A Case of Colorectal Cancer during Pregnancy: A Brief Review of the Literature

Khodaverdi, Sepideh; Valeshabad, Ali Kord; Khodaverdi, Maryam

doi:10.1155/2013/626393

Cited by 23 publications

(32 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Lower endoscopy may often be reasonably deferred during pregnancy for bright red blood per rectum because of this high incidence of hemorrhoidal bleeding during pregnancy and the low incidence of colon cancer in this generally relatively young female population. Colon cancer and colonic polyps, however, become a concern in older (> 40 years old) pregnant patients with chronic lower gastrointestinal bleeding [42,43] . Sigmoidoscopy can often reasonably replace colonoscopy to evaluate suspected IBD flares during pregnancy.…”

Section: Lower Endoscopymentioning

confidence: 99%

Gastrointestinal endoscopy in the pregnant woman

Friedel

Stavropoulos

Iqbal

et al. 2014

WJGE

View full text Add to dashboard Cite

About 20000 gastrointestinal endoscopies are performed annually in America in pregnant women. Gastrointestinal endoscopy during pregnancy raises the critical issue of fetal safety in addition to patient safety. Endoscopic medications may be potentially abortifacient or teratogenic. Generally, Food and Drug Administration category B or C drugs should be used for endoscopy. Esophagogastroduodenoscopy (EGD) seems to be relatively safe for both mother and fetus based on two retrospective studies of 83 and 60 pregnant patients. The diagnostic yield is about 95% when EGD is performed for gastrointestinal bleeding. EGD indications during pregnancy include acute gastrointestinal bleeding, dysphagia > 1 wk, or endoscopic therapy. Therapeutic EGD is experimental due to scant data, but should be strongly considered for urgent indications such as active bleeding. One study of 48 sigmoidoscopies performed during pregnancy showed relatively favorable fetal outcomes, rare bad fetal outcomes, and bad outcomes linked to very sick mothers. Sigmoidoscopy should be strongly considered for strong indications, including significant acute lower gastrointestinal bleeding, chronic diarrhea, distal colonic stricture, suspected inflammatory bowel disease flare, and potential colonic malignancy. Data on colonoscopy during pregnancy are limited. One study of 20 pregnant patients showed rare poor fetal outcomes. Colonoscopy is generally experimental during pregnancy, but can be considered for strong indications: known colonic mass/stricture, active lower gastrointestinal bleeding, or colonoscopic therapy. Endoscopic retrograde cholangiopancreatography (ERCP) entails fetal risks from fetal radiation exposure. ERCP risks to mother and fetus appear to be acceptable when performed for ERCP therapy, as demonstrated by analysis of nearly 350 cases during pregnancy. Justifiable indications include symptomatic or complicated choledocholithiasis, manifested by jaundice, cholangitis, gallstone pancreatitis, or dilated choledochus. ERCP should be performed by an expert endoscopist, with informed consent about fetal radiation risks, minimizing fetal radiation exposure, and using an attending anesthesiologist. Endoscopy is likely most safe during the second trimester of pregnancy.

show abstract

Section: Lower Endoscopymentioning

confidence: 99%

Gastrointestinal endoscopy in the pregnant woman

Friedel

Stavropoulos

Iqbal

et al. 2014

WJGE

View full text Add to dashboard Cite

show abstract

“…Colorectal cancer (CRC) during pregnancy is rare, with an incidence of 1 in 13,000 pregnancies [2,10,14]. Although infrequent, CRC cases during pregnancy have been reported in the past decade [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. With thetrendindelayedchild-bearing,theraresituationofCRCduring pregnancy will likely rise in incidence.…”

Section: Introductionmentioning

confidence: 99%

The Treatment of Colorectal Cancer During Pregnancy: Cytotoxic Chemotherapy and Targeted Therapy Challenges

2016

View full text Add to dashboard Cite

Cancer diagnosed during pregnancy has increased because of delayed child-bearing and the known occurrence of agedependent malignancies. Cases of colorectal cancer (CRC) in pregnancy have recently been reported. With the expected rise in CRC diagnosed in young adults coupled with the current trend of delayed child-bearing, CRC during pregnancy is likely to increase. Treating pregnant women with CRC by using antineoplastics presents a dilemma because there are many unknowns to guide treatment decisions. We review the issues regarding the use of 10 CRC-approved agents in pregnancy. The Oncologist 2016; 21:563-570Implications for Practice: Colorectal cancer (CRC) in pregnancy is likely to become more common because of the current population trend in delayed child-bearing and the increase in CRC incidence expected among young adults. Practitioners should become familiar with the challenges associated with systemic treatment of a pregnant patient with CRC. This review addresses concerns surrounding the 10 systemic agents approved for CRC to help provide treatment guidance when such a case arises.

show abstract

“…5 The low incidence of CRC in this age group and the symptomatic overlap with common conditions of pregnancy and the post-partum period mean that these cancers represent a significant diagnostic and therapeutic challenge and are commonly diagnosed late worsening their prognosis. 6 These complex patients require multidisciplinary management including obstetric, neonatology, surgical, oncology, radiology and psychology input.…”

Section: Introductionmentioning

confidence: 99%