How Can Cervical Cancer Affect An Ongoing Pregnancy
Pregnancy is a joyously overwhelming occurrence in a woman’s life. In terms of the woman’s physical and emotional health, the period of nine months comes with its ups and downs due to constant hormonal changes and other factors. Thus, you can imagine how off-kilter one might feel when diagnosed with cervical cancer during pregnancy.
The good news is that it is not a very common phenomenon to be pregnant and have cervical cancer at the same time.
Globally, only around 1-3% of women are reported to undergo both conditions at the same time. However, this number is slowly going up due to women opting for late pregnancies.
Here’s some data for you:
- Around 3% of cervical cancer cases are diagnosed during pregnancy.
- Most of these cases are in the early stage of development and thus treatable with simpler procedures
- While treatment is possible during pregnancy, it increases the risk of delivering preterm, or suffering from a miscarriage
- Pap smear tests can detect almost 95% of cervical cancer stages before they’re even visible to the naked eye. Thus, women between 21 to 65 years of age should get a Pap smear test every three years, to eliminate the possibility of having cancer during pregnancy. Pap Smears can be stopped after 65, if the last three tests come negative, or the woman is not diagnosed with cervical cancer.
Hence, even if the incidence of this fact is presently low, it does not mitigate the importance of knowing the related risk factors and available treatment options for curing the malaise while having a healthy pregnancy all through.
What causes cervical cancer
Cervical cancer is a disease transmitted by HPV 16 and HPV 18, primarily via sexual contact. Family history of cancers, smoking, low immunity, being sexually active with multiple partners all increase the risk of getting affected by this cancer.
Hence, it is prudent to start getting tested for cervical cancer from the time you become sexually active; especially because, cancer takes around 5-10 years to get developed enough to be detectable via other symptoms such as foul-smelling vaginal discharge, bleeding after sex, bleeding after menopause, or sudden pelvic pain, among others.
What screening methods are available for the detection of cervical cancer
Cancerous cells in the cervix can be detected even in the precancerous stage via two simple screening methods – the Pap Smear test, and the HPV test. Both of these are ordinary swab tests that can give initial evidence of whether your cervix contains cancerous cells.
It is recommended to get at least a Pap smear test done once every three years for effective management of cervical cancer or any other genital diseases. However, many women feel shy or afraid of the procedure and thus avoid going for this test as part of their routine medical check-up. That becomes an important reason why cancer (if present) is detected during the first prenatal visit to the doctor after the pregnancy is confirmed.
While Pap smears cannot diagnose cancers, they are reported to detect around 95% of cervical cancer cases when they are not even developed to the stage that they can be seen by the naked eye.
How to know if I have cervical cancer, while pregnant?
While Pap smears are usually most effective in detecting cancerous cervical cells, in the odd chance where they do not detect lurking cancer, a pregnant woman should immediately consult her doctor if she suffers from irregular vaginal bleeding, bloody secretions, or unnaturally foul-smelling vaginal discharge. This is especially important because cervical cancer shows no obvious symptoms of its presence.
If the doctor suspects the pregnant woman to be containing cancerous cells in her cervix, she is sent for confirmatory diagnostic procedures such as HPV testing, colposcopy, or cervical biopsy.
A biopsy is usually avoided unless very necessary since it can lead to heavy bleeding and miscarriage.
What are the risks of being pregnant with cervical cancer?
The main risk of being pregnant with cervical cancer lies in how late the cancer is diagnosed. The spread of cancer beyond the cervix, correlated with how far along the woman is in her pregnancy, determines the type of treatment procedure she can be subjected to. Hence, cancer should be detected as early as possible.
If diagnosed in the early stages, cancer can be removed from the cervix itself via procedures like:
- Conization (where a cone-shaped part of the affected cervix is shaved off).
- Loop Electrosurgical Excision Procedure aka LEEP (wherein a wire-loop heated with electrical current is used to remove parts of the affected cells and tissue).
While these procedures are fairly simple, they run the risk of having excessive parts of the cervix being removed, thus resulting in infections, pre-term labor, or miscarriage. Some studies have also shown that LEEP makes it difficult to ascertain if cancer has been entirely removed.
- Radical trachelectomy is another viable option to cure cervical cancer in pregnant women without making them lose their baby and their fertility.
- If the cancer is of a fairly advanced stage, the doctor will give an option of waiting until delivery and then conducting a hysterectomy. In such cases, since the uterus is removed, it is not possible to have another child later.
The decision of when and what kind of treatment to take becomes complicated if the pregnancy is barely a few months old and cancer has spread beyond a certain level. In such cases, it becomes necessary to terminate the pregnancy and go in for immediate surgery to eliminate cancer. This helps prevent the fetus from being affected, as well as, stops metastasis of cancer in the mother’s body.
Prevention is the best cure
Even though cervical cancer may not affect the unborn baby directly, nevertheless it can be a distressing experience to undergo a pregnancy and cancer treatment at the same time.
Also, if the treatment entails chemotherapy, the fetus is at risk of developing complications due to exposure to the same in the earlier stages of pregnancy. Chemotherapy has been associated with miscarriage, low blood count, and birth defects in newborn babies. Chemotherapy after delivery also renders it inadvisable to breastfeed your baby while on chemotherapy drugs.
All in all, the best way to have a safe and healthy pregnancy is to rule out the presence of cervical cancer before it begins looming large. Thus, shed your inhibitions and start going for regular Pap smear tests to have a cervical cancer-free life ahead.
- Cancer Research UK - https://www.cancerresearchuk.org/about-cancer/cervical-cancer/treatment/pregnancy
- American Pregnancy Association - https://americanpregnancy.org/womens-health/pap-smear/
- National Center for Biotechnology Information - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6745864/