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The Cancer in Pregnancy ForumArchived Questions and Answers
This Forum has been the centre of an exceptional exchange of knowledge diagnosis, treatment, symptoms and other effects of cancer during pregnancy and lactation. All are welcome to review the Questions and Answers posted here, provided that they acknowledge and accept the important proviso and disclaimer below.
My patient has been diagnosed recently with nasopharyngeal carcinoma and will start radiotherapy treatment soon. Unfortunately she is also pregnant now in the first trimester.Will the radiation therapy affect the fetus to warrant an abortion? We have had 3 patients with naso-pharingeal carcinoma that had a major resection (Commando operation?). Is surgical removal an option for this tumor?
A distance of over 30 cm from the field edges to the uterus (in this case radiotherapy to the head and neck) should result in an exposure to the embryo-fetus of only 4 to 20 cGy (the acceptable dose is up to 10 cGy). Lead shielding over the uterus should be used to reduce the dose, and with this direct radiotherapy to the pharynx should not be a risk. A dosimetry of scatter to the pelvis (with shielding) should be performed as the radiation is planned. If the scatter to the pelvis is low there is no need for termination. The plans for radiation may be altered to minimize such scatter. More details on radiotherapy are provided in the Cancer in Pregnancy section of the Motherisk website.