Cervical cancer ranks among the most prevalent cancers, arising from abnormal cellular proliferation in the cervix, often instigated by a persistent infection with the human papillomavirus (HPV). Typical manifestations of cervical cancer include vaginal bleeding, swelling, pain during sexual intercourse, and pelvic discomfort. Nevertheless, during pregnancy, certain symptoms associated with cervical cancer may be misinterpreted as pregnancy-related complications.

Dr. Nidhi Sharma Chauhan, a consultant obstetrician and gynaecologist, stated, “The diagnosis of cervical cancer may be postponed during pregnancy, as some symptoms can be confused with complications of pregnancy. It is crucial that the treatment of cervical cancer during pregnancy is not deferred.”

What treatment is recommended for cervical cancer during pregnancy?

The recommended treatment for cervical cancer is determined by the duration of the pregnancy and the specific stage of the cancer. This approach prioritizes the safety of the unborn child while ensuring that treatment is not postponed unnecessarily. Routine cervical screenings, such as pap tests or HPV testing, can be conducted following the delivery of the baby. However, if a pap test yields suspicious results shortly before conception, it is advisable for the woman to proceed with a colposcopy during her pregnancy, as explained by Dr. Nidhi Sharma Chauhan.

Is colposcopy safe during pregnancy?

Dr. Nidhi Sharma Chauhan emphasized the significance of accurately staging cervical cancer to formulate an appropriate treatment strategy. She stated, "Colposcopy is advisable during pregnancy when necessary, as the advantages of the procedure surpass the minimal risks involved. Proper staging of cervical cancer is essential to provide the most suitable treatment plan for the expectant mother. The staging process is primarily clinical and also incorporates MRI technology. However, interpreting MRI results can be challenging during pregnancy due to the physiological changes that occur. For cases of early-stage cervical cancer that are confined to the cervical tissue, a cone biopsy, which involves the excision of a portion of the cervical tissue, may be performed," she further explained.

When should chemotherapy be considered?

Chemotherapy may be deemed appropriate following the first trimester of pregnancy. Once the pregnancy reaches 22 weeks, the removal and examination of lymph nodes are generally discouraged due to the increased size of the uterus, which poses potential risks to the pregnancy. In this context, neoadjuvant chemotherapy is advised. The gynecologist underscored the importance of not postponing the treatment of cervical cancer during pregnancy.

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