Your daughter's treatment will depend on the stage of her melanoma. The likelihood is that her pregnancy won't affect her treatment because most melanomas are diagnosed early.

Pregnant women with melanoma do just as well as non-pregnant women with the same stage of melanoma.

Early stage melanomas (less than 1mm thick) are easily removed with a local anaesthetic. This is completely safe during pregnancy.

If the melanoma is thicker a wide local excision (removing more tissue and a margin of healthy tissue) is usually done. This can also often be carried out with a local anaesthetic. But sometimes an operation under a general anaesthetic is needed.

Most anaesthetic drugs are safe and won't affect the baby or the pregnancy. There are some which may cause problems but these are easily avoided. What's important is that the anaesthetist and surgeon know in advance if a woman is pregnant. Most operations can be safely carried out during pregnancy. If a woman is near the end of her pregnancy an operation may be delayed until after the baby is born.

A type of test called a sentinel node biopsy, which is done to check whether cancer cells have spread to the glands, is avoided during pregnancy. This is because it involves using a tiny amount of radioactive liquid. But sometimes it can be done using a dye instead.

There's no evidence that giving treatment after surgery, such as interferon or chemotherapy, reduces the risk of deeper melanomas coming back or spreading. So this type of treatment isn't given to pregnant women with melanoma.

If, a woman has melanoma which has spread to other parts of the body chemotherapy may help to slow its growth and control symptoms. Chemotherapy can only be given after the first 12 weeks of pregnancy because of the risk of miscarriage and harm to the baby. If the disease is spreading quickly doctors may advise that the pregnancy is ended (termination).

Melanoma during pregnancy is a stressful situation. The news comes at a time which is usually joyful. A woman in this situation is looked after jointly by her cancer specialist and her obstetrician (doctor who specialises in childbirth). And she should always be fully involved. She needs to understand her illness and how treatment may affect her and her pregnancy so that she can make her own decisions. Your daughter will need to talk things over with her doctors, partner and family. There is also specialist support available from nurses and counsellors.

Reference:

• Cancer and pregnancy: Poena magna, not anymore! European Journal of Cancer 42 (2006) 126-140