Pregnancy and cervical cancer

If you're diagnosed with cervical cancer when you are pregnant, what will happen depends on: 

• the type of cervical cancer you have
• how big the tumour is and whether it has spread (its stage)
• how many weeks pregnant you are
• what your wishes are

Multi disciplinary team

Your doctor is part of a multi disciplinary team that will discuss your situation. They will decide with you about the best treatment options for your case. This team includes a:

• doctor specialising in cancer drug treatment such as chemotherapy (medical oncologist)
• doctor specialising in radiotherapy and cancer drug treatment (clinical oncologist)
• surgeon specialising in cancer of the female reproductive system (gynaecological oncologist)
• doctor specialising in the care of women during pregnancy (obstetrician)
• doctor specialising in the care of newborn babies (neonatal doctor)
• expert in examining and identifying cells (pathologist)
• psychologist or counsellor
• nurse specialist

To make a decision, you will need full information about your options. Your medical and nursing team can help with this. They can tell you about the benefits and possible risks of each option.

Treatment by stage during pregnancy

Pregnancy usually lasts between 37 and 42 weeks and is split into 3 stages. They are known as trimesters. Most women diagnosed with cervical cancer during pregnancy are in the first two trimesters.

There is not enough good evidence to say how being pregnant affects the outcome of cervical cancer.

Stage 1A1 without lymphovascular space invasion (LVSI)

Your doctor may treat stage 1A1 cancer with a cone biopsy. The best time to do this is between weeks 14 and 20.

If the border around the removed tumour contains cancer cells, you might have another cone biopsy. This is called a positive margin.

Stage 1A1 with LVSI, 1A2 and 1B1

Less than 22 weeks pregnant

If a pelvic lymph node removal is positive, your doctor may suggest ending the pregnancy.

If you wish to continue the pregnancy, your doctor may suggest having neoadjuvant chemotherapy. This will only be after the first trimester.

If the lymph nodes are negative, your doctor may suggest:

• a trachelectomy
• delaying treatment until after delivery

More than 22 weeks pregnant

Treatment may include:

• neoadjuvant chemotherapy
• delaying treatment until after delivery

Stage 1B2

Less than 22 weeks pregnant

If a pelvic lymph node dissection is positive, your doctor may suggest ending the pregnancy. If you decide to end the pregnancy, you will have a:

• radical hysterectomy
• pelvic lymph node removal

If you wish to continue the pregnancy, your doctor may suggest having neoadjuvant chemotherapy. This will only be after the first trimester. Or they may suggest delaying treatment until after delivery.

More than 22 weeks pregnant

Treatment may include:

• neoadjuvant chemotherapy
• delaying treatment until after delivery

Delivery will be by caesarean section. After delivery, you will have a:

• radical hysterectomy
• pelvic lymph node removal

Stage 1B3 and above

Less than 22 weeks pregnant

Treatment may include:

• neoadjuvant chemotherapy
• ending the pregnancy

More than 22 weeks pregnant

Treatment may include:

• neoadjuvant chemotherapy
• delaying treatment until after delivery

Delivery will be caesarean section. After delivery, you might have either surgery or radical chemoradiotherapy.

Making decisions about treatment

Deciding on treatment when you are pregnant can be very difficult. You will need some time to think and to find out what all your options are. Make sure you have had the opportunity to ask all the questions you need to ask. You can also ask if there is anyone else you (and your partner) can talk to such as a specialist nurse or counsellor.