St. Louis Post-Dispatch Examines Treatment Options For Pregnant Women With Cancer

Main Category: Pregnancy / Obstetrics
Also Included In: Cancer / Oncology
Article Date: 23 Jul 2008 - 7:00 PDT

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The St. Louis Post-Dispatch on Sunday examined the "life-and-death" decisions pregnant women with cancer must make and the treatment options available to them. According to the Post-Dispatch, as many as one in every 1,000 pregnant women in the U.S. is diagnosed with cancer. As more women delay childbirth into their 30s and 40s, some doctors believe the rate will increase because such women are at an increased risk of developing cancer.

According to the Post-Dispatch, a "growing body of research also helps reassure" pregnant women diagnosed with cancer. Although abortion was "once seen as the only option to save" a pregnant woman with cancer, "now, starting chemotherapy during pregnancy is becoming more common" because physicians have discovered that infants exposed to chemotherapy during the second and third trimesters are not at greater risk of birth defects, compared with infants not exposed to it, the Post-Dispatch reports. Chemotherapy administered in the first trimester of pregnancy has been shown to lead to a greater risk of cleft palates and other conditions. Radiation therapy can cause mental retardation and other birth defects, but surgeries such as mastectomies and anesthesia usually are considered safe, the Post-Dispatch reports.

Jennifer Litton, an oncologist at the M.D. Anderson Cancer Center, and colleagues in Houston manage a registry of women diagnosed with breast cancer while pregnant. The researchers followed 75 patients whose infants were exposed to chemotherapy in the second and third trimesters. They found that none of the children developed cancer; one was born with Down syndrome, which is genetic and unrelated to the mother's cancer; and two children developed two separate birth defects, but it is unclear whether they were related to the cancer drugs. Elyce Cardonick of Cooper University Hospital in New Jersey -- who runs another nationwide database of 224 women who were diagnosed with any type of cancer while pregnant -- also did not find a higher rate of birth defects among chemotherapy patients.

Litton said, "If you're pregnant [and have cancer], the only wrong answer is to do nothing about it." She added, "There is a choice to both treat you and keep the baby safe." With chemotherapy, not much is known about why some infants are not harmed by the treatment. "We don't know if the chemo is getting through the placenta, and if it is, if the placenta is pumping it back out," Litton said. To better understand the effects of chemotherapy to infants, the physicians have planned tests to detect any developmental abnormalities as the children age, and will compare the results with siblings not exposed to the chemicals, the Post-Dispatch reports (Bernhard, St. Louis Post-Dispatch, 7/20).

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