Question regarding pregnancy and breast cancer?
Sunday, November 1st, 2009 at
11:03 am
Ethan’s Mommy asked:
My very good friend is 16 weeks pregnant and just found out she has breast cancer. Unfortunatley, she is in the late stages and needs immediate treatment. They won’t put her under general anesthesia because of risks to the baby. They say that chemo and radiation at the same time is the best way to treat it. What effects will these treatments have on her unborn baby? One doctors even suggested she consider terminating her pregnancy so that she could have a better chance to beat this. What should she do?
My very good friend is 16 weeks pregnant and just found out she has breast cancer. Unfortunatley, she is in the late stages and needs immediate treatment. They won’t put her under general anesthesia because of risks to the baby. They say that chemo and radiation at the same time is the best way to treat it. What effects will these treatments have on her unborn baby? One doctors even suggested she consider terminating her pregnancy so that she could have a better chance to beat this. What should she do?
Filed under: Breast Cancer
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My heart goes out to your friend.
ok i dont want this to come out wrong but i don’t believe in aborotion. But this is a tough one. She and her baby are in my prayers i hope she can beat this and have her baby and im sure if she does she will go on to be a great mother to that child and if all works out she will have a major story to tell her child someday.
Wow, this is a tough question to pose. I don’t believe I have the right to tell your friend what to do with her pregnancy. However, I do believe that for her to make a decision that she can live with, she should have as many facts as possible. And regardless of whatever you find out here, have her or her baby daddy talk to plenty of health professionals about this. Talk to a breast cancer specialist, a clinical pharmacist that specializes in breast cancer, a drug information center, or other women who have had to make this decision. If she can’t do this, do it for her or make sure someone in her family will.
Here’s what I can tell you about the standard therapy for breast cancer (her doctors will probably tweak this though):
It is standard for all women who have breast cancer to have surgery. Only patients with Stage IV (the most advanced breast cancer) do not get surgery.
Women will receive radiation if the tumor is larger than 5 cm, has some remaining cancer after surgical removal, has spread to lymph nodes, or if a lumpectomy was performed (only the tumor was removed instead of the entire breast).
There are four popular chemotherapy regimens. The most common one is sometimes called “AC”. It is a combination of doxorubicin and cyclophosphamide. The other regimens have three or more agents so will have more toxicities and difficult side effects. Being that she is pregnant, they will probably stick to AC unless there is a compelling reason to go with something else. They may go with a differnt regimen because doxorubicin can be toxic to the heart.
They will also give paclitaxel if the cancer has spread to her lymph nodes.
They will type her tumor and if it is “HER-2″ positive, she will receive trastuzumab
When she is no longer pregnant, she will get tamoxifen.
Now, all of these drugs, with the exception of trastuzumab, will cross into the fetus and may cause harm to it. However, it is a judgment call to continue with therapy while pregnant. All the literature says that the benefits of therapy may outweight the risks. So, push comes to shove, they may give them in a pregnant patient to save the mother’s life even if the fetus will be harmed.
Now, another thing to realize is that she WILL be sick once she is on chemotherapy and radiation. It is not like taking an antibiotic and it goes way beyond losing hair. Chemo drugs and radiation make you feel really bad. Expect intense nausea, vomiting, and diarrhea. Mouth sores are really common in many cancer regimens and they can get so painful that the patient can’t swallow food or drink (bad if she’s pregnant even though they can provide nutrients through an IV). A suppressed immune system is a very common result of chemo and patients tend to get sick from every day bugs. And depending upon which drugs are used, other organs may suffer from drug toxicities.
The bottom line is that chemo and radiation are very tough to get through physically, mentally, and spiritually for any one, let alone a pregnant woman. There will be risks to her baby including mental and physical disabilities. If she is willing to accept those risks and any consequences, then that is her choice. I hope she has a good support system around her that will see her through whatever decision that she makes. Breast cancer is tough enough, don’t make her feel bad or unsure about whatever she decides. And have her talk to lots of health professionals about this.