A cancer common among youngsters and pregnant women
The most frequent malignancies that can occur during pregnancy are breast cancer, cervical cancer, haematological malignancies, and melanoma. The prevalence and detection of cancer during pregnancies have increased because many women postpone pregnancy until a later age.
Hodgkin lymphoma mainly affects young individuals in their teens and twenties — the same age where women often become pregnant. Hence, developing Hodgkin disease during pregnancy is not unusual. It is estimated that between one in 1,000 and one in 6,000 women will have this disease during pregnancy.
What are the symptoms? The symptoms of Hodgkin lymphoma can overlap with symptoms seen with pregnancy and this may lead to delay in diagnosis in some cases. Some of these symptoms include feeling tired, having night sweats, and experiencing itchy skin.
Hodgkin lymphoma behaves, grows and spreads the same way for women who are pregnant or those who are not.
How to confirm diagnosis
For pregnant females, doctors will analyse various test results to diagnose and stage this disease than if they weren’t pregnant. Tests like Xrays, CT scans, and PET scans are generally avoided during pregnancy to prevent radiation exposure to the fetus. Ultrasonography or MRI scans are used instead — they are equally good while being harmless during pregnancy.
Treatment
It is rarely necessary to terminate a pregnancy when someone is diagnosed with Hodgkin lymphoma. Most often, treatment can be delayed or modified until the baby is mature enough to be delivered relatively safely. Only if the disease is so advanced that it threatens the life of the mother, or makes a viable delivery impossible, an abortion is considered.
There are no fixed rules on treatment of lymphoma during pregnancy. The stage of lymphoma, the time of pregnancy and the wishes of the mother are all considered when making the treatment decision. Treatment is often delayed or modified so that the best balance can be obtained between disease control and the safety of the unborn child.
Chemo, radiotherapy harmful
If Hodgkin is diagnosed during the first trimester of pregnancy, the intention is to delay the treatment if possible to prevent any damage to the fetus. The baby is most prone to harm from cancer treatments during the first three months when its organs are being formed. Chemotherapy and radiotherapy are harmful at this stage, and must be avoided.
Second and third trimester
Managing lymphoma in the latter half of pregnancy is easier because more choices are available. Watchful waiting until the baby’s lungs mature (and becomes suitable for delivery) is easier. Chemotherapy drugs are administered if necessary, without a high risk of damage to the fetus, as shown in some of the long term studies.
Radiation may also be delivered to some select areas of the body if the abdomen can be carefully shielded.
Outcomes of the treatment
As per the studies, the results of treating pregnant women with Hodgkin lymphoma are no different from those who did not have the pregnancy. Survival rates are the same.
Hodgkin lymphoma is one of few cancers where the chances of cure are high in all stages. A few months of treatment delay during pregnancy does not alter treatment results too much.