Melanoma Might Not Delay Family Planning

Unlike many other cancer types that are typically diagnosed in older adults, melanoma tends to strike women when they are in their prime child-bearing years. Despite this, a melanoma diagnosis may not deter women from becoming pregnant after treatment, according to a study published in the Journal of Surgical Research.

A group of researchers from Pennsylvania State University investigated whether women diagnosed with melanoma would have a lower rate of pregnancy than women without the disease, as well as the relationship between treatment and pregnancy among those diagnosed.

“What is unclear and difficult to study is the relationship between melanoma and subsequent pregnancy rates, and pregnancy on melanoma outcomes,” the researchers wrote. “Very little data exists to guide women and physicians as to the safety of pregnancy after a diagnosis of melanoma.”

Using the Truven Health MarketScan database, the researchers looked at more than 11,000 women between the ages of 18 and 39 with melanoma who were not pregnant at the start of the study. They were matched at a 1:1 ratio with women who did not have a history of melanoma, and pregnancy rates were compared between the two groups. This was the nation’s largest population-based study on post-melanoma pregnancy rates in the United States.

The group of women with a history of melanoma reported slightly higher rates of pregnancy within two years — which is typically the recommended amount of time to wait from diagnosis to becoming pregnant – compared to their matched counterparts (15.8 percent vs. 13.6 percent).

However, the reasoning for this slight increase could not be explained. “It is unknown whether women do not follow recommendations on pregnancy after melanoma or that women simply not counseled on this issue at all,” the researchers wrote.

According to the authors, these findings were consistent with those previously seen in a study conducted in Sweden. “These results suggest that a diagnosis of melanoma may serve as an impetus for some families to begin childbearing or have additional children sooner than they otherwise would have,” they wrote.

The researchers offered two hypothesis that may explain their findings. First, they explained that a melanoma diagnosis may bring a couple closer and make them prioritize family. Another potential reason is that when a woman has melanoma, the couple may decide to start or complete their family sooner rather than later, just in case the cancer recurs and affects fertility down the line.

“Either way, the increased likelihood of pregnancy after a melanoma diagnosis suggests an optimism about their future among families in the current childbearing generation in the United States,” the researchers wrote.

However, the researchers also admitted that for some women, the diagnosis may not have been considered at all when getting pregnant.

The findings also showed that women who became pregnant did not have a higher rate of further melanoma treatment than those who did not become pregnant, indicating that pregnancy might not have an adverse effect on melanoma outcomes.

“The fairest interpretation of this data is that recurrence after pregnancy is rare,” the researchers wrote. “An alternative explanation is that women who become pregnant and then develop recurrent melanoma do not receive treatment during the pregnancy. This may be the case; however, young women would likely receive treatment after delivery, which would be captured later in the analysis.”

However, not all melanoma survivors in the study resulted in high pregnancy rates. Those who were still within nine months of their melanoma diagnosis and who had adjuvant treatment were 74 percent less likely to become pregnant.

“Women who receive postsurgical treatment for melanoma, indicating advanced or recurrent disease, have a lower rate of pregnancy than untreated women,” the authors wrote.

Moving forward, the researchers hope that these findings will spark more research into any possible relationships between melanoma and pregnancy, so that precise guidelines can be crafted for young women with the disease.