The thyroid gland is subject to various changes. When creating special conditions, benign or malignant tumors can occur in it. If, under normal conditions, active diagnostics is carried out and aggressive methods of therapy are applied, how to be when thyroid cancer is detected in one of the trimesters of pregnancy? Is it possible to save the baby’s life or is it necessary to have an abortion, does the tumor affect the development of the fetus and the course of pregnancy?
The formation of thyroid cancer: as it happens during pregnancy
Of course, when thyroid cancer is suspected, this is a serious diagnosis, especially if suspicion is formed during the period of gestation. Today, a lot of research has been done that proved that pregnancy in the presence of a similar diagnosis does not require interruption. However, it is not uncommon in the regions that there are cases when doctors aggressively offer a medical abortion, if an oncological pathology is detected. But experts involved in endocrinology and oncology do not confirm this information, there is not a single substantiated publication confirming the negative impact of the oncological process in the thyroid gland in the process of developing the baby in the womb.
Therefore, do not immediately worry: the correct approach to the diagnosis of thyroid cancer and its therapy allows you to save the pregnancy, fully make and give birth to a completely healthy baby. The main danger of gestational thyroid cancer is the difficulty in identifying the initial symptoms. This is due to the fact that they are quite nonspecific and may have similarities with early pregnancy symptoms.
Does pregnancy affect the development of cancer?
Also today, a lot of data has been received on the effect of pregnancy on the oncological process. Negative influence that would form a pregnancy against a tumor was not detected by doctors. Experts remind that differentiated forms of thyroid cancer, such as papillary or follicular types, are classified as slowly progressing tumors. Therefore, even if the hormonal background changes as a result of carrying a fetus, it does not adversely affect the growth of tumors, it does not worsen the prognosis for life and health of a woman. Statistics data regarding the compatibility of cancer education with by pregnancy However, about 5% of women may have thyroid nodules by the time they become pregnant, but not all of these formations are malignant. The probability of cancer in nodules does not exceed 5%.
How to diagnose whether they affect the baby?
The basis of the diagnosis is an examination by a doctor, probing the neck area, where thyroid with detection of nodes or diffuse compaction. In addition, it is necessary to conduct an ultrasound scan of the organ, as well as special blood tests with the detection of tumor cells, and an organ biopsy. They will reveal not only the localization of the node, but also the presence of cancer cells, as well as the type of tumor. In connection with the need to carry out procedures for the determination of thyroid cancer, pregnant women have many questions. Many doubt the acceptability of a fine needle biopsy during pregnancy. However, this study is safe, neither the baby nor his mother will suffer from it. A procedure will be shown when nodules are detected with sizes from 10 mm and more; they are performed under local anesthesia.
Of course, you can wait a little with a biopsy, waiting for the moment when the baby is born, but it is preferable to find out as early as possible the type of education present in the thyroid gland. This is necessary to either calm down (when it is a benign node), or to resolve the issue of the admissibility of breastfeeding and treatment soon after giving birth.
But any studies that are carried out with the use of radioactive iodine during gestation are prohibited. From this substance, the baby can suffer greatly, because it has teratogenic and mutagenic effects. These studies are also prohibited if the woman is breastfeeding.
If cancer is detected, how to proceed?
When the thyroid gland is infected with cancer during gestation, you should immediately consult a oncologist who has experience working with expectant mothers with similar problems. An operation to remove a tumor in the area of the thyroid gland will be carefully planned and carried out only within the walls of specialized clinics. The decision to hold it while the woman is pregnant, or after the birth of the baby will be taken by the doctor. Most often, thyroid cancer is operated after the baby is born. Observations of doctors and scientific publications do not show differences in when there was an operation – during pregnancy, or when the childbirth took place. Moreover, with a slow growth of the tumor, a woman can even be allowed to breastfeed the baby, and only then will the operation be scheduled.
Surgery during pregnancy
If it is decided that the operation falls to a pregnancy, then a decision is made on the timing of its operation. Any surgical intervention is permissible in the second trimester, up to a period of 24 weeks, when the risks of anesthesia on the mother and fetus are minimal, but during the first or third trimester, the operations will be contraindicated.
The timing of the operation is also significantly affected by the localization of the cancer and the size of the formation. If the size of the tumor site is no more than 3 cm, the formation is located at a distance from the trachea and nerves, there is no contact with the capsule of the gland itself, then it is quite possible to postpone the operation until after the birth. If there is evidence of the spread of cancer to the tissues surrounding the gland, there are metastases to the lymph node area, then the decision on the timing of the operation is made with the woman and is planned for the second trimester. If thyroid cancer is detected in the third trimester, the operation will be postponed for the postpartum period.
What is forbidden to do?
One of the methods of treatment in the presence of cancer of the gland, is the use of radioactive iodine. During pregnancy, it is strictly forbidden to use it, the baby will be the first to suffer from such treatment. Therefore, if a similar method of therapy is planned, it is postponed until the woman recovers after the birth of the baby or later, as the woman feeds the baby with breast milk. When a decision is made to immediately treat a woman with radioactive iodine preparations, then breastfeeding should be stopped.