This is a very important question. Cancer can happen to anyone and we do see patients with cancer during pregnancy.
For any cancer, treatment is usually multipronged. If cancer is localized and if it is possible to remove it by surgery then this is the preferred approach. Surgery can be done during pregnancy. However, the type of surgery varies, risks and complications involved should be discussed. Anesthesia is also not contraindicated during pregnancy.
During the first trimester, it is not advisable to take chemotherapy but it is safe during the second and third trimester. During the first trimester, fetus cells are forming and hence no major systemic therapy should be given. There is a good amount of research to establish what all chemotherapy drugs can be given during pregnancy and which are to be avoided. Chemotherapy such as Doxorubicin, Cyclophosphamide, and Taxanes can be given. Contraindicated chemotherapeutics during pregnancy include Methotrexate.
Certain other kinds of anticancer therapy such as hormonal therapy, targeted therapy e.g. Trastuzumab, oral tablets being used in the treatment of blood cancer (Imatinib) is contraindicated during pregnancy.
So, what to do if a doctor recommends chemotherapy and pregnancy in the first trimester. One option is to consider ending pregnancy especially if treatment of cancer can contribute to good long-term outcomes. The second is to have a detailed discussion with your doctor in case you don’t want to discontinue the pregnancy. Surgery could be done on close observation in few cases. It is very important to involve a counselor or psychologist to develop a support system.
The bottom line is- it is very much possible to treat any cancer during pregnancy. Also, there are chemotherapy medicines possible to be administered without causing any harm to the growing baby. It important is not to panic if such treatment has been suggested during pregnancy.