REFORM AGENCY
Mexico city
A great fear for a mother is putting her child’s life at risk; This scenario becomes real when you are diagnosed with breast cancer during your pregnancy.
In the face of fear and uncertainty of what may happen, there are treatment options.
According to Cynthia Villarreal Garza, Director of Medical Oncology at the Zambrano Hellion Hospital Breast Cancer Center, breast cancer associated with pregnancy can occur in any of the trimesters of pregnancy.
If chemotherapy treatment is given beginning in the second trimester of pregnancy, this is safe for the mother and the baby.
Yes, certain types of chemotherapy can be treated, not all, but the most common ones needed to treat breast cancer.
However, when cancer is diagnosed in the first trimester of pregnancy, it will be necessary to wait until the second trimester to be able to start chemotherapy and it is very important not to delay the mother’s treatment any longer because if this is delayed until the mother has the baby, this it can condition more chances of recurrence that the cancer could return, he explains.
The multidisciplinary medical team that should be behind the care of a breast cancer associated with pregnancy is made up of a medical oncologist, who is the one who dictates oncological treatments; the breast surgeon, the gynecologist and a psychologist.
TREATMENT
Villarreal Garza recommends that you must first know the cancer well, since not all breast cancers are treated the same.
Some require chemotherapy, some do not, some require antibodies, some do not, some require radiation therapy, some do not.
Then the diagnosis has to be established very well to propose the best treatment plan, explains the specialist.
Once that is established you have to consider whether to remove the tumor or have breast surgery. This can be done safely during pregnancy, usually starting in the second trimester.
And if the patient requires chemotherapy, it should be given during the second and third trimesters.
Antibodies cannot be given during pregnancy and neither can radiotherapy. There you must wait to have the baby and then do the complementary treatment with radiotherapy if it is needed.
WHAT HAPPENS IF THE BIRTH IS ADVANCED?
lvaro Cabrera, head of the Creher Cancer and Pregnancy Clinic and member of the Council of Padma, AC, in Mexico City, mentions that mortality in these cases is high because cancer treatment is delayed or stopped due to pregnancy.
There are complications of pregnancy and there are complications of cancer. In this case, the two meet at the same time. If cancer requires treatment from the first trimester of pregnancy, we have a woman who may lose her baby to treatment. Between week 18 or 20 of gestation we can already give cancer treatment with less risk.
Women who are close to giving birth, can terminate the pregnancy, as long as we are above 32 weeks of gestation. And this in order to give the baby a better prognosis. But if a pregnancy is terminated before 32 weeks of gestation, we could condemn the baby to neurological sequelae and pulmonary sequelae.
PSYCHOLOGICAL TREATMENT
Cynthia Villarreal Garza, Director of Medical Oncology at the Breast Cancer Center at Zambrano Hellion Hospital, comments that it is important that the mother receives psychological and emotional support during treatment.
A woman who does not expect a diagnosis of this type and is also experiencing a pregnancy is recommended, and sometimes even the couple, that they have additional support with psychology or psycho-oncology to help them to go through the whole process in a better way.
Definitely, when this comprehensive management is incorporated with the patient and her relatives, it makes the treatment better; When the patient is emotionally stable, everything is better, even the treatments are better tolerated, there are fewer side effects than when a patient is emotionally better than when a patient is very sad or very anxious.
HEALTHY FROM CNCER AND SAVE YOUR BABY
Martha Álvarez Ovando, 32, was diagnosed with breast cancer on October 16, 2018 when she was 7 months pregnant and although the prognosis was not favorable, she managed to defeat the cancer.
They told me that I had stage 3B cancer with a malignant tumor (it is when the tumor measures more than 5 centimeters), and that I needed to take the treatment, but that they were going to interrupt my pregnancy, they were going to do me an abortion at Although I was seven months old, but I did not allow them to interrupt my pregnancy, he says.
They asked me if I had to choose a life which I chose, that of my baby.
Martha received five chemotherapies during her pregnancy and was monitored by her oncologist and the gynecologist who, upon finishing the chemotherapies, reviewed her with an ultrasound.
I went to Mexico City with another doctor and they did new tests, blood biopsies, ultrasound, everything that had to be done. When I was pregnant they began to give me chemotherapy and I was worried about the baby that it would affect cancer.
Something that helped me a lot was that I had psychological support because I cried a lot and could not express what I felt, the fear.
Martha is currently in remission and her 2-year-old son Rey David Zavala lvarez is healthy.
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