Is chemotherapy during pregnancy safe for the baby?

Question

Hello doctor,

I am 38 and was recently diagnosed with pregnancy-associated breast cancer at 20 weeks. Everything feels so overwhelming. My oncologist says I can continue the pregnancy, but I am terrified for my baby. During my first chemo session, I broke down, worried about the effects on my baby.

Will chemotherapy impact the baby’s development?
Some people are suggesting termination, but I want to keep this child. Are there any success stories in similar situations?
How can I protect my baby, or do you also recommend termination?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

For your confirmation of breast cancer diagnosis, the following things can be done:

First is the type of breast cancer. You have been diagnosed with pregnancy-associated breast cancer, which occurs during pregnancy or within a year of giving birth.
Then stage and grade. Your cancer is stage II with a grade three tumor, meaning it is locally advanced but has not spread to distant parts of the body.
About hormone receptor status, your tumor is estrogen receptor-positive (ER+) and progesterone receptor-positive (PR+), so hormone therapy may be a treatment option.
Your tumor is HER2-negative, meaning targeted therapies like Trastuzumab are not necessary.

It is important to review any current medications you are taking with your oncologist to ensure they are compatible with your pregnancy and cancer treatment plan. Continuing pregnancy with breast cancer treatment can be difficult; however, you can find the following information useful.

Many women with breast cancer continue their pregnancies with proper management and close monitoring from both their oncologist and obstetrician.
Chemotherapy can be safely given during pregnancy, but the timing and type of chemotherapy must be carefully planned. Your oncologist will tailor the treatment to minimize risk to your baby.

The effects of your breast cancer on your baby's development can be

The risk of birth defects from chemotherapy is low, especially if treatment begins after the first trimester.
Regular prenatal check-ups and ultrasounds will be important to monitor your baby’s growth and well-being.
Research suggests that children exposed to chemotherapy in utero typically have similar cognitive and developmental outcomes as those not exposed.

You can take the following steps to protect your baby:

Ensure your oncologist and obstetrician are working together to closely monitor both your cancer treatment and your pregnancy.
Stay on top of your prenatal care to track the baby's development and catch any potential issues early.
Stick to your recommended treatment, and discuss any worries or adjustments with your healthcare team as needed.

While termination is always an option, it is essential to weigh your personal values, the medical risks, and the potential benefits of continuing the pregnancy.

Before making any decisions, you should think about the following steps:

You may want to consult another oncologist or obstetrician to review your treatment options and confirm the best path forward.
Share your fears and emotions with your healthcare team to help guide you through the decision-making process.
Consider connecting with support groups, counseling services, or other women who have faced similar challenges.

Remember, each situation is unique, and there is no one-size-fits-all solution. Take your time, trust your healthcare team, and make the decision that feels right for you and your baby.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.