Cervical Cancer Treatment during Pregnancy

Cervical cancer during pregnancy is rare. When it occurs, the cancer is usually found early and confined to the cervix, and it may not need to be treated immediately. But sometimes the cancer is fast-growing or found at a later stage and needs immediate treatment. Before treatment begins, it is important to discuss the benefits and risks of all your treatment options, including how treatment could affect you, your pregnancy, and your future fertility. Your cancer care team will consider your personal wishes when helping you decide the best treatment.

Typically, treatment depends on your trimester of pregnancy.

Treatment of slow-growing stage I cervical cancer in the first trimester

If you have a type of slow-growing cervical cancer that is diagnosed in stage I, are less than 3 months pregnant, and want to continue your pregnancy, your cancer care team might suggest that you delay treatment until later in your pregnancy or after delivery.

Your cancer care team may also suggest you deliver early (around 37 weeks) via cesarean section. You may have a hysterectomy (surgery to remove the uterus and cervix, and sometimes surrounding structures) at the same time as the cesarean section.

To learn more about hysterectomy, see Cervical Cancer Treatment.

Treatment of fast-growing or advanced stage cervical cancer in the first trimester

Tests will be done throughout your pregnancy to find out if the cancer has grown much larger or has spread outside of the cervix. Cervical cancer that is fast-growing or has evidence of spread outside the cervix to other tissues and organs may require immediate treatment, which may include

• hysterectomy, surgery to remove the uterus (womb), cervix, and sometimes surrounding structures
• chemotherapy
• radiation therapy

It is not possible to continue the pregnancy during any of these treatments. Chemotherapy is not safe for the fetus during the first trimester, and radiation therapy is harmful throughout fetal development.

To learn more about these treatments, see Cervical Cancer Treatment.

Treatment of stage I cervical cancer in the second or third trimester

If you are diagnosed with stage I cervical cancer during the second or third trimester of pregnancy, your cancer care team might suggest surgery with cold knife conization or radical trachelectomy.

Cold knife conization uses a scalpel to remove a cone-shaped piece of tissue from the cervix and cervical canal. Cold knife conization is done in the hospital under general anesthesia.

Radical trachelectomy (also called radical cervicectomy) removes the cervix, nearby tissue, and the upper part of the vagina. Lymph nodes may also be removed. After the surgeon removes the cervix, they attach the uterus to the remaining part of the vagina. A special stitch or band is placed on the uterus (in a procedure called a cerclage) to help keep the uterus closed during pregnancy.

Your cancer care team may suggest you deliver early via cesarean section. If all the cancer couldn’t be removed with cold knife conization or radical trachelectomy, you may receive other treatments after delivery, such as hysterectomy and radiation therapy.

To learn more about hysterectomy, see Cervical Cancer Treatment.

Treatment of stage II, III, or IV cervical cancer in the second or third trimester

If you are diagnosed with stage II, III, or IV cervical cancer during the second or third trimester of pregnancy, your cancer care team may suggest you continue the pregnancy and receive chemotherapy.

Chemotherapy, such as with or and , given in the second or third trimester does not usually harm the fetus but may cause early labor and low birth weight.

Your cancer care team may suggest you deliver early via cesarean section so you can receive other treatments, such as hysterectomy and radiation therapy.