Facing a cervical cancer diagnosis during pregnancy

Tuesday January 21 2020

Facing a cervical cancer diagnosis during pregnancy-Agnes and Moses - conceive a child -vaginal bleeding-

Conceiving a child after several years of trying is special for new parents-to-be. PHOTO | FILE 

By Dr Chris Peterson

Agnes and Moses (not their real names) had been trying to conceive a child for the past five years.

When they learnt that Agnes was finally pregnant, they were overjoyed.

Unfortunately the new parents-to-be were taken aback when Agnes started having unusual pregnancy symptoms.

She was experiencing light vaginal bleeding at the beginning of the second trimester of her pregnancy, and that’s when her primary gynaecologist referred her to me for further check-ups.

She came to me with signs and symptoms upon which I requested for her to get a biopsy done. The results, a shock for Agnes and Moses - she had stage 1b cervical cancer.

One thing I remember so vividly is that on the day I invited them in my office to break the news, they both couldn’t hold tears, looked very hopeless as they lost their faith in becoming parents.

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In the middle of all this, Moses aggressively asked me, “So what next doctor? Is my wife going to be okay? After all the expectations we had, does this mean it won’t happen anymore?”

I couldn’t give them any prognosis on that day as I needed to evaluate the case further.

On that day, the new parents-to-be left my office sad with the perception that to prevent cancer’s complication to pregnancy and Agnes’s life, termination of the pregnancy might be the only solution.

That was the same thing that ran on her primary gynaecologist’s mind when I spoke to him on the same day.

Like any gynaecological cancer, cervical cancer and its treatments tend to cause plenty of complications especially in pregnancy and in most cases, women opt to terminate their pregnancies to avoid such complications that tend to threaten their lives. But this wasn’t the case for Agnes.

Upon consulting a senior oncologist, Dr Heri Tungaraza based at Muhimbili National Hospital (MNH), he said abortion may not be the only option.

Based on experience, Dr Tungaraza said that Agnes still had a chance to bear a child even after going through several rounds of treatment therapy that she will be recommended.

He further recommends that to avoid cancer complications to the pregnancy and life, she (Agnes) should continuously attend both gynaecology and oncology clinic for further routine assessment. “It is now a journey for her and her husband. They should visit both the clinics more often for a comprehensive approach to monitor the development of pregnancy and cancer management throughout the time of pregnancy,” explained Dr Tungaraza.

I asked the new parents-to-be to come visit me after two days where I was able to give them the good news that they still stand a chance to be parents.

I checked the size and location of the tumour and offered her three rounds of chemotherapy, a type of cancer treatment that is safe during pregnancy.

After this treatment, I expect the tumour will be highly reduced and Agnes will be able to deliver normally.

The couple is now happily waiting to meet their child while Agnes receives her treatment for cervical cancer and attends her prenatal clinics for routine assessment.

The author is a medical doctor based in Dar es salaam

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