cancer and pregnancy

Medical research and clinical practice indicate that cancer and pregnancy are not mutually exclusive. In many cases, treatment can proceed with careful planning, allowing pregnancies to continue while prioritising maternal health. Clarifying what is medically possible remains central to informed decision-making.

Although cancer during pregnancy is uncommon, its incidence has increased slightly as more women delay childbirth into their thirties and forties, when cancer risk is generally higher. Studies show that breast cancer, cervical cancer, melanoma and certain blood cancers are among the most frequently diagnosed during pregnancy. Despite this, public understanding has not kept pace with medical advances. Many assumptions still reflect older clinical practices rather than current evidence, contributing to confusion among patients, families and even within some healthcare settings.

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Misconception 1: Pregnant women cannot receive cancer treatment

The reality: Cancer treatment during pregnancy is feasible, although it requires careful coordination. Surgery is generally considered safe throughout pregnancy. Chemotherapy may be administered during the second and third trimesters, when the risk to fetal development is lower. Radiation therapy is usually avoided or postponed due to potential risks to the fetus.

According to the American Cancer Society, treatment decisions are guided by cancer type, stage and gestational age. Management plans aim to balance effective cancer treatment with fetal safety.

Clinical approach: Multidisciplinary care is standard practice in these cases. Coordination between oncology, obstetrics and neonatal specialists allows treatment to be timed and adjusted appropriately throughout pregnancy.

Misconception 2: A cancer diagnosis automatically requires termination of pregnancy

The reality: Termination is not a routine outcome of a cancer diagnosis during pregnancy. Many women continue their pregnancies while receiving treatment. Guidance from the FIGO Best Practice Advice on cancer and pregnancy emphasises that clinical decisions should be individualised.

In a small number of cases, termination may be considered when cancer is aggressive or when treatment options during early pregnancy are severely restricted. These decisions depend on clinical circumstances rather than fixed protocols.

Clinical approach: Counselling typically involves discussion of medical options, timing of treatment and potential risks. Decisions are made on a case-by-case basis, informed by both clinical evidence and patient preferences.

Misconception 3: Cancer treatment inevitably harms the baby

The reality: Outcomes vary depending on treatment type and timing. Chemotherapy during the first trimester is associated with a higher risk due to fetal organ development. When administered later in pregnancy, chemotherapy has been linked to favourable outcomes in many cases. Surgical procedures are generally considered safe when appropriately planned.

A review published in Frontiers in Psychology reports that children born to mothers treated for cancer during pregnancy often show positive short and long-term outcomes when clinical care is carefully managed.

Clinical approach: Risk assessment focuses on treatment timing, dosage and monitoring. Ongoing follow-up of both mother and infant forms part of standard care.

ALSO READ: Breast Cancer Care and Culture: The Stigma Still Holding Women Back

Psychological and Emotional Considerations

Cancer during pregnancy is associated with increased psychological stress. Pregnant women may experience anxiety related to treatment decisions and fetal health. Partners and families may also experience uncertainty, particularly when managing simultaneous concerns for cancer outcomes and pregnancy progression.

Support organisations such as the Cancer Association of South Africa (CANSA) outline the role of counselling and psychological services for people affected by cancer, including free tele‑counselling and support groups available throughout the country.

Clinical approach: Psychological support may be offered alongside medical treatment, particularly when distress affects decision-making, adherence to care or overall wellbeing.

Implications for Awareness and Education

• Clear differentiation between pregnancy symptoms and cancer warning signs may support earlier diagnosis.
  • Case-based reporting can provide context for how cancer is managed during pregnancy in practice.
  • Evidence-led communication helps address persistent misconceptions.
  • Expert discussion across oncology, obstetrics and mental health disciplines reflects current standards of care.

Closing Perspective

World Cancer Day’s theme, United by Unique, highlights individual variation in cancer experiences, while Pregnancy Awareness Week focuses on informed maternal care. Together, they offer a timely context for revisiting assumptions about cancer and pregnancy.

Current evidence indicates that with specialist care and coordinated treatment, many women diagnosed with cancer during pregnancy can be managed safely. Ongoing education and accurate reporting remain essential to ensure that clinical decisions are guided by evidence rather than misconceptions.