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If I am pregnant will my cancer diagnosis be delayed?

Medical negligence lawyer Kirsten Wall talks about cancer diagnosis in pregnancy and how this can be missed or delayed.

Anonymous pregnant woman
Kirsten is an experienced medical negligence solicitor with a particular interest in cases involving the delayed diagnosis of cancer, including Hodgkin's and non-Hodgkin's lymphoma.
I have been instructed by a number of clients to bring medical negligence claims for them after the delayed diagnosis of their cancer.  These are always difficult cases, both technically, but also because feelings, understandably, run high when someone has been told that they are going to die because of a doctor or hospital’s failing.  This is even more so when the person is a young woman whose cancer was missed during their pregnancy and who faces the devastating likelihood that they are now going to leave their young child without a mother as a result.

I am currently working on a number of cases where cancer was missed during my clients’ pregnancies, despite them seeking medical attention, often, on numerous occasions.  

The incidence rate of cancer in pregnancy (or within one year of delivery) is 1 in 1,000 – thankfully rare – but I decided to see how common it was for the diagnosis to be delayed for these women.  I was astonished to see that if you search online using the term ‘cancer being diagnosed in pregnancy’ the first thing that comes up is “being pregnant may delay a cancer diagnosis”.    

Public Health England’s figures show that the three most common cancers seen during pregnancy are breast cancer, melanoma of the skin, and cervical cancer.  

There has been limited clinical research undertaken on this issue but what I have found is rather alarming.  62% of the women in one of the studies had the diagnosis of their cancer delayed by the actions or inactions of healthcare providers.  As a result, women are more likely to be diagnosed with large tumours and more advanced disease.   

The obvious reason seems to be that symptoms of the cancer are easily attributed to pregnancy related symptoms.  For example breast cancer is classically identified due to a change in breast tissue or breast lumps, which can also be seen during pregnancy or when breast feeding.  Cervical cancer has symptoms of unusual spotting (bleeding) and lower back and pelvic pain.  Again, these are symptoms that can be seen during or after pregnancy.  

Due to an increase in maternal age and obesity levels, the recorded instances of cancer in pregnancy is increasing.  Thankfully, despite the statistics, this is still a rare occurrence.  However, given the devastating consequences both to the mother and potentially also the baby, should the index of suspicion be higher?  Should more importance be put on the symptoms that don’t seem to match what you might expect to see in pregnancy?  For example, weight loss?  One of my clients lost 3 1/2 stone during pregnancy, which combined with other symptoms should surely have raised concerns.  

Treatment options during pregnancy can be more difficult but what is clear is that a more timely diagnosis needs to be made in order to give the woman and her baby the best chance of a healthy future.

If you have experienced a missed cancer diagnosis during pregnancy you might find it useful to contact the charity Mummy’s Star whose focus is on raising awareness of the fact that symptoms of cancer are often confused as being pregnancy related. The charity supports any family where the mother is diagnosed with cancer in pregnancy or 12 months post partum, irrespective of whether the diagnosis was missed or not. 

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