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Hodgkin's Lymphoma in Pregnancy - Frequently Asked Questions

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Updated June 17, 2014

Is Hodgkin’s Lymphoma common during pregnancy?

Hodgkin’s lymphoma mainly affects young individuals in their teens and twenties. Many young adult women may get pregnant at this age. So, a diagnosis of Hodgkin’s while a young woman is pregnant is not an unusual condition.

Does Hodgkin’s lymphoma behave differently in women who are pregnant?

No. The way the disease grows and spreads is the same. Occasionally the symptoms of lymphoma may be initially mistaken for something related to pregnancy, but the signs and symptoms are similar in pregnant and non-pregnant individuals.

Are tests for lymphoma any different?

X-rays, CT scans and PET scans are generally avoided during pregnancy to prevent radiation exposure to the fetus. MRI scans are used instead; they are equally good while being harmless during pregnancy. The other tests are similar and so are the stages of Hodgkin’s lymphoma.

Is an abortion necessary if this cancer is detected during pregnancy?

Very rarely. In most young women, treatment can be delayed or modified until the baby is mature enough to be delivered relatively safely. Only if the disease is so advanced that it threatens the life of the mother or makes a viable delivery impossible is abortion considered.

How is Hodgkin’s lymphoma treated during pregnancy?

There are no fixed rules on treatment of lymphoma during pregnancy. The stage of lymphoma, the time of pregnancy and the wishes of the mother are all considered when making the treatment decision. Treatment is often delayed or modified so that the best balance can be obtained between disease control and the safety of the unborn child.

The first half of pregnancy:

If Hodgkin’s is diagnosed during the first half of pregnancy, the intention is to delay the treatment if possible to prevent any damage to the fetus. The baby is most prone to harm from cancer treatments during the first three months when its organs are being formed. Chemotherapy is harmful at this stage, and must be avoided. Radiation is harmful too if it reaches the womb. But it may be delivered to areas far away from the womb (like the neck or the upper chest) with careful shielding of the abdomen from the rays, if it becomes necessary to start treatment. In most young women diagnosed in an early stage, it is possible to delay treatment until the baby is delivered.

The second half of pregnancy:

Managing lymphoma in the latter half of pregnancy is easier because more choices are available. Waiting until the baby’s lungs mature (and it becomes suitable for delivery) is easier and steroids given to hurry this process work quite well. If starting treatment becomes necessary, some chemotherapy drugs may be started without a high risk of damage to the fetus. In fact, a few studies show that the standard combination of chemo drugs like ABVD may be given safely during the last few months of pregnancy. Radiation may also be delivered to some select areas of the body if the abdomen can be carefully shielded.

What are the outcomes of treating Hodgkin’s lymphoma in pregnancy?

Results from a study that followed patients up for 20 years after treatment showed that the results of treating pregnant women with Hodgkin’s were no different from others. Hodgkin’s lymphoma is one of few cancers where the chances of cure are high in all stages. A few months of treatment delay during pregnancy does not alter treatment results too much. Keeping your baby is a definite option and few expectant mothers will let that pass.

Sources:

Lishner et al. Maternal and foetal outcome following Hodgkin's disease in pregnancy. British Journal of Cancer, 1992.

Avilés et al. Growth and development of children of mothers treated with chemotherapy during pregnancy: current status of 43 children. American Journal of Hematology, 1991.

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