Cervical cancer and pregnancy, although are not a pleasant combination but it’s important to know that pregnancy can be continued successfully till full term despite cervical cancer. Cervical cancer is one of the top three cancers among women, occurring once in every 10, 000 pregnancies.
Because about 3% of cervical cancer cases are diagnosed during pregnancy, it’s become a cause for emotional concern among women. Pregnancy neither cause cancer nor increase the chances of cancer occurrence but sometimes they happen to occur at the same time.
Cervical cancer refers to the presence of abnormal cells in the cervical canal lining; marking the presence of an ongoing disease process. Cervical cancer is mostly silent in its early stage, however it may lead to excessive vaginal bleeding and if allowed to enlarge, it may block the vaginal canal. The earliest symptoms are painful intercourse and menstruation or vaginal bleeding. 95% cervical cancer presents vaginal bleeding as the first symptom and this is believed to be associated with the fact that hormonal changes increase the blood supply to the cervix.
Although, cervical cancer and pregnancy are not directly related; however most concealed cases are detected during pregnancy through pap smears, an excellent screening test for the detection of early cervical cancer, are routinely performed in pregnancy.
The course of action for cervical cancer detected first during pregnancy depends upon the stage of pregnancy and how far the cervical cancer has progressed. If the cervical cancer is in early stage, pregnancy can be continued well till full term and the course of treatment can be decided once the baby is delivered.
Considering what the patient suffering from cervical cancer decides, the degree of cellular dysplasia and cancer spread, options like cone biopsy, LEEP or hysterectomy can be attempted. The balancing factor is to ensure the expecting mom get the best treatment while avoiding any potential harm to the fetus.
The likely diagnosis of cervical cancer from Pap smear must be further confirmed or investigated through other methods because sometimes the suspicion of cervical cancer may turn out to be mild dysplastic changes (presence of merely disordered cells but not necessarily cancer cells). Therefore, each case of cervical cancer diagnosed through pap smear must be further confirmed by cone biopsy and colposcopy.
Most physicians postpone the diagnostic and confirmatory procedures of cervical cancer until post-delivery period because procedures like Cone biopsy and LEEP increases the risk of pre-term delivery and affects the emotional health of the expecting mom too.
There are a few women who are diagnosed with aggressive and widespread cervical cancer during pregnancy; in that case the physician may advise the pregnancy be terminated, especially if you’re in your early stages of gestation.
Though depending on what option you prefer and your physical conditions, if cervical cancer is detected later in pregnancy, your physician may take the risk of waiting till the period of viability is achieved, after which childbirth may be intervened. The reason for such childbirth intervention is because some cancer treatments can harm the baby.
However, in all such cases, the mode of delivery will be a Cesarean section followed by hysterectomy as it’s not adequate to deliver the baby vaginally with cervical cancer due to risk of life threatening bleeding.
It’s a known fact that the chances of becoming pregnant after the treatment of cervical cancer are very low. This is because the ideal treatment for aggressive cervical cancer is hysterectomy.
If you have an early stage of cervical cancer i.e. Stage 0, your physician may commence with the treatment (which is just excision biopsy or excision of cancer cells) and your chances of becoming pregnant are still fair.
However, as pregnancy is a high-estrogen state, the chances are certain that the cancer may return. That’s why a scale of criteria has been set by cancer professional community, according to which a pregnancy must only be opted under any of the following conditions;
After radiotherapy of cervical cancer, the chances of becoming pregnant are almost negligible. It’s therefore recommended for every women of child-bearing age to avoid HPV infection and get Pap smear twice yearly. With regular Pap smears, the risk of developing aggressive cervical cancer during pregnancy is rare, but when it does occur you can be sure that cervical cancer and pregnancy can be safely managed.