Historically, pregnant people diagnosed with cancer have faced the wrenching choice of deciding whether to terminate their pregnancies in order to undergo cancer treatment, or delay care until giving birth—in some cases, earlier than ideal for a healthy delivery. That’s because treatments like chemotherapy and surgery were often avoided out of fears that they could cause miscarriage or birth defects.
But as cancer rates among people of reproductive age rise—including an uptick in pregnancy-associated breast cancer and cervical cancer—the leading professional organization for OB-GYNs who treat high-risk patients has issued its first-ever guidance for the treatment of people diagnosed with cancer during pregnancy. Cancer treatment should not be withheld solely because a patient is pregnant, the Society for Maternal-Fetal Medicine announced on March 12, 2026.
Previously, there were no specific guidelines for OB-GYNS from the organization, meaning oncologists and other providers advised pregnant patients on their treatment options on a case-by-case basis. The new guidelines reflect more recent data that suggests cancer care is safe under certain conditions.
The group further recommends that surgery for cancer should not be delayed or denied at any point in pregnancy; that chemotherapy can be given after 12 weeks’ gestation or earlier in consultation with oncology providers; and that pregnant people should have access to a full range of reproductive health options, including abortion care.
“This document brings together the best available evidence to help manage pregnant patients with cancer while supporting both maternal health and pregnancy goals,” said Dr. Moti Gulersen, the lead author of the guidance, in a press release.
The new guidance will affect the estimated 5,300 people in the U.S. diagnosed with cancer during pregnancy each year. The Royal College of Obstetricians and Gynecologists in the U.K. released similar breast cancer-specific guidance last year.
Rewire News Group spoke with maternal-fetal medicine specialist Dr. Elyce Cardonick, a co-author of the new guidance who tracks maternal and fetal outcomes related to cancer in pregnancy, to learn more about what these new guidelines mean for pregnant people with the disease.
The following conversation has been edited for length and clarity.
What’s the main takeaway of the new guidance?
If you’re diagnosed with cancer, you don’t have to choose between your baby’s life and your own life in the sense that you don’t have to choose between getting cancer treatment or not getting cancer treatment, having your pregnancy or not having your pregnancy. You can have both, in most cases.
I want pregnant women to … ask: “If I weren’t pregnant, how would you treat me?” And try to be treated as closely as possible.
And if your doctor would wait when you’re not pregnant, fine. But if they’re saying they would wait only because you’re pregnant, then we need to look at what the treatment involves and if we can still give it while you’re pregnant. We just don’t want the knee-jerk reaction to be that you have to terminate or you can’t be treated.
It may be that you don’t need treatment, but I just want to make sure pregnancy, for the sake of the first discussion, is taken out of the equation.
Was there anything specific that spurred the guidance?
I’ve been saying for a long time—[cancer in pregnancy] is becoming more common, and is something we really need to address.
You could go through a whole obstetric career and never have a pregnant patient who has cancer, or go through a whole oncology career and never have a cancer patient who’s pregnant. … Each case was kind of handled one at a time, thinking, ‘Well, this is never going to happen again.’
Now, it is becoming more common. And women getting pregnant older is a little bit of a risk factor for cancer in pregnancy. So as the population is getting pregnant later, the need for these guidelines came.
How common is cancer in pregnancy? Are there certain cancers that you see more commonly in pregnant people?
Cancer occurs in about 1 in 1,000 pregnancies. … The most common is breast. But we also see lymphoma, cervical cancer.
For ovarian cancers, because we’re doing ultrasounds of the fetus, we can pick up ovarian cancers earlier than if the person wasn’t pregnant. … Or you’re looking at the cervix. So let’s say someone’s not due for a Pap smear but they come in with vaginal bleeding. You put a speculum in and you look at the cervix for the source of bleeding, and you see a tumor. So there’s certain things that get done in pregnancy that might pick it up earlier that may not have happened if you weren’t pregnant.
On the contrary, sometimes things you might notice [are dismissed as symptoms] because you’re pregnant. … So if you have a breast mass someone might say, “oh, that might be due to pregnancy,” whereas if you weren’t pregnant, you’d go right to mammogram or ultrasound. … If you have rectal bleeding, constipation, they [may] say “oh that’s due to pregnancy,” while meanwhile, you have a tumor—or colon or rectal cancer—and because you’re pregnant, they think those symptoms are due to pregnancy.
So sometimes pregnancy helps the diagnosis and sometimes the pregnancy hinders a diagnosis.
You can say to your [provider], “If I wasn’t pregnant, what would you do with my rectal bleeding? What would you do with my breast mass? I want to be evaluated the same as if I weren’t pregnant.”
That’s why I love the question: “How would you evaluate me if I weren’t pregnant?”
What do we know about the kinds of cancer treatments that are safe in pregnancy?
Surgery can be done at any time during pregnancy. General anesthesia, spinal anesthesia, epidural anesthesia. You don’t have to be second trimester—[it] can be done at any time.
Radiation depends on the gestational age of the patient and the location of the tumor. So if there’s a brain tumor, and the [pregnancy is] only 12 weeks … the distance between the tumor and the uterus is such that you can safely give radiation in pregnancy. … If you have a pelvic tumor, it’s going to be hard to do radiation because the fetus is right there.
We avoid chemotherapy in the first trimester, and we ideally would like to start it after the first trimester is finished. And some chemotherapy does cross the placenta. However, if you wait three weeks from the last chemotherapy to deliver, in most cases, the placenta has a chance to metabolize that chemotherapy.
When we do developmental testing on children who have been exposed to chemotherapy…they performed just as well on developmental testing, learning testing [as other children who weren’t exposed]. There are some issues … with short-term memory. But the long-term memory is fine. And even though there was a difference, it still fell within normal range for what it should be. These babies do very well.
In some cases of recurrent cancer—recurrent lymphoma or metastatic melanoma—we do have information that certain immunotherapies can be safe to give. But these are the sicker of the sickest patients. … We’re [still] learning more about immunotherapy and pregnancy.
How do you think this guidance will impact the access to and quality of care that patients diagnosed with cancer in pregnancy get?
I ask every pregnant person diagnosed with cancer if they were advised to terminate their pregnancy. Of all pregnant women who contacted the cancer and pregnancy [database] after a diagnosis of cancer in the first 15 years, 20 percent told me their physicians had recommended a termination. When I looked at the subsequent 15 years of the database collection, recommendation has decreased to 12 percent.
So I hope that this guideline continues to have that decrease. It’s not that termination is never warranted. … But it shouldn’t be the first response, until you’ve investigated what your options are.
The post Cancer Can Often Be Treated Safely During Pregnancy: New Expert Guidance appeared first on Rewire News Group.