Cervical Cancer During Pregnancy

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During the mid 1930s, more women died of cervical cancer than from any other type, including breast cancer. Today, it is one of the most curable cancers, due to early detection and treatment methods. Getting cervical cancer while pregnant presents a challenging set of circumstances, because the normal methods used to treat the disease are no longer possible without placing the fetus in danger.


Symptoms

The symptoms of cervical cancer remain the same for pregnant women as for non-pregnant women. Vaginal bleeding, pain during sex and pelvic pain are symptoms of cervical cancer. A watery discharge that has a bad odor is another warning sign. Diagnosis can be a challenge, because several symptoms of cervical cancer are also related to normal pregnancy, so symptoms are sometimes ignored. As cervical cancer progresses, leg pain and renal failure can develop.

Abnormal Pap Smears

In many cases, cervical cancer is detected during routine pap smears. When a pregnant woman has an abnormal pap smear, the ensuing investigation has to be altered to protect the developing fetus. According to Dr. William Rich, a clinical professor at San Francisco University, while pregnancy typically does not impact cervical issues, during the first trimester it is prudent not to get a cervical biopsy, due to the 20 percent risk of spontaneous miscarriage during this trimester.

Cervical cancer is slow growing, so medical professionals do not rush to investigate abnormal pap smears in pregnant women.

Considerations

Treatment for cervical cancer in a pregnant woman depends on how far along she is. If the pregnancy is new, terminating the pregnancy is typically recommended. If the pregnancy is more than 24 weeks along and the cancer is not in an advanced stage, she will generally be given the option to wait until after delivery to begin treatment. Cervical cancer treatment includes chemotherapy and radiation. Both methods are dangerous to a developing fetus.

Time Frames

The extent of the cervical cancer’s growth is identified through a staging process. Each progressive stage denotes the size of the tumor, how far spread it is and whether it has traveled to other parts of the body. Typically, cervical cancer is staged between T1a and T4b, with T1 being the least invasive. Staging is determined by physical examination findings and does not change, even if later surgical exploration discovers it is more widespread than originally believed.

Surgical hysterectomy is usually the first phase of treatment, so pregnant women whose cervical cancer is a T1b stage are asked to consider terminating the pregnancy to begin treatment. Women who are staged at T1a can typically wait to begin treatment until after the delivery. A woman who chooses to maintain the pregnancy will deliver her baby by cesarean section as soon as the baby is deemed viable so that the treatments can begin. If the cancer has passed the T1b stage, medical professionals will urge her to begin immediate treatment due to its advanced stage and current progression.

Warning

Though several symptoms of cervical cancer and pregnancy can be similar, do not dismiss any symptoms that may concern you. Call your doctor if you experience new discharge or spotting. Be honest when discussing your past sexual history, which can have an influence on your risk of cervical cancer.

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