Cancer specialists reject ‘no chemo for pregnant women’ claims

Cancer specialists reject ‘no chemo for pregnant women’ claims Dr David Fennelly

Leading oncologists have dismissed claims that pregnant women cannot safely be treated for cancer, and will be denied chemotherapy.

Rumours that chemotherapy is not an option for pregnant women with cancer have been rife during the referendum campaign around Ireland’s constitutional protections for the unborn, but such rumours are unfounded, Dr David Fennelly told The Irish Catholic.

“Women who are pregnant can and do have chemotherapy,” he said, continuing: “There are certain types of chemotherapy, and there are stages of the pregnancy where you have got to be more careful with chemotherapy,  (notably) so in the first trimester, but we occasionally do have to give chemotherapy in the context of a pregnancy.”

Another oncologist, who asked not to be named, rejected claims that pregnant women with cancer must choose between having an abortion so treatment can begin, or delaying treatment until after birth.

“That’s untrue – I’ve given lots of pregnant women chemo,” he said.

“We don’t like giving chemotherapy in the first trimester of pregnancy,” he continued, “it runs an extremely high risk of foetal malformation, though after the first trimester it does not.”

Such situations, he added, are highly unusual.

“The reality is that it seldom happens it’s that acute because by the time people are diagnosed with pregnancy they’re usually six or seven weeks pregnant, and when you’re planning the treatment.

“So it would be a rare, rare situation where you thought there was an urgency about giving chemotherapy in the first trimester,” he said, adding, “I have not ever found myself in any conflicted situation.”

Dr Elizabeth Toy, Clinical Director for Cancer Services at the Royal Devon and Exeter NHS Trust, told this newspaper that while caring for both patients can be difficult, many treatments can be safely given during pregnancy.

“A multi-disciplinary approach to care is typical, involving oncologists, obstetricians, foetal medicine experts and paediatricians,” she said. “These need to balance risks to both mother and child at all stages of disease so there may well be compromises in optimal treatment of cancer or the pregnancy to achieve this.”

Noting that chemotherapy, unlike radiotherapy, is relatively safe after 14 weeks, she added: “There is more research needed on the effects of pregnancy on the biology of the cancer and also the relative effectiveness of chemotherapy during the state of pregnancy.”