Depending on the staging of the cancer and the progression of the pregnancy, different courses of treatment may be required.
In order to determine the best approach, physicians will need to perform a biopsy along with one or more imagine tests. Typically, the go to diagnostic in this scenario is Magnetic Resonance Imaging (MRI), since it does not involve using radiation (which could be harmful to the baby).
Here are the typical treatment courses depending on the various stages of cervical cancer.
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If the biopsy determines the presence of local carcinoma, this means the cancer is still in an early stage and hasn’t begun to spread.
In this case, there will usually be no treatment until the pregnancy is concluded, since this type of cancer is usually slow growing. However, a colonoscopy may be used to confirm the cancer remains localized and has not begun to invade surrounding tissues.
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In this case the ideal course of action will be determined after performing the biopsy and determining if the cancer is slow-growing or fast-growing (that depends on the type of cells that have mutated).
When the cancer is found to be slow-growing, the treatment will be postponed until late in the pregnancy or, ideally, after it has been concluded.
When the cancer is found to be fast-growing, chances are some type of preliminary treatment may need to be initiated sooner than later; usually a conization (partial excision) or a radical trachelectomy (full removal of the cervix).
Additional tests will be performed to check if the cancer has already spread beyond the cervix. In this case, the staging will be higher and the beginning of treatment will be more urgent.
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In case the cancer turns out to be in a more advanced stage, it’s likely an immediate course of treatment will be required.
Common options include chemotherapy and radiation therapy. Chemotherapy is typically used first to shrink the tumor, and it is usually performed from the second trimester of pregnancy.
Radiotherapy is usually done only after delivery, to complement the effects of chemotherapy.
In more complicated cases that require the urgent application of both courses of treatment, chances are the pregnancy will need to be terminated - as radiation would have extremely negative implications for the developing fetus.
Make sure to talk with your doctor, to learn more about the ideal course of treatment for your particular case.