Good news on the active management of pregnant cancer patients

Abstract

Cancer occurs in approximately 1/1000 to 1/2000 pregnancies and presents complex medical and ethical dilemmas for patients and providers. The most common cancers diagnosed in the gestational period include breast, cervical, melanoma, and lymphomas. The majority of existing evidence regarding the treatment of cancer during pregnancy is derived from experiences with breast cancer. Other cancers often pose unique challenges given the location of the tumors and their traditional mode of treatment with pelvic surgery and radiation. Additionally, many emerging therapies for cancer target mechanisms that are necessary for fetal development, such as angiogenesis, and are contraindicated in pregnant women. Although limitations on the treatment of cancer during pregnancy currently exist, increasing evidence shows that many surgical and systemic therapies can be effective for a mother’s oncologic outcomes without significant detriment to the developing fetus. Traditional perspectives of cancer during gestation may sway providers to encourage pregnancy termination, delays in therapy, or early delivery. However, recent studies and reviews discourage such practices. Although every cancer diagnosis in pregnancy requires an individualized approach and should use the multidisciplinary perspectives of maternal–fetal medicine specialists as well as medical and surgical oncologists, providers should feel empowered to safely employ systemic, surgical, and even reserved cases of radiation therapies for their pregnant patients with cancer. The aim of this review is to highlight some of the recent advances in cancer therapies for common cancer subtypes and encourage providers to use this growing body of evidence to employ treatments with curative intent while continuing to evaluate the long-term effects of these therapies on mothers and their children.

Ovarian cancer in Lebanese women: a 12-year comparative epidemiological study and trend analysis

“…Meanwhile, the 25–29 years age group presents the highest childbirth rate (109.91 births per 1,000 women) [ 19 ], and since it has been stated that ovarian mass [ 20 ], and mostly cancer [ 21 ], is extremely rare during pregnancy, it is not surprising to obtain a drop in the ovarian cancer ASIRs in this specific age group.…”

Is It Possible to Personalize the Diagnosis and Treatment of Breast Cancer during Pregnancy?

“…Table 3. Personalization of breast cancer treatment in pregnancy with regard to its stage (adapted according to [46][47][48]).…”

“…As methods of stereotactic radiation and improved modalities of delivery are developed, radiation therapy may be an option for more women during pregnancy [ 46 ].…”

Neonatal outcomes for women diagnosed with cancer during pregnancy — single-center study

“…After a natural birth, oncological treatment can be started faster -chemotherapy after a natural delivery is possible almost immediately, and after an uncomplicated caesarean section, after about a week. The decision to perform caesarean section may be made based on obstetric or oncological indications [6,[10][11][12]. Breastfeeding of a newborn by a pregnant woman suffering from a malignant tumor during pregnancy is possible.…”