The moment of greatest illusion and hope in a woman’s life can end up becoming the most dramatic. Some 150 are seen each year in Spain in the position of having to face a pregnancy and a diagnosis of cancer, generally breast cancer, at the same time. The protocols for both situations usually make it possible to successfully overcome both challenges; but a large international group, with the participation of 18 Spanish hospitals, has reviewed the existing protocols and published the first results of this work. The greatest novelty of the document is the certainty that maintenance hormonal therapy -which seeks to avoid a relapse- can be interrupted without risk if she seeks to become pregnant after having faced an oncological disease.
The progress of the study is of such depth that it is published today in the ‘New England Journal of Medicine’, one of the classic journals with the greatest international impact in the field of science. The work, promoted by the Spanish breast cancer foundation GEICAM and the Solti oncology research group, has involved the participation of hospitals from 20 countries, including 72 women from 18 Spanish centers.
One in 3,000 pregnant women receives the news that they have a tumor, generally of the breast (25%), but also of the cervix, with a similar frequency, leukemia (15%) or lymphoma (10%). Added to this figure are the many survivors who seek to become mothers while still receiving cancer treatment or so-called endocrine therapy, which allows for better hormonal control.
Pregnancy and lactation
The ‘Positive’ study, as it is called, has brought good news for these women. The work has shown that pausing this endocrine therapy for a while in order to promote pregnancy and lactation does not increase the risk of short-term relapse in young patients with hormone-sensitive breast cancer.
Under medical supervision, the maximum time during which treatment could be suspended would be two years, enough to plan the pregnancy, experience it and breastfeed the baby. The coordinator of the study in Spain, Cristina Saura, head of the breast cancer unit at the Vall d’Hebron hospital, adds that the research supports the importance and the need to preserve fertility before cancer therapy begins. Planning, in this case, is very important because, as she explains, endocrine therapy cannot be suspended until at least 18 months of treatment have elapsed.
Breast cancer is becoming more common among young women. If this circumstance is added to the increasing delay in the age of maternity, the need for oncological controls and surveillance becomes a necessity rather than a recommendation, according to specialist Manuel Ruiz Borreho, an oncologist at the Virgen Hospital. del Rocío de Sevilla and member of the GEICAM board of directors.
“I wanted a child and cancer could not prevent it”
“It was always very clear to me that I wanted to be a mother again,” says Laura Lavall, who was diagnosed with breast cancer while pregnant with her eldest daughter. She entered the operating room 27 weeks pregnant. Once the girl was born, she began the real fight against the tumor, radiotherapy and a hormonal treatment that lasted for five years.
“In the midst of all this process, I spoke with the oncologist Cristina Saura, from the Clinic hospital, because I did not want cancer to prevent me from being a mother again,” says the woman. She was then 35 years old. Waiting for the hormonal treatment to finish put her at 40. She opted to participate in the ‘Positive’ study and pause therapy for two years to facilitate the pregnancy and lactation of the baby. She fulfilled her wish.
Four months ago, Laura resumed hormonal treatment to avoid relapses. “Cancer can arrive in the middle of our fertile lives, but the disease does not have to be synonymous with not being able to be a mother. It is increasingly possible to achieve it safely », she assures. By the way, the second was another girl.
“In the midst of all this process, I spoke with the oncologist Cristina Saura, from the Clinic hospital, because I did not want cancer to prevent me from being a mother again,” says the woman. She was then 35 years old. Waiting for the hormonal treatment to end put her at 40. She opted to participate in the ‘Positive’ study and pause therapy for two years to facilitate the pregnancy and lactation of the baby. She fulfilled her wish.
2023-05-03 18:47:38
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