Sean Parker, IBM Watson, and Cancer During Pregnancy

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Cancer during pregnancy‪Sean Parker, the co-founder of the file-sharing site Napster and Facebook’s first president, made headlines this week when he announced that he would found the Parker Institute for Cancer Immunotherapy. The Institute will speed development of cancer-fighting drugs that harness the immune system in a new way: it will create a virtual “sandbox” in which approximately 300 scientists at six different institutions will work collaboratively. The research is at an early stage and new treatments will take time to develop. “We’ll make progress against three or four cancer types in the next several years,” Parker predicts.

This week, it was also announced that IBM is developing a new weapon in the battle against cancer that will put its Watson analytic technology to work in a new way. Partnering with the American Cancer Society, IBM is building a virtual advisor that uses machine learning to give patients personalized information and advice. The advisor will begin by looking at the type of cancer the patient has, the stage of the disease, and the treatments administered so far. Using that and other data, it will try to offer care advice and answer patients’ questions.

Those are great pieces of news. New treatments and new methods to advise cancer patients are always welcome. But, how can they help pregnant women with cancer? In order to answer this question, let’s first review this topic.

How frequently does cancer occur in pregnancy and what are the most common types of cancers?

Cancer is rare during pregnancy, affecting 0.02 to 0.1% of pregnancies per year. Breast cancer is estimated to occur in 1 in 3,000 pregnancies, while certain types of leukemia have been reported in 100 pregnant women. Cervical cancer, thyroid cancer, and Hodgkin’s lymphoma have also been found, but very rarely.

Does cancer cause problems during pregnancy?

Cancer doesn’t appear to cause an increase in pregnancy complications. However, women treated with chemotherapy during the first trimester of pregnancy are at a higher risk of miscarriage.

Does cancer during pregnancy cause problems for the baby?

Cancer per se does not appear to cause problems to the baby; however, chemotherapy and radiation for cancer do: birth defects are found in 12 to 17 percent of newborns and low birth weight in 40 percent. The risk for birth defects is highest when treatment is given during the first trimester. Some chemotherapy drugs are also toxic to the baby’s developing brain. Finally, because maternal use of chemotherapy drugs can lower the baby’s white blood cells and red blood cells, it is recommended not to deliver the baby for at least 2 to 3 weeks after receiving chemotherapy.

What should I know about using medications to treat cancer during pregnancy?

The type of cancer will determine which type of treatment is needed; however, all chemotherapy drugs are harmful to the developing baby if they are given during the first trimester. Because of this, when cancer is diagnosed during the first trimester, evidence is available to support waiting to start cancer treatment until the second or third trimester, if this is a slow-growing cancer. For these slower-growing tumors, survival rates are not affected by delaying treatment. However, there are certain types of cancers that are more aggressive and waiting to begin treatment will not be an option. In these situations, terminating the pregnancy may be needed to begin life-saving treatments. It is important to talk with you cancer specialist about these options.

Health habits during treatment

During the pregnancy and cancer treatment, it is important to keep yourself as healthy as possible. Eating a well-balanced diet, getting plenty of rest, and following all recommendations that your cancer specialist gives you are important. Regular exercise is also recommended to improve your physical functioning and mood during treatment. Depression is not uncommon during pregnancy and with cancer treatment. Seeking out cancer support groups (see below) and counseling may help lessen depression symptoms but if you feel that you are developing depression, don’t hesitate to discuss this with your health care provider so that a treatment plan can be made.

Are treatments for cancer safe for a breastfed baby?

In general, breastfeeding while being treated with chemotherapy is not recommended because there is not enough information available to know if it is safe. There are a few exceptions to this, so it is recommended to discuss whether or not nursing is safe for you and your baby with your healthcare provider.

A reason for optimism

In the past, a termination would have usually been recommended if cancer was diagnosed during pregnancy. New evidence shows that most pregnancies can be safely continued without affecting the mom’s survival and without causing significant problems for the developing baby, if treatment can be delayed until after the first trimester.

Bottom line

If you are diagnosed with cancer during pregnancy, it is important to talk with your cancer specialist and pregnancy care provider about the risks your particular cancer has on the pregnancy. Knowing if your cancer requires immediate, aggressive treatment or if treatment can be safely delayed until later in the pregnancy is important to help you decide if the pregnancy can progress without risk.

Will Sean Parker and IBM Watson help pregnant women with cancer?

Cancer is rare in pregnancy and, therefore, it is unlikely that the researchers at the Parker Institute for Cancer Immunotherapy and at IBM Watson thought about the implications of their work on pregnant women. Our hope is that the Parker Institute will include pregnancy experts in its teams and that the therapies they develop will be safe and effective for pregnant women with cancer. Similarly, we will expect that IBM Watson will be able to provide personalized information and advice to pregnant women with cancer.

Diego Wyszynski
Dr. Diego Wyszynski is the Founder and CEO of Pregistry. He is an expert on the effects of medications and vaccines in pregnancy and lactation and an accomplished writer, having published 3 books with Oxford University Press and more than 70 articles in medical journals. In 2017, he was selected a TEDMED Research Scholar. Diego attended the University of Buenos Aires School of Medicine and Johns Hopkins School of Public Health.

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