If you are a cancer survivor, having a baby is a difficult decision for 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 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 health care providers recommend that women not get pregnant in the first 6 months after finishing chemotherapy. They say that any damaged eggs will leave the body within those first 6 months. Other health care providers suggest waiting 2 to 5 years before trying to have a baby. This is because the cancer may be more likely to come back in the earlier years. And cancer treatment during pregnancy is more complicated.
How cancer treatments may affect pregnancy
Treatments can affect a future pregnancy in many ways:
Radiation therapy. Radiation therapy may affect the support cells and blood supply of the uterus. It also may 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. Anthracycline chemotherapy includes treatment with doxorubicin (Adriamycin), daunorubicin (Cerubidine), epirubicin (Ellence), and idarubicin (Idamycin). These treatments may damage heart cells and weaken the heart. As a result, the heart needs to work harder during pregnancy and labor. Sometimes this chemotherapy is used with radiation therapy to the upper abdomen or chest. This combination increases the risk of heart problems.
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, but health care providers 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 he or she will have a greater risk of developing serious health problems.
Other concerns about having a child after cancer treatment
Risk of children getting cancer. Many people who have had cancer worry that their children may get cancer, too. Research shows that children of patients with cancer and of survivors are not at higher risk. However, a few cancers are passed from parents to children through genes. If you have one of these hereditary cancers, there may be higher risk. Talk with your health care provider or a genetic counselor about having children. They can help you understand cancer risk and genetics.
Risk of cancer recurrence. Studies show that getting pregnant does not seem to make cancer return. Some health care providers 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. But there is no scientific proof that cancer risk increases if a woman gets pregnant within 2 years of completing treatment. Some studies even suggest that risk of breast cancer recurrence is lower after a subsequent pregnancy.
For some survivors, getting pregnant may require stopping certain medications. But stopping medications such as tamoxifen (multiple brands) or imatinib (Gleevec) raises the risk of cancer returning. People who are planning to have children need to talk about how much risk they are willing to accept. Talk with your health care provider and a fertility preservation expert before trying to get pregnant after cancer.
Coping with uncertainty. All cancer survivors deal with the idea that cancer could return. Survivors and their partners must talk about the chances that the child will be raised by only 1 parent. This decision is very difficult and personal. Consider talking with a counselor for guidance.
Infertility. Some cancer treatments make it difficult or impossible for survivors to have children. All men and women who want to have children should talk with their health care provider 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.
Talking with your health care provider
Having a baby is a big decision. No matter what treatment you have had, you should talk with your health care provider about the potential risks of pregnancy and birth. Your health care provider may need to check certain 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.
Questions to ask your health care provider
Will my cancer treatment plan affect my ability to have children?
Are there ways to preserve my fertility before I start treatment?
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 myself? For my spouse or partner?
Moving Forward Video: Fertility for Young Adults with Cancer