Cervical cancer is the fourth most common type of cancer that affect women. And, around 99% of the diagnosed cervical cancer is from an infection from the human papillomavirus (HPV). It is a very common type of virus that is transmitted with sexual contact.
Although there is a global prevalence of this cancer, a very slim percentage of it occurs during pregnancy or right after delivery as a postpartum complication. Getting a diagnosis of such a rigorous form of cancer during pregnancy can be a daunting experience. However, with advancements in medicine, the condition is manageable, if diagnosed early.
Here we will discuss more about cervical cancer during pregnancy, how it impacts pregnancy, diagnosis, and available treatment options.
In this Article
- 1 What is the Prevalence of Cervical Cancer during Pregnancy?
- 2 Does Cervical Cancer Negatively impact a Pregnancy?
- 3 What are the Symptoms of Cervical Cancer during Pregnancy?
- 4 How is Cervical Cancer diagnosed during Pregnancy?
- 5 How is Cervical Cancer Treated during Pregnancy?
- 6 What is the Prognosis of Cervical Cancer during Pregnancy?
- 7 Conclusion
What is the Prevalence of Cervical Cancer during Pregnancy?
Amidst all the different forms of cancers, cervical cancer accounts for 71.6% of the total cases in females. From that, around 1-3% of the cases are diagnosed during pregnancy.
Despite what you might think, the numbers are a testament that getting a diagnosis of cervical cancer during the pregnancy term isn’t a hoax but a reality.
Although prevalence is quite less, it is a possible situation. However, the good news is that the spread of cervical cancer isn’t influenced by pregnancy. It won’t “speed up” or “slow down” just because of pregnancy. The manifestation of the disease is typically what would happen if it was diagnosed in a “non-pregnant” person.
Does Cervical Cancer Negatively impact a Pregnancy?
Cervical cancer might have negative impacts on the pregnancy. So, being mentally prepared for the worst, is the advice most doctors emphasize on after a diagnosis. Some of the common complications include:
- Risks of hemorrhaging during childbirth
- Metastasis of cancer
- Preterm labor
- Risks of embolism
- Not getting treatment
- Tearing of the tumor during delivery
Most of the cancer treatment regimens, including chemotherapy are very rough on the body. Chemotherapy is also not advised or administered during the first trimester of pregnancy since it can lead to miscarriage.
Delay in treatment due to pregnancy is a very common choice that most mothers make to ensure the safe delivery of their baby. However, it isn’t always a safe choice, especially depending on the stage of cancer and how much it has spread in the body.
However, there are studies that suggest chemotherapy as a comparably safer treatment option during the second and third trimester of pregnancy after a formal diagnosis.
What are the Symptoms of Cervical Cancer during Pregnancy?
The symptoms of cervical cancer are pretty standard, irrespective of whether or not the patient is pregnant. The earlier stages of cancer don’t showcase any drastic symptoms, which is one of the reasons why the cancer is often diagnosed at a progressive or advanced stage.
Some of the most common symptoms include:
- Abnormal vaginal bleeding
- Vaginal discharge
- Pain during sexual intercourse
- Pelvic or abdominal pain
- Swelling in the legs
- Blood in the urine
- Painful urination
- Painful bowel movement
If you are experiencing any or multiple of these symptoms during your pregnancy, don’t take them lightly. Instead, consider talking about the same with your OBGYN. Cervical cancer symptoms generally manifest as pregnancy symptoms, so getting a comprehensive evaluation is always ideal.
How is Cervical Cancer diagnosed during Pregnancy?
The symptoms of cervical cancer depend on the stage of cancer. If it is localized, the symptoms are often mild and manageable. However, if there are risks of distant metastases, the symptoms get aggressively worse.
So, if you are experiencing any of the symptoms or complications, book a consultation with your OBGYN to get a comprehensive evaluation of the cervix. If the doctor finds any kinds of abnormalities in the cervix, your OBGYN will either handle the situation themselves or refer you to a gynecologist.
Since radiation and other invasive testing procedures aren’t safe during pregnancy, there are three primary modes of cervical cancer diagnosis during pregnancy:
Cervical cytology – involves screening the cervical cell samples to check for abnormalities. It doesn’t provide a 100% accurate diagnosis all the time. So, your doctor will prescribe a few other tests to confirm their suspicions.
Colposcopy – involves the use of a colposcope, which visually assesses the cervix and the adjoining area, including the vagina and vulva of the patient. The test can look for early signs of lesions and abnormalities in the cervix.
Cervical biopsy – involves the analysis of excised cervical tissue from the patient. The test looks for signs of early cervical cancer and confirms a suspected diagnosis.
Once a formal diagnosis is drawn, the doctor will then assess the stage of cancer and then align the treatment regimen depending on the pregnancy and the stage the cancer is in.
How is Cervical Cancer Treated during Pregnancy?
As we mentioned in a previous part of the article, administering rigorous cancer treatments, especially chemotherapy and radiation isn’t ideal during pregnancy, especially during the first trimester.
However, there are certain pregnancy-safe cervical cancer treatments that are now available. Let us walk you through them in detail in the table below:
|Cervical Cancer Stage||Administered Treatment Options|
|Stage IA1||-Advised during 14-20 weeks pregnancy
-Treatment involves cone biopsy
-Might involve a pelvic lymph node dissection if needed
|Stage IA2||-Advised under 22 weeks pregnancy
-Mode of treatment involves staging lymphadenectomy
– Neoadjuvant chemotherapy (NACT) is advised in patients who continue with their pregnancy instead of terminating
-If the lymph nodes are negative, a delay in treatment is suggested or a trachelectomy for temporary fix
|Stage IB2 (less than 22 weeks pregnant)||Treatment involves:
– large loop excision of the transformationzone (LLETZ
– radical trachelectomy (not ideal if the tumor is very large)
– Neoadjuvant chemotherapy (NACT) is advised too
|Stage IB2 (over than 22 weeks pregnant)||-Start with Neoadjuvant chemotherapy (NACT)
-Following successful delivery, radical hysterectomy and pelviclymph node dissection is advisable
|Stage IB3 and up||-Starts with Neoadjuvant chemotherapy (NACT) to manage the disease
-Delivery should be done by lower segment cesarean section (LSCS)
-If cancer has metastasized aggressively, the last treatment option is palliative care
What is the Prognosis of Cervical Cancer during Pregnancy?
There is very limited data available about cervical cancer and its diagnosis and treatment during an active pregnancy. Research has found that aggressive treatments might enhance the risks of preterm labor or even a miscarriage.
In cases where the cancer is localized, delaying the treatment is an option. However, close monitoring is very crucial in that case to ensure that the cancer isn’t spreading.
The only way to get a clear prognosis is by discussing all the available options and the state of cancer with the doctor.
Cervical cancer is one of the most common forms of gynecological complications in women, prepartum and postpartum. If you receive a diagnosis during pregnancy, don’t think of the worst right away. Medicine and technology has advanced and so has the availability of treatment options. The first step is to get a confirmed diagnosis, following which your doctor will provide you with a comprehensive treatment regimen. Always assess the best and the worst before starting treatment.
Only 1-3% of cervical cancer diagnoses happen during pregnancy. So, it isn’t a very common occurrence and is typically a sensitive subject to deal with.
If cervical cancer is in its early stages, surgical approaches can excise the tumors and offer effective treatment for the condition. However, if cancer has metastasized, more aggressive treatment regimens might put risks on the health of the mother and the baby.
The American Cancer Society reports that women who have had 3 or more full-term pregnancies might be at risk of developing cervical cancer.