The Toughest 9 Months: Pregnant With Cancer

As scary as it sounds, the surprising truth is that in many cases, both mother and baby can survive, and thrive. Here’s the real (and reassuring) story.

Lisa Spindler
When she found the lump in her breast, Jessica Denton had known she was pregnant with her first child for just a few days. Her primary care doctor (she hadnt yet signed up with an obstetrician) told her not to worry, that the small, hard mass she felt was most likely a blocked milk duct. Denton put her misgivings aside, and over the following months she watched with delight as her belly began to swell.

But the lump was growing, too. Finally, five months along, Denton pointed it out to her OB, who immediately ordered a needle biopsy. The result: malignant. Hanging up the phone, "I felt like Id been shot," Denton recalls. "How could I possibly have cancer?"

Its an agonizing paradox: At the very moment a woman is giving life to a child, she must fight a potentially deadly disease. Usually, its simply a terrible accident of timing: The pregnancy has nothing to do with the cancers emergence. (For example, studies suggest that breast tumors found during pregnancy are more likely to be hormone-receptor negative, meaning they are not fed by pregnancys higher levels of estrogen and progesterone.) Cancer of any kind is found in an estimated 1 in 1,000 pregnancies, making it relatively rare. But the incidence of cancer in pregnant women appears to be on the rise, probably due to the growing number of women who delay childbearing.

"As women age, their odds of developing cancer go up—so if they wait until their 30s or 40s to have a baby, its more likely that a pregnancy and a cancer diagnosis will happen at the same time," explains Jennifer Litton, MD, a breast medical oncologist at MD Anderson Cancer Center in Houston, who treated Jessica Denton. Dr. Litton adds, "The good news is that we can treat the woman without harming the fetus."

For the most part, that means proceeding with cancer treatment even as the pregnancy continues. This wasnt always the case. Not so long ago, women were routinely advised to delay treatment until after the baby was born—or to terminate the pregnancy and begin the regimen immediately, out of concern that pregnancy would promote the growth of the cancer and even put the womans life at risk. But research conducted over the last few decades has shown that this is not the case. For example, a recent study led by Dr. Litton found that women who were pregnant while receiving care for breast cancer did as well as, and in some cases better than, women who werent pregnant during treatment.

Doctors also worried that the fetus would be harmed by the harsh drugs used to treat cancer. "Thirty years ago, there was almost no information on how children with prenatal exposure to chemotherapy turned out," says Elyce Cardonick, MD, a maternal-fetal medicine specialist at Cooper University Hospital in Camden, New Jersey. "Today we know that its relatively safe after the first trimester." (That said, there are still situations where treatment just isnt compatible with pregnancy.) Now more than ever, women have the chance to conquer their cancer—and have a healthy baby, too.

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Annie Murphy Paul
Last Updated: April 07, 2011

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