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Study: Women Diagnosed with Cancer at a Young Age Have Higher Risk of Pregnancy and Birth Complications

August 03, 2017

A recent study has found that certain cancer survivors may have an increased risk of pregnancy and birth complications as a result of their treatment.

In the study, published in JAMA Oncology, researchers at the University of North Carolina, Chapel Hill reviewed data from nearly 2,600 women in the North Carolina Cancer Registry who had cancer when they were younger and had subsequent pregnancies. The study also included women who were diagnosed with cancer when they were pregnant.

Researchers sought to compare birth outcomes in these cancer survivors, who were diagnosed between ages 15 and 39, and women who had never been diagnosed with cancer. The average age of the women in the cancer survivors’ group was 28 years old. It also had been three years, on average, between their original diagnosis and pregnancy.

The study found women who had been diagnosed with cancer at a young age were more likely to have premature deliveries, to deliver babies with low birth weight and to have C-sections. Those who had chemotherapy without radiation also were more likely to have premature babies and C-sections, while gynecologic cancer survivors who only had surgical treatment and those who had chemotherapy treatment for breast cancer and non-Hodgkin's lymphoma were more likely to have babies born preterm. The latter two groups also were more likely to have babies born with low birth weight. Overall, 13 percent of cancer survivors had preterm births compared to 9 percent of the control group.

Cancer Treatment & Pregnancy

The study indicates the potential side effects of cancer treatment can extend years after a woman has completed treatment and gone into remission. Researchers also found women who were diagnosed with cancer while they were pregnant had the greatest risk of premature births and low birth weight, which may be because they are delivering early so they could start cancer treatment sooner, researchers said. However, women diagnosed with cancer right before they became pregnant also had an increased risk of these pregnancy and birth complications.

Cancer treatment not only affects babies born to cancer survivors — it can affect a woman’s chances of getting pregnant in the first place. We know it’s possible for women to have healthy pregnancies after cancer treatment, but that certain treatments, like chemotherapy, can affect fertility and damage a woman's eggs. Because of the possibility of a recurrence and the toxicity of certain cancer drugs, many cancer survivors are advised to wait at least a couple of years after they complete treatment before they try to get pregnant.

Additional research needs to be done to more clearly understand the link between cancer treatment and pregnancy and birth complications in cancer survivors. The study’s researchers said they’d like to get more information on what specific treatments affect the pregnancies of cancer survivors, but that there’s one clear silver lining: many women were still able to get pregnant and have children despite the fertility risks that coincide with certain cancer treatments. About 60 percent of young women diagnosed with cancer say they want the possibility of having children, researchers said, so it’s extremely encouraging that many cancer survivors are able to do it.

There are very few studies on how cancer treatment affects babies born to women diagnosed during their most fertile years, so this research is just the beginning of helping us understand this population. According to the American Cancer Society, some women diagnosed with cancer are less likely than men to be given information about how to preserve fertility, so we also need to do a better job of educating women about the potential fertility risks posed by certain courses of treatment. Taking this approach will help us as doctors better serve cancer survivors who would like to get pregnant after treatment, and improve their odds of having a healthy pregnancy.

Here at Orlando Health UF Health Cancer Center we have Reproductive and Infertility Specialists who work closely with our women diagnosed with gynecologic cancers to discuss the options that may be available to them: such as egg or embryo preservation.  We want every woman who desires fertility to be able to do so if the circumstance permits. This is an important discussion the patient and her oncology team should explore.

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