For the longest time, cancer has been associated with aging. However, modern research is showing that younger people are being diagnosed, which means that younger women of reproductive age are suffering. Cancer and pregnancy are no longer mutually exclusive. Many women will have to navigate family planning around their cancer diagnosis and treatment.
A recent update from the American College of Obstetricians and Gynecologists (ACOG) reveals that cancer in pregnancy is increasing. Cancer during pregnancy remains uncommon, occurring in about 1 in 1,000 pregnancies or within the first year postpartum. However, cases are increasing, driven in part by women waiting to have children and improved detection.
Cancer diagnoses in women under 50 are on the rise, especially breast and gynecological cancers. The most common cancers diagnosed during pregnancy are breast cancer, melanoma, and cervical cancer, which are all seen in younger women.
The newest guidance from the ACOG can help OB-GYNs and oncologists shape care for young patients who want to have children.
Patients have always been encouraged to delay treatment or consider termination, but with modern advances, views are shifting. There’s no longer a need to choose between the mother and the fetus. Many cancers are treatable during pregnancy, particularly after the first trimester. Chemotherapy, for example, may be safe in the second and third trimesters.
Roe vs. Wade may complicate cancer care options for pregnant women in some states. There have been prominent cases of women being denied critical care because of pregnancy, and each month of delayed cancer treatments led to an overall 13 percent increased risk in mortality.
That’s why timing and monitoring are critical. The first trimester carries the highest risk for the fetus, so the second and third trimesters are ideal. Delivery planning is often carefully coordinated around treatment cycles and fetal development, requiring close collaboration between oncology and obstetric teams.
That collaboration is not optional, as multidisciplinary care is necessary. Research finds that pregnant patients with cancer have better outcomes when managed by teams that include obstetricians (most likely maternal-fetal medicine specialists), oncologists, and neonatologists to monitor the baby. This approach helps to improve outcomes.
Fertility and survivorship must also be addressed early in the care process. Even in the context of an active cancer diagnosis during pregnancy, future reproductive health remains a priority for many patients. Emerging guidance emphasizes both the feasibility of fertility preservation strategies and the importance of discussing long-term reproductive goals at the outset of treatment planning.
Finally, cancer care does not end with delivery. Breastfeeding decisions can be complicated, as some treatments are contraindicated while others may be compatible. Postpartum care requires careful monitoring to balance the risk of cancer progression with the physical recovery from childbirth, reinforcing the need for continued, coordinated follow-up well beyond pregnancy.
One of the most important clinical priorities is not dismissing symptoms simply because a patient is young or pregnant. Time is of the essence, and in many cases, delays are a major risk. Pregnancy can both mask and mimic cancer symptoms, so it’s important to listen to your patients’ concerns. This overlap often leads to later-stage diagnoses, making a lower threshold for investigation essential.
Cancer risk assessment should also be more fully integrated into reproductive care. While the ACOG already states the need for breast cancer screening, there is no standardized approach.
Reproductive planning visits could be an opportunity to evaluate family history for cancer risk, including assessing risk factors such as BRCA mutations and any unexplained symptoms that could signal elevated risk. This could be complicated by the fact that many people don’t plan for pregnancy, and therefore don’t go over risk factors until after they’ve become pregnant.
At the same time, clinicians should anticipate that these cases will become more common rather than less. As maternal age continues to rise, there will likely be an increase in cancer diagnoses during pregnancy, a growing number of patients entering pregnancy with a prior cancer history, and a greater need for oncofertility expertise integrated into routine care.
Disparities and the social determinants of health (SDOH) must also be part of the discussion. Younger patients and those from marginalized backgrounds are more likely to experience delayed diagnoses and face barriers to care. They may also experience worse overall outcomes.
Cancer in pregnancy is no longer a rare anomaly — it’s a growing intersection of two major trends: delayed childbearing and rising early-onset cancer. That’s why care models must evolve to become proactive. Patients no longer need to choose between cancer treatment and pregnancy. They can now navigate both at once.
By subscribing, you consent to receive emails from BlackDoctor.pro You may unsubscribe at any time. Privacy Policy & Terms of Service.
Are you a healthcare professional? Register with us today!