurethral resection of bladder tumor (TURBT) or intravesical therapy?
Will any treatment pose a risk to our baby, or are there safer alternatives that can be considered until delivery?

Kindly advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I am sorry to hear about your wife's diagnosis. Managing bladder cancer during pregnancy requires a careful approach to ensure the best possible outcome for both the mother and the baby.

A multidisciplinary team of specialists, including obstetricians, medical oncologists, urologists, and radiation oncologists, will work together to create the safest treatment plan. The primary goal is to effectively manage the urothelial cancer while minimizing any risks to the fetus.

As your wife has been diagnosed with non-muscle invasive bladder cancer (NMIBC), it is usually managed using endoscopic procedures and intravesical therapy. Transurethral resection of bladder tumor (TURBT) is a procedure that can be performed during pregnancy. However, modifications may be required to reduce any potential risks to the baby.

Intravesical therapy involves delivering medication directly into the bladder. However, certain treatments, such as Bacillus Calmette-Guérin (BCG), are not recommended during pregnancy due to the risk of infection. In some cases, alternative options like Mitomycin C may be considered, depending on the patient’s condition.

TURBT is generally considered safe during pregnancy, but the use of anesthesia may pose some risks. The safety of intravesical therapy during pregnancy is not well established, and the medical team will need to carefully assess the benefits and risks before proceeding with treatment.

Systemic chemotherapy is typically avoided during pregnancy, especially in the first trimester, as it can pose significant risks to fetal development.

Please try not to worry. Many women with bladder cancer have had successful pregnancies with good outcomes for both the mother and baby. If you need further guidance, please consult your healthcare provider for a personalized treatment plan.

I hope you are satisfied with my answer.

For further queries, you can consult me

Thank you.