If you are a cancer survivor, having a baby is a difficult decision. This applies to both men and women. Survivors and their partners need to think about many things before starting or adding to their families.
Pregnancy after cancer treatment
Often, pregnancy after cancer treatment is safe for both the mother and baby. Pregnancy does not seem to raise the risk of cancer coming back. Still, some women may be told to wait for a number of years before trying to have a baby. How long depends on several factors:
Cancer type and stage
Type of treatment
A woman’s age
Some doctors recommend that women not get pregnant in the first 6 months after finishing chemotherapy. They feel that any damaged eggs will leave the body within those first 6 months. Other doctors suggest waiting 2 to 5 years before trying to have a baby. This is not because conceiving sooner will trigger cancer but because the cancer may be more likely to come back on its own in the earlier years. Cancer treatment is more complicated during pregnancy. In addition, waiting this long allows time for treatment for some cancer types to be finished and time for possible recurrences of certain cancers to be caught.
Increased pregnancy problems after cancer treatment. Different treatments can affect a pregnancy in many ways. Some cancer treatments that use radiation or surgery can increase the risk of miscarriage. A miscarriage is when the baby doesn’t survive the pregnancy. Treatments can also lead to problems during labor and childbirth. Other treatments may weaken critical organs, such as the heart. Weakened organs increase the risks of complication during the pregnancy. Here are some specifics:
Radiation therapy. Radiation therapy may affect the support cells and blood supply of the uterus and increase the chances of miscarriage, early birth, low birth weight, and other problems.
Surgery to the cervix. Removing all or part of the cervix may make miscarriage or early birth more likely. This is because the cervix may not be able to support a developing pregnancy.
Chemotherapy and radiation therapy. Anthracycline chemotherapy includes treatment with doxorubicin (Adriamycin), daunorubicin (Cerubidine), epirubicin (Ellence), and idarubicin (Idamycin). These treatments may damage heart cells and weaken the heart. Because the heart needs to work harder during pregnancy, problems may become more serious as the pregnancy advances. When this chemotherapy is used with radiation therapy to the upper abdomen or chest, the risk of heart problems increases. Those problems can worsen during labor.
Talking with your doctor
Having a baby is a big decision. No matter what treatment you have had, you should talk with your doctor about the potential risks of pregnancy and birth. Cancer treatments can damage parts of the body, such as the heart or lungs. Your doctor may need to check these organs to make sure your pregnancy is safe. You may be referred to an obstetrician who is trained to work with women who have health concerns that may affect a pregnancy. An obstetrician is a doctor who cares for a woman during and shortly after a pregnancy.
Fathering a child after cancer treatment
Men can try to have a child after cancer treatment ends. There are no firm rules for how long men should wait after treatment. Doctors usually recommend waiting 2 to 5 years. Sperm may be damaged by chemotherapy or radiation therapy. Those sperm should be replaced in 2 years. Even if a child is conceived soon after treatment ends, it hasn’t been proven that that child has a greater risk of developing serious health problems. To be safe, doctors often advise men to use birth control for about 1 year after treatment.
Risk of children getting cancer. Many people who have had cancer worry that their children may get cancer, too. Research studies show that children of patients with cancer and survivors are not at higher risk. However, a few cancers are hereditary. “Hereditary” means that something is passed from the parents to their children. If you have a hereditary cancer, then there may be higher risk. Talk with your doctor or a genetic counselor about having children. They can help you understand any risks. Learn more about cancer risk and genetics.
Risk of cancer recurrence. Research studies show that getting pregnant does not seem to make cancer return. Some doctors advise breast cancer survivors to wait 2 years before trying to get pregnant. There is a link between some hormones that rise during pregnancy and the growth of breast cancer cells. However, there is no scientific proof that cancer risk increases if a woman gets pregnant before 2 years after treatment. There are even studies which suggest that risk of breast cancer recurrence is lower after a subsequent pregnancy. You should consult with a fertility preservation expert before attempting pregnancy after cancer.
Coping with uncertainty. All cancer survivors deal with the idea that the cancer could return. Recurrence is a risk. People who are planning to have children need to talk about how much risk they are willing to accept. This is certainly the case if getting pregnant requires stopping certain medications. For example, stopping tamoxifen (multiple brands) or imatinib (Gleevec) raises the risk of cancer returning. Survivors and their partners must talk about the chances that the child will be raised by only one parent. This decision is very difficult and personal. Consider talking with a counselor for guidance in this decision.
Infertility. Some cancer treatments make it difficult or impossible for some survivors to have children. All men and women who want to have children should talk with their doctor about potential infertility before treatment begins. They should also discuss options to preserve fertility. Read ASCO's guideline on fertility preservation and cancer treatment to learn more about options.
Questions to ask the doctor
Will my treatment plan affect my ability to have children?
Will my treatment plan cause problems during labor and delivery?
How long should I wait before trying to have a child?
How will trying to have a child affect my follow-up care plan?
Will trying to have a child increase my risk of recurrence?
Should I talk with an obstetrician who has experience with cancer survivors?
Where can I find emotional support? For my spouse or partner?
Moving Forward Video: Fertility for Young Adults with Cancer