A little over a month ago, I found out I was pregnant. That's exciting news, right? It sure is. However, for an oncology nurse it raises a major question: Do I continue to administer chemotherapy or not?
For the first few weeks, I decided I would try to avoid giving chemo, but if I couldn't, I'd just be extra cautious. In the few weeks between finding out and telling my colleagues and manager, I gave chemo two or three times, luckily with no issues. Once I was ready to tell people at work, though, I decided I would no longer give chemo unless it became absolutely necessary due to staffing, which should never be an issue.
So what is the big deal with giving chemo while pregnant? Obviously, there's risk of exposure. But we always have that risk. The problem is, if I were exposed, my developing baby would be, too. This exposure may or may not have long-term effects on me, but more so, we really don't know what kind of effects it would have on baby.
What we do know is that medications as simple as aspirin and ibuprofen can harm the developing fetus, so something more complex and known to be toxic would surely cause more issues, right? Well, a recent news report from August 2012 claims this may not be the case.
A European study performed on mothers who underwent chemotherapy while pregnant suggested that avoiding treatment during the first trimester is important, but it appears to be safe after that. This study, though, seemed to look only at birth weight, prematurity, and issues obvious at birth (defects, blood disorders, hair loss); it didn't look at the long-term effects on the child. For all we know, if we were to follow these children over the next 20 years or so, we might find they are at a higher cancer risk when compared to those not exposed.
This study looked at mothers being treated for breast cancer, so my first thought was that the exposed fetus may be at a higher risk for developing a hematological malignancy in childhood, much like their mothers after receiving treatment.
Personally, I'm going to continue to err on the side of caution and avoid any exposure to my little one from chemo for the next 29 weeks. We really don't know enough regarding the long-term effects a potential exposure could have later on down the road. Is it really worth the risk?
I am wondering what others' work place policies are on pregnant women administering chemotherapy? Did you or would you administer treatment while pregnant?