One of the amazing changes I have witnessed in my career has to do with women, childbearing, and cancer. When I was a nursing student, if a woman got cancer, she was lucky to survive; much less, get pregnant, carry her baby to term, and breastfeed. Cancer during pregnancy was a death sentence for mother, and often, her baby.
For years, the Centers for Disease Control have said that receiving chemotherapy is an absolute contraindication to breastfeeding. My friend LInda, whose story is described in a guest blog on the Best for Babes site (http://www.bestforbabes.org/milk-train-brings-healing-to-baby-and-mom) was able to give her milk to her premature baby just once, before starting chemotherapy in 1990.
Now, in the 21st century, the boundaries for cancer chemotherapy in pregnancy and lactation are expanding. Medical journals report that certain chemotherapy agents can be used in in the second and third trimesters, with good outcomes for mother and baby. In May 2004, the medical journal Lancet Oncology published a review of cancer treatments during pregnancy, with recommendations about specific drugs, timing of dosing, and encouragement to others to publish cases.
A case report of a mother being treated for papillary thyroid cancer who pumped and dumped during treatment with carboplatin and paclitaxil is in the November 2012 issue of the Journal of Human Lactation. Her milk was analyzed for drug levels; the authors conclude that the potential adverse effects of infant exposure to the drugs via breast milk would be “unlikely, following exposure to the levels of carboplatin and paclitaxel” that were measured. The evidence about specific cancer chemotherapy during breastfeeding is expanding with other journal reports of drug levels in milk.
Unfortunately, my friend Linda died of inflammatory breast cancer (IBC) which even today carries a dreadful prognosis, although she might have had a longer life with today’s newer drugs. What is new about IBC is that those working in the fields of breastfeeding medicine and lactation management now know more than they did 20 years ago. A breastfeeding woman with symptoms of mastitis that do not resolve after 2 or 3 weeks of antibiotic therapy should receive an ultrasound examination and biopsy, because the symptoms of IBC and mastitis are initially identical.
Other types of cancer have happier outcomes if a nursing mother is treated. For example, check out this story (http://babygooroo.com/2010/09/pumping-through-chemotherapy/) about a nursing mother who was treated 3 times for Hodgkin’s lymphoma while she was nursing her toddler. Each time, she bargained with her toddler to stop breastfeeding during the treatment, and pumped and dumped to keep up production. She even drank her own milk as an additional cancer treatment, figuring it wouldn’t hurt. This story has a happy ending; may there be many, many more!