If you are a cancer survivor, having a baby may be a difficult decision for both men and women. Survivors and their partners need to think about many things before starting or adding to their family.
Pregnancy after cancer treatment
Often, pregnancy after cancer treatment is safe for both the mother and baby. Pregnancy does not seem to raise the risk of cancer coming back. Still, some women may be told to wait a number of years before trying to have a baby. How long depends on several factors:
The type of cancer and stage
Type of treatment
A woman’s age
Some health care providers recommend that women not get pregnant in the first 6 months after finishing chemotherapy. They say that any damaged eggs will leave the body within those first 6 months. Other health care providers suggest waiting 2 to 5 years before trying to have a baby. This is because the cancer may be more likely to come back in the earlier years. And cancer treatment during pregnancy is more complicated.
How cancer treatments may affect pregnancy
Treatments can affect a future pregnancy in many ways:
Radiation therapy. Radiation therapy may affect the support cells and blood supply of the uterus. It also may increase the chances of miscarriage, early birth, low birth weight, and other problems.
Surgery to the cervix. Removing all or part of the cervix may make miscarriage or early birth more likely. This is because the cervix may not be able to support a developing pregnancy.
Chemotherapy. Anthracycline chemotherapy includes treatment with doxorubicin (available as a generic drug), daunorubicin (Cerubidine), epirubicin (Ellence), and idarubicin (Idamycin). These treatments may damage heart cells and weaken the heart.
As a result, the heart needs to work harder during pregnancy and labor. Sometimes, anthracycline chemotherapy is used with radiation therapy to the upper abdomen or chest. This combination increases the risk of heart problems.
Fathering a child after cancer treatment
Men can try to have a child after cancer treatment ends. There are no firm rules for how long men should wait after treatment, but health care providers usually recommend waiting 2 to 5 years. Sperm may be damaged by chemotherapy or radiation therapy. Those sperm should be replaced in 2 years. Even if a child is conceived soon after treatment ends, there is no research showing that he or she will have a greater risk of developing serious health problems.
Other concerns about having a child after cancer treatment
Risk of children getting cancer. Many people who have had cancer worry that their children may get cancer, too. Research shows that children of people with cancer and cancer survivors do not have a higher risk of the disease. But a few cancers are passed from parents to children through genes. If you have one of these hereditary cancers, there may be higher risk. Talk with your health care provider or a genetic counselor about having children. They can help you understand cancer risk and genetics.
Risk of cancer recurrence. Studies show that getting pregnant does not seem to make cancer return. Some health care providers advise breast cancer survivors to wait 2 years before trying to get pregnant. There is a link between some hormones that rise during pregnancy and the growth of breast cancer cells. But there is no scientific proof that cancer risk increases if a woman gets pregnant within 2 years of completing treatment. Some studies even suggest that risk of breast cancer recurrence is lower after a subsequent pregnancy.
For some survivors, getting pregnant may require stopping certain medications. But stopping medications such as tamoxifen (multiple brands) or imatinib (Gleevec) raises the risk of cancer returning. People who are planning to have children need to talk about how much risk they are willing to accept. Talk with your health care team and a fertility specialist before trying to get pregnant after cancer.
Coping with uncertainty. All cancer survivors deal with the idea that cancer could return. Survivors and their partners must talk about the chances that the child will be raised by only 1 parent. This decision is very difficult and personal. Consider talking with a counselor for guidance.
Infertility. Some cancer treatments make it difficult or impossible for survivors to have children. All men and women who want to have children should talk with their health care team about potential infertility before treatment begins. They should also discuss options to preserve fertility.
Talking with your health care team
Having a baby is a big decision. No matter what treatment you have had, you should talk with your health care team about the potential risks of pregnancy and birth. Your doctor may need to check certain organs to make sure your pregnancy is safe. You may be referred to an obstetrician. This is a specialized doctor who is trained to care for women during and shortly after a pregnancy
Questions to ask your health care team
Consider asking the following questions:
Will my cancer treatment plan affect my ability to have children?
Are there ways to preserve my fertility before I start treatment?
Will my treatment plan cause problems during pregnancy, labor, or delivery?
How long should I wait before trying to have a child?
How will trying to have a child affect my follow-up care plan?
Will trying to have a child increase my risk of recurrence?
Should I talk with an obstetrician who has experience with cancer survivors?
Where can I find emotional support for myself? For my spouse or partner?
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