chemotherapy administration during pregnancy

[eager to learn]

All the literature I have read states chemotherapy treatment during pregnancy should be just as aggressive as chemotherapy treatment in non-pregnant states. I have read mixed opinions concerning when treatment can begin, during the first trimester or only during the second and third trimesters. Many reports state that chemotherapy is safe during the second and third trimesters, and some specific drugs are safe throughout the pregnancy (e.g., tamoxifen).

Since chemotherapeutic drugs exert their effect by inhibiting cell division, can they really be considered safe to both the mother and fetus in any trimester? Do you have any experience or additional knowledge concerning the effects of chemotherapy administration during pregnancy?

What are your thoughts or opinions about chemotherapeutic drugs and pregnancy?

[suzanne4, RN]

Chemo-therapy is never a safe drug to give to any patient. You always outweigh the risks of giving it. Your first goal is to save the mother's life, and usually second in the baby. You can try to hold off on the chemo, most mothers try to chose this route, but if their life will be in jeopardy, then usually it is a go of the chemo or other treatments. Unfortunately, I have seen a few mothers die while pregnant thru the years because they did not want to chance the chemo during the pregnancy.

It is something that is discussed with the Ob/GYN, the HEM/ONC Dr, and the patient................but again, first goal is to save the mother, but she needs to be in agreement with this as well.

First trimester is usually the worst time to give any medication.

[SmilingBluEyes]

Suzanne stated it perfectly. Benefits versus risk---always a consideration whether pregnant or not.

[eager to learn]

Since the use of chemotherapy during pregnancy is becoming more common, are the preceived risks considered less severe or less likely to occur within the 'safe' margin of administration in the second and third trimesters only?

Do the Ob/GYN and HEM/ONC doctors receive additional training to administer chemotherapeutic drugs to pregnant women or is the practice of chemotherapy administration during pregnancy too recent a practice to have specialized courses devoted to it?

[Blee O'Myacin, BSN, RN]

and since the goal is myeloablation (most of the time) before a bone marrow transplant, female patients are not allowed to become pregnant (if they even could after many, many cycles of chemo) and receive treatment. I also deal with strictly hematological cancers where I work though. The conventional wisdom is to deliver as early as possible and aggressively treat mom post partum.

I would not give chemo to a pregnant woman. We don't even let our pregnant nurses administer chemo where I work!

Blee