Cervical cancer is the most common form of gynecological cancer. A small number of diagnoses occur during pregnancy, or in the postpartum period immediately following childbirth.
Receiving a diagnosis of cervical cancer during pregnancy may feel overwhelming, and people will likely worry about their own health, as well as that of the fetus. Treatment options are available at certain stages of pregnancy, and a person can discuss these options with their doctor.
This article discusses the prevalence of cervical cancer during pregnancy, how the cancer may affect pregnancy, and whether it can cause complications.
We also outline the symptoms of cervical cancer and the procedure for diagnosing and treating the disease during pregnancy. Finally, we offer information on the different forms of support available.
A person can develop or receive a diagnosis of cervical cancer during pregnancy.
According to Cancer Research UK, research suggests that cervical cancer will not grow or spread any faster in a pregnant person than in a person who is not pregnant.
Cervical cancer is the most commonly diagnosed gynecological malignant tumor, accounting for
However, doctors diagnose only around
Cervical cancer can have a negative impact on pregnancy. Some potential issues
- hemorrhaging during delivery
- tearing or breaking of the tumor during delivery
- cancer spreading to other areas of the body
- preterm labor
- delayed treatment
- risk of embolism
Cervical cancer may not cause complications directly. However, cancer treatments may have a negative effect on the pregnancy.
Chemotherapy is a common treatment option for many types of cancer, including cervical cancer.
However, receiving chemotherapy in the first trimester of pregnancy can harm the developing fetus and can cause miscarriage. As such, doctors will only administer chemotherapy to a person who is at least 12 weeks pregnant.
Though a person can opt to delay treatment until after the delivery, some medical professionals advise against this, particularly if a person receives the diagnosis early in the pregnancy. This is because the timeframe necessary for the fetus to reach maturity could allow the cancer to progress.
As an alternative, some medical professionals recommend chemotherapy treatment during the second and third trimesters. As a 2020 case study notes, experts consider chemotherapy at this stage to be safe for the unborn fetus.
According to the
- abnormal vaginal bleeding, such as:
- unusual or bloody vaginal discharge
- pain during sex
- pelvic pain
In the later stages, a person may experience additional signs and symptoms, such as:
- blood in the urine
- swelling of the legs
- difficulty urinating or having a bowel movement
A person who develops symptoms of cervical cancer during pregnancy may mistake them for symptoms of other conditions that can occur during pregnancy. For this reason, a person should talk with their doctor or midwife about any unusual symptoms they develop while pregnant.
A person who is pregnant or in the postpartum period should talk with their doctor if they experience any unexplained symptoms, such as vaginal bleeding or discharge.
In many cases, these symptoms will not be a sign of cancer. However, a doctor will likely want to rule out any serious medical conditions that may affect the health of the mother or fetus.
According to a
- Cervical cytology. This is a rapid diagnostic test that involves screening cervical cell samples for abnormalities. It can help to diagnose cervical cancer. However, it can also lead to false-positive results.
- Colposcopy: This minimally invasive procedure involves using an instrument called a “colposcope” to visually examine the cervix, vagina, and vulva. A colposcopy can help to detect signs of cervical cancer, such as lesions and abnormalities. Doctors often recommend the procedure during the first and second trimesters,
- Cervical biopsy: This surgical procedure involves removing a small amount of tissue from the cervix to test for signs of cancer or pre-cancer. It does not increase the risk of miscarriage or other pregnancy complications.
Following diagnosis, a person and their doctor will work together to decide on an appropriate treatment plan. Factors to consider include:
- the stage of the cancer
- the size of the tumor
- the type of cervical cancer the person has
- how far along the pregnancy is
- the person’s wishes for the pregnancy and treatment
Receiving a diagnosis of cervical cancer during pregnancy can feel overwhelming and distressing. A person who receives such a diagnosis may want to prepare some questions to ask their doctor at their next appointment.
Though not exhaustive, the following questions may provide a helpful starting point:
- How large is the tumor?
- What stage is the cancer?
- What are your recommendations for treatment?
- How experienced/comfortable are you with treating cervical cancer during pregnancy?
- How will delaying treatment affect my health?
- What impact, if any, will the treatment have on the pregnancy?
- What is the best course of action to take now?
Treatment for cervical cancer during pregnancy will depend on several factors, including:
- how far along the pregnancy is
- the size of the tumor
- whether or to what extent the cancer has spread
- the person’s wishes regarding their care and the future of their pregnancy
A person should keep in mind that scientists and medical professionals
Less than 3 months pregnant
The first trimester refers to the first 3 months of pregnancy. A person who wishes to keep their pregnancy will not likely undergo any treatment during this time. Chemotherapy can cause harm to the developing fetus or may result in pregnancy loss.
A person who wants to pursue treatment during the first trimester may need to talk with their doctor about the possibility of ending their pregnancy.
Second and third trimester
A doctor may recommend delaying treatment until the second or third trimester.
A doctor may also suggest that a person deliver early via a cesarean delivery (C-section).
In some cases, a doctor may recommend removing the womb at the time of the C-section. This will depend on several factors, including the size and extent of the cancer and the person’s wishes regarding their health and future fertility.
Following the delivery, the doctor will likely recommend chemotherapy or other aggressive treatment options.
For small tumors
A doctor may be able to remove a small tumor using trachelectomy. This procedure involves removing part of the upper vagina and most of the cervix.
However, trachelectomy can cause bleeding or pregnancy loss, and there is limited data on its use during pregnancy.
For larger tumors
For larger tumors, a doctor may recommend chemotherapy during the second and third trimesters. Chemotherapy kills cancer cells and prevents them from reproducing. This can help to prevent cancers from growing and spreading.
Further research is necessary to fully establish the safety of chemotherapy during pregnancy. However, experts generally believe that chemotherapy treatment is safe beyond 12 weeks of pregnancy.
Very limited data exist on cervical cancer during pregnancy. This is partly due to the fact that cervical cancer diagnoses during pregnancy account for only around
Treatment can increase the risk of preterm labor and pregnancy loss. However, delaying treatment may increase the risk of the cancer spreading.
A person should talk with their doctor to determine the best options for their unique situation.
A person who receives a diagnosis of cancer while pregnant can talk with their doctor or treatment team for information on local support groups.
Alternatively, the National Cervical Cancer Coalition offers online support groups for people diagnosed with cervical cancer. Joining a support group can be a good way for people to share experiences, work through the emotional impact of their diagnosis, and seek practical advice.
A person may also find that speaking with a counselor or therapist helps. The decision of whether and when to proceed with treatment while pregnant can be both daunting and distressing.
Therapy may help people to better cope with these feelings in a way that helps them make informed decisions about their treatment.
Cervical cancer is the most common gynecological cancer. However, only around 1–3% of diagnoses occur during or immediately following pregnancy.
Treatment for cervical cancer typically entails chemotherapy. However, chemotherapy during the first 3 months of pregnancy may harm the fetus or cause miscarriage.
As such, doctors recommend delaying treatment until after the first trimester. Doing so helps protect the pregnancy. However, it also increases the risk of the cancer developing.
A doctor will work closely with a person to discuss all the available options regarding their pregnancy and treatment. Decisions on how to proceed should reflect the person’s individual situation and desires.
A person may benefit from attending a support group online or in person. Therapy may also help people to better cope with the emotional impact of their diagnosis.