In an interview with HT Lifestyle, Dr Gaurav Dixit, Unit Head - Haemato Oncology at Artemis Hospital in Gurugram, shared, “The treatment options for this depend on factors like the type and stage of cancer, and the gestational age. Traditional treatments for blood cancer include chemotherapy, radiation therapy, and stem cell transplants. However, their use at the time of pregnancy is carefully considered because they might have some serious effects on the fetus. Health professionals generally consider delaying or modifying treatment plans to ensure the best possible consequences for the baby and the mother.”

He revealed, “During the first trimester, when fetal organ development is at a critical stage, some treatments may be postponed. However, this decision must be taken keeping in mind the risk of allowing the cancer to progress. In the second and third trimesters, it's generally possible to proceed with chemotherapy or other treatments, but under the careful supervision of the medical team. Furthermore, supportive care, like blood transfusions and medications, can be used to control symptoms and improve the mother's quality of life. These measures are also considered safe for the fetus.”

Asserting that regular monitoring through blood tests, ultrasounds and other assessments is essential to track the mother's condition as well as the baby's development, Dr Gaurav Dixit said, “If complications increase, an early delivery may be required. Unfortunately, in some cases, where the cancer is extremely detrimental, the mother may need to consider some difficult options, which may even include terminating the pregnancy to focus on her health. This is an extremely difficult decision, and should be made with the guidance and support of the family and friends, medical team and mental health professionals.”

Stating that coping with a difficult situation like this can be emotionally challenging, Dr Gaurav Dixit highlighted, “What significantly helps in managing blood cancer in pregnancy is open communication and shared decision-making. If the burden of this problem becomes too much for the mother to bear, then joining support groups or seeking individual counseling can help her in managing stress and anxiety. Blood cancer during pregnancy is a complex issue but with the expertise of a dedicated medical team and a strong support system, it is possible to get through this challenging journey and ensure good health and safety for the mother and the baby.”

Bringing his expertise to the same, Dr Kumardeep Dutta Choudhary, Senior Consultant and Unit Head Department of Medical Oncology at Action Cancer Hospital, said, “A diagnosis of blood cancer during pregnancy can be an overwhelming experience, as it combines the challenges of both medical treatment and motherhood. Finding the delicate balance between managing your health and nurturing your growing baby is crucial.” Explaining the unique journey of dealing with blood cancer during pregnancy, he suggested how women can navigate the complexities -

• The Medical Challenge: Blood cancer encompasses a range of diseases, including leukemia, lymphoma, and myeloma, each requiring a tailored treatment plan. However, during pregnancy, treatment options may be limited due to potential harm to the developing fetus. Thus, a careful balance must be struck between addressing the mother's health and safeguarding the baby's well-being.
• Multidisciplinary Care: Seeking specialised care is essential. A team of healthcare professionals, including hematologists, obstetricians, and neonatologists, can collaborate to create a personalized treatment plan. This plan must consider the type and stage of cancer, the gestational age, and the potential risks and benefits of treatment.
• Choosing the Right Time: Timing is crucial. Deciding when to initiate treatment depends on the severity of the cancer and the stage of pregnancy. In some cases, delaying treatment until after delivery may be an option, while in others, immediate intervention may be necessary.
• Emotional Support: Coping with cancer during pregnancy is emotionally challenging. Seek support from friends, family, or support groups to help manage the emotional toll. Ensuring open communication with your healthcare team can alleviate some of the anxiety associated with treatment decisions.

Dr Kumardeep Dutta Choudhary added, “Balancing blood cancer treatment with the journey of pregnancy is a complex and emotional process. However, it's important to remember that many women successfully navigate this path, delivering healthy babies while receiving appropriate medical care. Expert medical guidance, emotional support and informed decisions are essential in achieving the delicate equilibrium between managing your health and embracing motherhood during this challenging time.”

Echoing that blood cancer in pregnancy is a complex and challenging medical condition that requires careful management and collaboration between healthcare providers, Dr (Prof) Vijay Patil, Consultant - Medical Oncology at PD Hinduja Hospital and Medical Research Centre in Khar, said, “Blood cancers, also known as hematologic cancers, include conditions like leukemia, lymphoma and multiple myeloma. When a pregnant woman is diagnosed with blood cancer, several factors come into play, including the type and stage of the cancer, the trimester of pregnancy and the overall health of the mother and fetus.” As per him, here are some important points to consider -

1. Diagnosis and staging: It is essential to determine the type and stage of the blood cancer. The treatment and prognosis will depend on the specific diagnosis.
2. Timing: The stage of pregnancy at which the diagnosis is made plays a significant role. Treatment options may be limited in the first trimester, when fetal development is most vulnerable. In the later trimesters, the approach may be different.
3. Treatment Options: Treatment decisions need to balance the mother's health with the well-being of the fetus. Treatment options may include chemotherapy, radiation therapy, and stem cell transplantation. The choice of treatment should be made in consultation with a team of healthcare professionals, including oncologists, hematologists, and obstetricians.
4. Monitoring: Frequent monitoring of both the mother and the fetus is crucial throughout the pregnancy. This may involve blood tests, ultrasounds, and other diagnostic tests to assess the progression of the cancer and the well-being of the fetus.
5. Risks and Benefits: Treatment of blood cancer during pregnancy carries risks to the fetus, but these must be weighed against the risks of not treating the cancer. Your healthcare team will help you understand the potential risks and benefits of various treatment options.
6. Supportive Care: Pregnant women with blood cancer may require supportive care to manage symptoms and side effects. This may include medications to alleviate nausea, pain, and other symptoms.
7. Delivery Timing: The timing and mode of delivery will depend on several factors, including the mother's health and the baby's development. In some cases, early induction or a cesarean section may be recommended.
8. Neonatal Care: Specialised neonatal care may be needed if the baby is born prematurely or with health complications related to the mother's treatment.
9. Emotional Support: A diagnosis of cancer during pregnancy can be emotionally challenging. Seek support from healthcare professionals, support groups and counselors who specialise in pregnancy and cancer.

Each case is unique and the approach to managing blood cancer during pregnancy should be individualised to the specific circumstances. It is crucial to have open and ongoing communication with your healthcare team to make informed decisions that prioritise the health and well-being of both the mother and the baby.