Ovarian cancer and pregnancy: what you need to know

Tumors and lumps on the ovaries are relatively common during pregnancy. However, if a doctor locates an ovarian tumor during pregnancy, it is rarely cancerous. Ovarian cancer during pregnancy is rare.

Doctors may have difficulty diagnosing ovarian cancer during pregnancy because certain symptoms of ovarian cancer, such as bloating or pressure in the pelvis, are also common during this time.

If a person has ovarian cancer during pregnancy, doctors will usually work to treat it and help the person deliver to term.

This article examines how ovarian cancer can affect the birthing parent and the fetus during pregnancy and the treatment options available. It also examines the options available for those trying to conceive after surviving ovarian cancer.

According to a 2020 review, masses on the ovaries can occur in 0.15 to 5.7% of pregnancies, and most of them are benign.

The authors note that it is very rare for benign ovarian tumors to develop into ovarian cancer. Ovarian cancer accounts for about 3-6% of abnormal growths on the ovaries during pregnancy.

If a person is diagnosed with ovarian cancer during pregnancy, a doctor will consider their pregnancy to be high risk.

Overall survival rates for pregnant women with ovarian cancer are similar to those who do not.

Learn more about survival rates for ovarian cancer here.

Cancer is unlikely to affect the health or development of the fetus. For cancer to affect the fetus, cancer cells would have to cross the barrier of the placenta.

Although nutrients and oxygen from a person’s blood supply travel through the placenta to the fetus, cancer cells rarely spread to the placenta and even rarer do they spread to the fetus.

Treatment for ovarian cancer, involving surgery and chemotherapy, may pose a higher risk to the fetus than the cancer itself.

Surgeons can perform surgery on ovarian cancer during pregnancy with relative safety. However, if a person has surgery in their first trimester, the risk of miscarriage is slightly higher. Although there may be a slight increased risk to the fetus, a person should not delay surgery if it is necessary.

It is safer for the fetus if a person receives chemotherapy during the second or third trimester of pregnancy. The first trimester is when the fetus is developing organs. There is a 10-20% risk of fetal malformation with chemotherapy in the first trimester and a 1.3% risk of malformation in the second or third trimester.

According to research, there are no significant long-term complications in fetuses exposed to chemotherapy during the second and third trimesters of pregnancy.

According to LabTestsOnline, human chorionic gonadotropin (hCG) is a hormone that is usually only measurable during pregnancy. A pregnancy test can detect hCG in urine.

Some abnormal tumors and cancers release hCG, which means it may be a tumor marker. However, pregnancy tests cannot diagnose ovarian cancer.

Blood is the preferred medium for measuring hCG levels as a diagnostic tool for cancer. Although high levels of hCG in the blood will mean that hCG levels will be high in the urine, the results are not interchangeable.

To diagnose ovarian cancer, a healthcare professional will perform the following tests:

  • a physical exam and pelvic exam
  • ultrasounds and other imaging tests
  • blood tests, such as a CA-125
  • excision of the mass, if a tumor is suspected

A person may also have a transvaginal ultrasound, which involves inserting an ultrasound probe into the vagina.

The healthcare team involved in the management and treatment of ovarian cancer during pregnancy may include:

  • an obstetrician
  • an oncologist
  • an anesthetist
  • a neonatologist
  • a psychologist

Indeed, the decision is complex and the well-being of the giving birth parent and the fetus can be of concern.

The type of treatment and the treatment schedule can depend on a variety of factors, including the stage or spread of the cancer, the type of cancer, and the subtype.

A doctor will administer and tailor treatment to an individual, which will usually involve surgery and chemotherapy.

A 2020 review notes that doctors can usually perform surgery between 16 and 20 weeks gestation and administer chemotherapy during the second and third trimesters of pregnancy.

If a doctor diagnoses cancer later in pregnancy, it may be possible for a person to wait until after birth to start treatment. A doctor may also consider inducing labor early to begin treatment and minimize the risk for a person with ovarian cancer.

In some situations, a person may need to decide with their doctor to continue the pregnancy. If the cancer is advanced or aggressive, a person may need immediate treatment.

How will the treatment affect future pregnancies?

Cancer treatment can affect future pregnancies in the following ways:

  • Surgery of the cervix: If a person has surgery to remove part of their cervix, they may be at a higher risk of miscarriage or premature labor. This is because the cervix may not be able to support a developing pregnancy after surgery.
  • Chemotherapy: Some chemotherapy treatments can damage heart cells and weaken the heart, which increases the risk of pregnancy.
  • Radiotherapy: If a person has radiation therapy, it can affect the cells and blood supply in the uterus. It could also increase the risk of early birth, miscarriage, and low birth weight.

Doctors may advise a person to wait sometimes before trying to get pregnant after cancer treatment. The duration depends on various factors, including:

  • the type and stage of cancer
  • the person’s age
  • the treatment they receive

A healthcare professional will be able to advise how long a person should wait before conceiving.

If a person has ovarian cancer, part of their treatment may include removing the ovaries, fallopian tubes, and uterus. This means that the person will not get pregnant naturally, but may have other options.

If doctors diagnose cancer at an early stage and it involves only one ovary, it may be possible to preserve the uterus and the other ovary may remain fertile. However, chemotherapy can increase a person’s risk of early menopause and could damage their remaining ovary.

Options for pregnancy after ovarian cancer may include:

In vitro fertilization (IVF)

If a person has not had a total hysterectomy as part of their treatment for ovarian cancer, they may be able to conceive through IVF.

IVF is a process by which sperm from a person’s or donor partner fertilizes a person’s or donor ‘s eggs, which a healthcare professional places in the uterus.

Surrogate mother

If a person has had a total hysterectomy with removal of the ovaries and uterus, or if IVF is not an appropriate option, they may consider surrogacy. Surrogacy means that another person carries the growing fetus during pregnancy for one person.

Healthcare professionals place sperm from a partner or donor into the surrogate mother by artificial insemination or place an embryo from a person’s or donor egg and sperm from a partner or donor. ‘a donor in the womb of the surrogate mother.

The American Cancer Society has a cancer helpline that people can call for cancer help at 800-227-2345, or individuals can to discuss with them online.

Organizations that offer support for ovarian cancer include:

Several cancer organizations offer specific support for people of color, such as:

Health professionals consider any pregnancy associated with cancer to be high risk. The treatment for ovarian cancer that a person receives during pregnancy is often similar to that of people who are not pregnant, involving surgery and chemotherapy. However, when and how they receive treatment may differ.

Doctors can schedule surgery after the first trimester, but it depends on several variables. They can administer chemotherapy during the second and third trimesters. This is to minimize the risk to the fetus. However, if the cancer is advanced or aggressive, a doctor may discuss terminating the pregnancy, as delaying treatment could be life threatening.

It may be more difficult to conceive after treatment for ovarian cancer involving surgery to remove one or both ovaries, fallopian tubes, and uterus.

If a person retains an ovary, their fallopian tubes, and their uterus, they can become pregnant naturally or may consider IVF. They may also consider surrogacy. A person can talk to their healthcare professional about how long to wait before getting pregnant.

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